2.本星期三（5.16）晚上十点前交稿
3.格式见置顶的文摘编译格式：y to long-held beliefs, the AHA's review of more than 50 years of scientific literature revealed that there is no definitive evidence that the prophylactic use of antibiotics prior to dental procedures prevents infective endocarditis (IE). Given that all drugs carry risks and that the bacteria that cause IE might become resistant to antibiotics, AHA now recommends that prophylactic antibiotic use be reserved for those patients who would have the worst outcomes if IE were contracted, such as patients with artificial heart valves, a history of endocarditis, certain serious congenital heart conditions and heart transplant patients who develop a problem with a heart valve.
A group appointed by the AHA that included experts in infectious disease and cardiology and members representing the ADA developed the guideline. The guideline was endorsed by the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society.
The complete text of the Guideline may be found on the AHA Journal's Web site under Scientific Statements.
Published online before print April 19, 2007
(Circulation 2007, doi:10.1161/CIRCULATIONAHA.106.183095)
ackground--The purpose of this statement is to update the recommendations by the American Heart Association (AHA) for the prevention of infective endocarditis that were last published in 1997.
Methods and Results--A writing group was appointed by the AHA for their expertise in prevention and treatment of infective endocarditis, with liaison members representing the American Dental Association, the Infectious Diseases Society of America, and the American Academy of Pediatrics. The writing group reviewed input from national and international experts on infective endocarditis. The recommendations in this document reflect analyses of relevant literature regarding procedure-related bacteremia and infective endocarditis, in vitro susceptibility data of the most common microorganisms that cause infective endocarditis, results of prophylactic studies in animal models of experimental endocarditis, and retrospective and prospective studies of prevention of infective endocarditis. MEDLINE database searches from 1950 to 2006 were done for English-language papers using the following search terms: endocarditis, infective endocarditis, prophylaxis, prevention, antibiotic, antimicrobial, pathogens, organisms, dental, gastrointestinal, genitourinary, streptococcus, enterococcus, staphylococcus, respiratory, dental surgery, pathogenesis, vaccine, immunization, and bacteremia. The reference lists of the identified papers were also searched. We also searched the AHA online library. The American College of Cardiology/AHA classification of recommendations and levels of evidence for practice guidelines were used. The paper was subsequently reviewed by outside experts not affiliated with the writing group and by the AHA Science Advisory and Coordinating Committee.
Conclusions--The major changes in the updated recommendations include the following: (1) The Committee concluded that only an extremely small number of cases of infective endocarditis might be prevented by antibiotic prophylaxis for dental procedures even if such prophylactic therapy were 100% effective. (2) Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis. (3) For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa. (4) Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of infective endocarditis. (5) Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary or gastrointestinal tract procedure. These changes are intended to define more clearly when infective endocarditis prophylaxis is or is not recommended and to provide more uniform and consistent global recommendations.
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AHA Issues New Infective Endocarditis Guideline
美国心脏病协会发布新的感染性心内膜炎指南
On April 19, 2007 the American Heart Association (AHA) published its updated recommendations for the prevention of infective endocarditis in heart patients scheduled to undergo dental procedures. The new guideline will significantly affect oral and maxillofacial surgery practice patterns and simplify the management of many patients.
2007年4月19日，美国心脏病协会发布了最新的针对已安排行牙科操作的患者预防感染性心内膜炎措施。这项新的指南将明显影响口腔颌面外科的操作模式，并简化许多患者的处理。
Contrary to long-held beliefs, the AHA's review of more than 50 years of scientific literature revealed that there is no definitive evidence that the prophylactic use of antibiotics prior to dental procedures prevents infective endocarditis (IE).
与长期奉行的观念相反，美国心脏病协会对50多年的科学文献的综述显示，在进行牙科操作前预防性应用抗生素以避免感染性心内膜炎并没有确切证据。
Given that all drugs carry risks and that the bacteria that cause IE might become resistant to antibiotics, AHA now recommends that prophylactic antibiotic use be reserved for those patients who would have the worst outcomes if IE were contracted, such as patients with artificial heart valves, a history of endocarditis, certain serious congenital heart conditions and heart transplant patients who develop a problem with a heart valve.
考虑到所有的药物带来风险并且引起IE的细菌可能对抗生素产生耐药，AHA现在推荐预防性抗生素应用应留给那些感染了IE预后不佳的患者，例如人工心脏瓣膜患者，有心内膜炎病史的，某些严重的先天性心脏病患者，以及由于心脏移植产生心瓣膜病变的患者。
A group appointed by the AHA that included experts in infectious disease and cardiology and members representing the ADA developed the guideline. The guideline was endorsed by the Infectious Diseases Society of America and the Pediatric Infectious Diseases Society.
AHA指定的一个包括了感染性疾病和心脏病学专家，以及代表美国牙科协会的成员的专家小组共同制定了此项指南，并受到了美国感染性疾病协会和儿科感染性疾病协会的赞同。
The complete text of the Guideline may be found on the AHA Journal's Web site under Scientific Statements.
指南全文可在AHA杂志主页下的科学声明中查阅到。
Published online before print April 19, 2007
(Circulation 2007, doi:10.1161/CIRCULATIONAHA.106.183095)
发表于2007年4月19日网络版（循环杂志2007，
Background--The purpose of this statement is to update the recommendations by the American Heart Association (AHA) for the prevention of infective endocarditis that were last published in 1997.
背景：此项声明的目的在于对美国心脏病协会在1997年最后发布的感染性心内膜炎的预防措施进行更新介绍。
Methods and Results--A writing group was appointed by the AHA for their expertise in prevention and treatment of infective endocarditis, with liaison members representing the American Dental Association, the Infectious Diseases Society of America, and the American Academy of Pediatrics.
方法和结果：由AHA指定的具有预防和治疗IE专业知识的著述小组，包括了美国牙科协会，美国感染性疾病协会和美国儿科学会的代表成员。
The writing group reviewed input from national and international experts on infective endocarditis.
著述小组对国内和国际上IE专家意见进行了综述。
The recommendations in this document reflect analyses of relevant literature regarding procedure-related bacteremia and infective endocarditis, in vitro susceptibility data of the most common microorganisms that cause infective endocarditis, results of prophylactic studies in animal models of experimental endocarditis, and retrospective and prospective studies of prevention of infective endocarditis.
这份资料中的推荐意见反映了操作相关的菌血症和IE的相关文献分析，大部分引起IE的普通微生物的体外易感性资料，实验性IE动物模型预防用药研究结果，以及IE预防的回顾性和前瞻性研究。
MEDLINE database searches from 1950 to 2006 were done for English-language papers using the following search terms: endocarditis, infective endocarditis, prophylaxis, prevention, antibiotic, antimicrobial, pathogens, organisms, dental, gastrointestinal, genitourinary, streptococcus, enterococcus, staphylococcus, respiratory, dental surgery, pathogenesis, vaccine, immunization, and bacteremia.
应用以下主题词对1950年～2006年的MEDLINE 数据库中英文文献进行搜索：心内膜炎，感染性心内膜炎，预防，prevention，抗生素，抗菌素，病原体，生物，牙齿的，胃肠的，生殖泌尿的，链球菌，肠球菌，葡萄球菌，呼吸道，牙科手术，发病机理，疫苗，免疫接种，菌血症。
The reference lists of the identified papers were also searched. We also searched the AHA online library. The American College of Cardiology/AHA classification of recommendations and levels of evidence for practice guidelines were used.
对相关文献列表也进行了检索。我们还检索了AHA在线图书馆。采用了美国心脏病学院/美国心脏病协会关于临床指南的建议分类方法和证据水平。
The paper was subsequently reviewed by outside experts not affiliated with the writing group and by the AHA Science Advisory and Coordinating Committee.
文章随后由非著述小组专家和AHA科学咨询和协调委员会进行评论。
Conclusions--The major changes in the updated recommendations include the following: (1) The Committee concluded that only an extremely small number of cases of infective endocarditis might be prevented by antibiotic prophylaxis for dental procedures even if such prophylactic therapy were 100% effective.
结论：更新的建议中的主要改变包括以下几点：1、委员会总结只有极少数病例可以通过进行牙科操作时预防性应用抗生素来阻止IE发生，即使这种预防性治疗100％有效；
(2) Infective endocarditis prophylaxis for dental procedures should be recommended only for patients with underlying cardiac conditions associated with the highest risk of adverse outcome from infective endocarditis.
2、进行牙科操作时预防给药对于那些可能产生IE这一不良预后的高风险心脏疾病的患者应当推荐使用；
(3) For patients with these underlying cardiac conditions, prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa.
3、具有潜在心脏疾病的患者，在进行所有牙科操作时都推荐预防给药，包括牙龈组织或者牙根尖周区域或者口腔黏膜穿孔等。
(4) Prophylaxis is not recommended based solely on an increased lifetime risk of acquisition of infective endocarditis.
4、不推荐仅仅基于增高的罹患IE的终生风险而预防给药；
(5) Administration of antibiotics solely to prevent endocarditis is not recommended for patients who undergo a genitourinary or gastrointestinal tract procedure.
5、不推荐仅仅为预防心内膜炎而对将进行生殖泌尿系和胃肠道操作的患者予以抗生素。
These changes are intended to define more clearly when infective endocarditis prophylaxis is or is not recommended and to provide more uniform and consistent global recommendations.
这些改变将对是否推荐IE预防性给药进行更明确定义，并且提供更统一的全球性推荐。
编译稿
2007年4月19日，美国心脏病协会发布了最新的针对已安排行牙科操作的患者预防感染性心内膜炎的建议。这项新的指南将对口腔颌面外科的操作模式产生明显影响，并使得许多患者的治疗简化。
美国心脏病协会对50多年的科学文献进行的综述显示，在进行牙科操作前预防性应用抗生素以避免感染性心内膜炎并没有确切证据,这一观点与长期奉行的观念相反。考虑到所有的药物带来风险并且引起感染性心内膜炎的细菌可能对抗生素产生耐药，目前，美国心脏病协会仅对那些一旦罹患感染性心内膜炎则预后不佳的患者推荐预防性使用抗生素。例如人工心脏瓣膜患者，有心内膜炎病史的，某些严重的先天性心脏病患者，以及由于心瓣膜病变进行心脏移植的患者。
此项指南由美国心脏病协会指定的一个包括了感染性疾病和心脏病学专家、及代表美国牙科协会的成员的专家小组共同制定，并受到了美国感染性疾病协会和儿科感染性疾病协会的认可。
该指南全文可在美国心脏病协会杂志网站的科学论述中查阅到，发表于2007年4月19日美国心脏病协会循环杂志网络版。指南主要内容摘录于下。
此项指南的目的在于对美国心脏病协会在1997年发布的感染性心内膜炎的预防建议进行更新介绍。
由美国心脏病协会指定的具有预防和治疗感染性心内膜炎专业知识的专家小组中，包括了美国牙科协会，美国感染性疾病协会以及美国儿科学会的代表成员。他们对国内和国际上感染性心内膜炎专家的意见进行了综述，这份研究资料中的建议包括了与操作相关的菌血症和感染性心内膜炎的相关文献分析，大部分引起感染性心内膜炎的普通微生物体外易感性资料，实验性感染性心内膜炎动物模型预防用药的研究结果，以及感染性心内膜炎预防的回顾性和前瞻性研究。研究小组对1950年～2006年的MEDLINE 数据库中英文文献进行检索时，共应用了以下主题词：心内膜炎，感染性心内膜炎，预防，防止，抗生素，抗菌素，病原体，生物，牙齿的，胃肠的，生殖泌尿的，链球菌，肠球菌，葡萄球菌，呼吸道，牙科手术，发病机理，疫苗，免疫接种，菌血症。此外他们对相关文献列表和美国心脏病协会在线信息库也进行了检索。此项指南采用了美国心脏病学院/美国心脏病协会关于临床指南的建议分类方法和证据级别。论文随后由非专家小组成员和美国心脏病协会科学咨询协调委员会进行回顾。最终得出的结论中新建议的主要更改包括以下几点：
1、委员会断定只有极少数感染性心内膜炎病例在进行牙科操作时有可能通过预防性应用抗生素避免其发生，即使这种预防性治疗100％有效；
2、建议那些一旦罹患感染性心内膜炎则预后更差的高危心脏疾病患者在进行牙科操作时预防给药；
3、具有潜在心脏疾患的患者，在进行所有牙科操作时都推荐预防给药，包括牙龈组织或者牙根尖周区域或者口腔黏膜穿孔等。
4、不推荐仅仅基于增高的罹患感染性心内膜炎的终生风险而预防给药；
5、不推荐仅仅为预防心内膜炎而对将进行生殖泌尿系和胃肠道操作的患者予以抗生素。
新指南中的这些改变对感染性心内膜炎预防用药是否建议使用进行了更明确定义，并且提供了更加一致的全球性建议。（丁香）
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针对第一篇文章的小建议，翻译忠于原文，但欠流畅，有些不合中文的习惯，供参考。
in heart patients scheduled to undergo dental procedures
原文：针对已安排行牙科操作的患者
改： 针对准备接受牙科操作的心脏病患者。
Contrary to long-held beliefs, the AHA's review of more than 50 years of scientific literature revealed that there is no definitive evidence that the prophylactic use of antibiotics prior to dental procedures prevents infective endocarditis (IE).
原文：与长期奉行的观念相反，美国心脏病协会对50多年的科学文献的综述显示，在进行牙科操作前预防性应用抗生素以避免感染性心内膜炎并没有确切证据。
改： AHA回顾了50余年的科学文献后认为： 与长期奉行的观念相反，目前尚无确切证据能够证实口腔操作前预防性使用抗生素能够预防感染性心内膜炎（IE）。
AHA now recommends that prophylactic antibiotic use be reserved for those patients who would have the worst outcomes if IE were contracted
原文： AHA现在推荐预防性抗生素应用应留给那些感染了IE预后不佳的患者
改： 目前，AHA仅对那些一旦罹患IE预后不佳的患者推荐预防性使用抗生素。
The guideline was endorsed by……
原文：并受到了美国感染性疾病协会和儿科感染性疾病协会的赞同 （这里有必要加上主语）
改： 该指南也得到美国感染性疾病协会和儿科感染性疾病协会的认可。
非常感谢ericwang站友的指正，编译稿中部分内容已更改。
ericwang wrote
The guideline was endorsed by……
原文：并受到了美国感染性疾病协会和儿科感染性疾病协会的赞同 （这里有必要加上主语）
改： 该指南也得到美国感染性疾病协会和儿科感染性疾病协会的认可。
此处内容，因前面一句为逗号，主语在前，均为“此项指南”，故未予更改：）
此项指南由美国心脏病协会指定的一个包括了感染性疾病和心脏病学专家、及代表美国牙科协会的成员的专家小组共同制定，并受到了美国感染性疾病协会和儿科感染性疾病协会的认可。