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目的 了解 90年代急性风湿热的特点。方法 选择 1990年 1月至 1999年 1月有详细病史、完整的体格检查和实验室检查资料的初发性急性风湿热 (ARF)病例 ,观察其主要临床表现和实验室检查结果 ,并与 5 6例 80年代初发ARF病例作比较。结果 ① 77例初发性ARF中典型病例组 (A组 ) 2 4例 ,不典型ARF组 (B组 ) 5 3例 ;② 90年代病例组关节痛、关节炎出现率较 80年代组增多 ;而心脏炎出现率降低。③A组关节痛、心脏炎的出现率较B组高 ,但B组心脏炎的严重程度较A组为明显。结论 ①初发ARF病例中不典型病例较典型病例的比例增高 (2∶1)。②ARF初发年龄有继续增大的趋势。③关节炎 /痛成为ARF的主要临床表现。关节痛、心脏炎在典型病例组出现率较高 ,但心脏受累的严重程度以不典型ARF组为明显 ,表现在心功能方面较为低下。④传统实验室检查 ,如ESR、ASO阳性率下降 ,新的特异性诊断方法PCA具有较高的临床意义。
Objective To understand the characteristics of acute rheumatic fever in the 90’s. Methods From January 1990 to January 1999, patients with acute rheumatic fever (ARF) who had a detailed medical history, complete physical examination and laboratory examination data were selected. The main clinical manifestations and laboratory findings were observed and compared with those of 5 6 cases of early 80s made ARF cases for comparison. Results ① In the 77 cases of primary ARF, 24 cases in typical cases (group A) and 53 cases in atypical ARF cases (group B); ② The incidence of arthralgia and arthritis in cases of 90 cases increased compared with those in 1980s; The incidence of heart disease decreased. ③A group of arthralgia, the incidence of carditis was higher than that of B group, but the severity of B group was significantly higher than that of A group. Conclusions ① The proportion of atypical cases of ARF cases is higher than that of typical cases (2:1). ② ARF age of onset has continued to increase the trend. ③ arthritis / pain as the main clinical manifestations of ARF. In the typical case group, arthralgia and carditis occurred more frequently, but the severity of heart involvement was markedly higher in the atypical ARF group and lower in cardiac function. ④ traditional laboratory tests, such as ESR, ASO positive rate decreased, the new specific diagnostic method PCA has a high clinical significance.