Feature changes of rheumatic fever in last ten years
10.3760/cma.j.issn.1007-7480.2009.07.010
- VernacularTitle:近十年风湿热的演变
- Author:
Xujing XIE
;
Li XU
;
Lin CHEN
;
Qiujing WEI
;
Buyun YU
- Publication Type:Journal Article
- Keywords:
Rheumatic fever;
Carditis;
Diagnosis;
Streptococcus
- From:
Chinese Journal of Rheumatology
2009;13(7):467-469
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changes of clinical and laboratory manifestations of rheumatic fever (RF) in recent ten years by reviewing the medical data of 315 patients with RF. Methods Three hundred and fifteen in-patients and out-patients with RF during 1985-1995 (group A) and 1997-2007(group B) were selected. Their manifestations were compared. Results Male/female ratio was about 1:2. Carditis and polyarthritis were common manifestations. Compared with group A, the rate of low-grade fever and carditis increased and the rate of heart failure, positive rate of C reaction protein and antistreptolysin O decreased in group B. In group B, 61.4% patients fulfilled the updated Jones diagnostic criteria. 76.2% fulfilled the 2002-2003 WHO criteria. The sensitivity and specificity of peripheral blood lymphocyte procoagulant activity (PCA) for the diagnosis of rheumatic carditis was 79.1% and 71.4% respectively. That of the anti-streptococcal group A polysaccharide (ASP) antibodies was 70.3% and 70% respectively. Five to ten years follow-up clinical data were available for 35 cases since Dec. 1997. The recurrent rate of RF was 62.8%. Only 1/3 cases received regular secondary prevention. Recurrence rate of patients with regular secondary prevention was significantly lower than that of patients without regular secondary prevention. Conclusion Mild earditis has been increasing during last ten years. PCA and ASP are valuable tests for diagnosing rheumatic carditis. More emphasis should be paid to atypical cases, early diagnosis and regular secondary prevention in order to improve prognosis.
