摘要
目的探讨小儿风湿热及风湿性心脏病的特点，从而为临床诊断和治疗提供指导。方法将2007年1月～2012年1月期间在本院住院治疗的70例因风湿热致风湿性心脏病患儿根据症状典型与否分为观察组43例和对照组27例，回顾性分析和比较两组患儿临床体征和实验室指标。结果观察组心肌炎26例，发病率为60．47％，明显高于对照组的33．33％（χ2=4．513，P〈0．05）；对照组多发性关节炎合并心脏炎、心力衰竭、关节痛发病率分别为55．56％、11．1l％和81．48％，显著高于观察组的30．23％、0．0％和53．49％（χ2=4．304、3．879、3．962，均P〈0．05）；两组患儿ERS增快发生率与AS0阳性率比较无显著性差异（P〉0．05）；观察组GAS指标阳性人数显著高于对照组（χ2=5．026，P〈0．05），而对照组CoxB阳性例数显著高于观察组（χ2=3．968，P〈0．05），提示临床症状典型患儿CoxB与GAS指标与不典型患儿之间存在显著性差异（P〈0．05）。结论应加强对不典型性小儿风湿热的鉴别诊断，重视小儿风湿热及风湿性心脏病的治疗。
Objective To explore the characteristics of pediatric rheumatic fever and rheumatic heart disease and provide guidance for clinical diagnosis and treatment. Methods 70 patients with rheumatic fever and rheumatic heart dis- ease according to the typical symptom divided into the observation group （43 cases） and control group （27 cases） were retrospectively analyzed. Results The incidence of myocarditis of observation group （60.47%） was significantly higher than that of the control group （33.33%） （χ2= 4. 513, P〈0. 05）. The incidence of multiple arthritis with carditis, heart failure and joint pain of control group were 55.56 %, 11.11% and 81.48 %, which were significantly higher than that of observation group （30. 23%, 0% and 53. 49%） （P〈0.05）. The incidences of ERS and ASO of observation group and control group were not different （P〈0.05）. The positive rate of GAS and CoxB of observation group were different from that of the control group. Conclusion It needs to strengthen differential diagnosis not typical pediatric rheumatic fever and pay attention to treatment of pediatric rheumatic fever and rheumatic heart disease.
出处
《西部医学》
2014年第3期294-295,300,共3页
Medical Journal of West China
基金
国家"十一.五"科技支撑计划项目(2008BA159B02)
国家高技术研究发展计划(863计划
012AA02A513)
深圳市医学重点学科建设资助项目(2005C10)
关键词
小儿
风湿热
风湿性心脏病
Pediatric
Rheumatic fever
Rheumatic heart disease
