Rullan E, Sigal L H
Department of Medicine, Division of Rheumatology, UMDNJ-Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place, PO Box 19, MEB-484, New Brunswick, NJ 08903-0019, USA.
Curr Rheumatol Rep. 2001 Oct;3(5):445-52. doi: 10.1007/s11926-996-0016-4.
Rheumatic fever is a multisystem inflammatory disease that occurs as a delayed sequel to group A streptococcal pharyngitis. It is less common than it was 50 years ago but is still a major cause of heart disease in developing areas of the world. The relationship between the site of infection, the type of causative organism, and susceptibility of the host is essential in the development of the disease. Its major clinical manifestations include carditis, migratory polyarthritis, chorea, erythema marginatum, and subcutaneous nodules. It can manifest as an acute febrile illness consisting of migratory polyarthritis involving the large joints, as carditis and valvulitis, or as Sydenham's chorea with involvement of the central nervous system. The disorder in its milder form resolves itself without sequelae. Carditis is the condition most associated with increased mortality and morbidity and may be fatal in its severe forms. Penicillin is the most appropriate primary and secondary prophylaxis. Anti- inflammatory agents provide symptomatic relief but do not prevent rheumatic heart disease.
风湿热是一种多系统炎症性疾病，是A组链球菌性咽炎的延迟后遗症。它比50年前少见，但仍是世界上发展中地区心脏病的主要病因。感染部位、致病生物体类型和宿主易感性之间的关系在该疾病的发生发展中至关重要。其主要临床表现包括心脏炎、游走性多关节炎、舞蹈病、边缘性红斑和皮下结节。它可表现为急性发热性疾病，包括累及大关节的游走性多关节炎、心脏炎和心瓣膜炎，或表现为累及中枢神经系统的Sydenham舞蹈病。病情较轻的形式可自行缓解，不留后遗症。心脏炎是与死亡率和发病率增加最相关的病症，严重时可能致命。青霉素是最适当的一级和二级预防药物。抗炎药可缓解症状，但不能预防风湿性心脏病。
