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[环境对西伯利亚移民人群中活动性风湿病病程的影响]

[Environmental effects on the course of active rheumatism in a migrant Siberian population].

作者信息

Satybaldyev A M, Nasonova V A

出版信息

Ter Arkh. 2002;74(5):19-23.

Abstract

AIM

To characterize antistreptococcal immune response in healthy subjects with cryoglobulinemia and rheumatic manifestations as well as a rheumatism course in population who came to Siberia to build and operate Baikal-Amur railway.

MATERIAL AND METHODS

Siberian migrants were examined. Among them there were 203 patients with rheumatic fever and rheumatic heart disease, and 1275 healthy subjects. 65 patients had active rheumatism, 106 healthy subjects had rheumatic manifestations and cryoglobulinemia with adaptation cryoglobulinemia syndrome. All the patients underwent examination of the cardiovascular system, standard laboratory tests and tests for antistreptolysine-0, antistreptokinase, antistreptohyaluronidase, streptococcal antigen, microbiological tests. The diagnosis of rheumatic fever was established on the basis of Kisel-Jones-Nesterov and revised Jones criteria.

RESULTS

The adaptation cryoglobulinemia syndrome in healthy persons was associated with cardialgia, arthralgia, lumbalgia, myalgia, lymphadenopathy and Raynaud's phenomenon. Patients with rheumatic fever and adaptation cryoglobulinemia syndrome were predisposed to chronicity of primary rheumatic carditis, development of compound and combined valvular defects, arrhythmia and hemodynamic disturbances.

CONCLUSION

The presence of the adaptation cryoglobulinemia syndrome aggravates the course of rheumatic fever and promotes its chronicity.

摘要

目的

对患有冷球蛋白血症和风湿表现的健康受试者以及来到西伯利亚建设和运营贝阿铁路的人群中的风湿病病程中的抗链球菌免疫反应进行特征描述。

材料与方法

对西伯利亚移民进行检查。其中有203例风湿热和风湿性心脏病患者,以及1275名健康受试者。65例患者患有活动性风湿病,106名健康受试者有风湿表现和冷球蛋白血症伴适应性冷球蛋白血症综合征。所有患者均接受了心血管系统检查、标准实验室检查以及抗链球菌溶血素O、抗链激酶、抗链球菌透明质酸酶、链球菌抗原检测和微生物学检测。风湿热的诊断依据基塞尔 - 琼斯 - 涅斯捷罗夫标准和修订的琼斯标准确定。

结果

健康人的适应性冷球蛋白血症综合征与心前区痛、关节痛、腰痛、肌痛、淋巴结病和雷诺现象有关。患有风湿热和适应性冷球蛋白血症综合征的患者易患原发性风湿性心肌炎的慢性化、复合性和联合性瓣膜缺损、心律失常和血流动力学紊乱。

结论

适应性冷球蛋白血症综合征的存在会加重风湿热的病程并促进其慢性化。

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