JAMA. 1992 Oct 21;268(15):2069-73.
The Jones Criteria for guidance in the diagnosis of acute rheumatic fever were first published by T. Duckett Jones, MD, in 1944 and have been revised over the years by the American Heart Association. The current guidelines are an update of these criteria. For the first time, the guidelines are designed to establish the initial attack of acute rheumatic fever. Major manifestations, minor manifestations, and supporting evidence of antecedent group A streptococcal infection are discussed. These updated guidelines expand on the available tools to diagnose streptococcal pharyngitis and clarify the available antibody tests for detecting antecedent group A streptococcal infection. At the present time echocardiography without accompanying auscultatory findings is insufficient to be the sole criterion for valvulitis in acute rheumatic fever. Finally, this article addresses overdiagnosis of rheumatic fever and lists exceptions to the Jones Criteria, including recurrent attacks in individuals with a history of rheumatic fever.
1944年，医学博士T. 达克特·琼斯首次发表了用于指导急性风湿热诊断的琼斯标准，多年来美国心脏协会对其进行了修订。当前指南是这些标准的更新版本。这些指南首次旨在确定急性风湿热的初次发作。文中讨论了主要表现、次要表现以及A组链球菌前驱感染的支持证据。这些更新后的指南扩充了诊断链球菌性咽炎的可用工具，并阐明了用于检测A组链球菌前驱感染的现有抗体检测方法。目前，没有伴随听诊发现的超声心动图不足以作为急性风湿热瓣膜炎症的唯一标准。最后，本文探讨了风湿热的过度诊断问题，并列出了琼斯标准的例外情况，包括有风湿热病史者的复发发作。
