Vukotić D, Radak-Perović M
Institute of Rheumatology, Belgrade.
Srp Arh Celok Lek. 1990 May-Jun;118(5-6):209-12.
The study concerned the effect of incomplete or omitted secondary prophylaxis on the onset of rheumatic heart disease as well as the effect of organized secondary prophylaxis on prevention of their Appearance. Of 142 patients with rheumatic heart disease as a result of previous rheumatic fever 39 (27.5%) were on incomplete secondary prophylaxis during one year and 103 (72.5%) had no prophylaxis. As consequence of incomplete or omitted prophylaxis recurrence of rheumatic fever appeared in a high percentage (30.7 of incomplete secondary prophylaxis and 63.1% of omitted prophylaxis). Incomplete and omitted prophylaxis with frequent rheumatic fever recurrence were the main cause of the onset of rheumatic heart disease and invalidism of the Ist IInd degree. On the contrary, during organized secondary prophylaxis the following results were obtained in 224 patients with rheumatic fever (with the average follow-up of 5.8 years): no recurrence of rheumatic fever was registered in patients on regular prophylaxis; in patients on irregular prophylaxis recurrence was noted in 12.2% of patients. In 8 subjects who refused secondary prophylaxis recurrence was established was established in 50% of cases. Of 224 patients with the Ist attack of rheumatic fever during organized secondary prophylaxis rheumatic heart disease were found in 5.35% of patients and in 10% of individuals with rheumatic fever and carditis (112 cases). The organized secondary prophylaxis, introduced in Serbia in 1974, is a reliable and tested procedure in the prevention and gradual eradication of rheumatic heart disease.
该研究关注不完全或未进行二级预防对风湿性心脏病发病的影响，以及有组织的二级预防对预防其出现的效果。在142例因既往风湿热而患风湿性心脏病的患者中，39例（27.5%）在一年中接受了不完全二级预防，103例（72.5%）未接受预防。由于预防不完全或未进行预防，风湿热复发率很高（不完全二级预防组为30.7%，未进行预防组为63.1%）。预防不完全和未进行预防且风湿热频繁复发是风湿性心脏病发病以及一级和二级残疾的主要原因。相反，在对224例风湿热患者进行有组织的二级预防期间（平均随访5.8年），获得了以下结果：接受常规预防的患者未出现风湿热复发；接受不定期预防的患者中有12.2%出现复发。在8例拒绝二级预防的患者中，50%出现了复发。在224例首次发作风湿热且接受有组织二级预防的患者中，5.35%的患者患了风湿性心脏病，在患有风湿热和心肌炎的患者（112例）中有10%患病。1974年在塞尔维亚推行的有组织的二级预防，是预防和逐步根除风湿性心脏病的可靠且经过验证的措施。
