Castagna P C, Frattini C, Vignati G, Austoni P
Divisione Pediatrica Mariani, Ospedale Niguardo, Cà Granda, Milano.
Minerva Pediatr. 1990 Dec;42(12):543-6.
We reviewed 57 patients who had previously suffered from rheumatic fever (RF) after an average period of 7.2 (+/- 2.8) years without penicillin prophylaxis. In 24 cases (42%) RF began with carditis and in 9 patients valvular damage remained after hospital discharge. Prophylaxis with retard penicillin every four week was carried out for 5.5 +/- 1.8 years. At present the patients are all asymptomatic. There was in 7 cases mild valvular damage without clinical and instrumental involvement. There was not recurrency after the end of prophylaxis, except for a doubtful case, analysed in the Discussion. Although our cases are not numerous, we believe that a regular prophylactic treatment over 5 or 6 years is sufficient to avoid any recurrency in patients with previous RF. After this period of treatment, only subjects with valvular damage should have further extensive treatment until their 20th year and always for a period not shorter than ten years.
我们回顾了57例曾患风湿热（RF）的患者，他们在平均7.2（±2.8）年未接受青霉素预防治疗后。24例（42%）风湿热以心脏炎起病，9例患者出院后仍存在瓣膜损害。每四周使用长效青霉素进行预防治疗5.5±1.8年。目前患者均无症状。7例有轻度瓣膜损害，但无临床及器械检查方面的受累表现。预防治疗结束后除1例在讨论中分析的可疑病例外无复发。虽然我们的病例数量不多，但我们认为对既往有风湿热的患者进行5至6年的规律预防性治疗足以避免任何复发。经过这段治疗期后，只有有瓣膜损害的患者应在20岁前接受进一步的广泛治疗，且治疗期始终不少于十年。
