Department of Pediatrics, University of Chieti, Chieti, Italy.
J Pediatr. 2012 May;160(5):832-6.e1. doi: 10.1016/j.jpeds.2011.10.009. Epub 2011 Nov 20.
To investigate the incidence and describe the characteristics of acute rheumatic fever (ARF) in the pediatric population in a community-based healthcare delivery system of the central Italy region of Abruzzo during 2000-2009.
A retrospective study was conducted in Abruzzo to identify patients aged <18 years with a diagnosis of ARF between January 1, 2000, and December 31, 2009. Each patient's age, sex, date of diagnosis, age at disease presentation, and fulfilled Jones criteria were recorded.
A total of 88 patients meeting the Jones criteria for the diagnosis of ARF were identified, with arthritis in 59.1% of the patients, carditis in 48.9%, erythema marginatum in 11.4%, 5.7% with chorea, and 4.6% with subcutaneous nodules. Residual chronic rheumatic heart disease was present in 44.3% of the children. Age at diagnosis ranged from 2.5 to 17 years (average, 8.7 ± 4.0 years). Twelve children (13.6%) were under age 5 years. The overall incidence rate of ARF was 4.1/100 000. The lowest incidence rate was documented in the year 2000 (2.26/100 000), and the highest in 2006 (5.58/100 000).
Our data indicate that ARF has not disappeared in industrialized countries and still causes significant residual rheumatic heart disease. Pediatricians should routinely consider the diagnoses of streptococcal pharyngitis and ARF to reduce long-term morbidity and mortality.
调查意大利中部阿布鲁佐地区 2000-2009 年社区医疗体系中儿科人群急性风湿热（ARF）的发病率并描述其特征。
在阿布鲁佐进行了一项回顾性研究，以确定 2000 年 1 月 1 日至 2009 年 12 月 31 日期间年龄<18 岁且符合 ARF 诊断标准的患者。记录每位患者的年龄、性别、诊断日期、发病年龄和满足琼斯标准的情况。
共确定了 88 例符合 ARF 琼斯标准的患者，其中关节炎占 59.1%，心炎占 48.9%，边缘性红斑占 11.4%，舞蹈病占 5.7%，皮下结节占 4.6%。44.3%的患儿存在遗留慢性风湿性心脏病。诊断年龄从 2.5 岁至 17 岁（平均 8.7±4.0 岁）。12 例（13.6%）患儿年龄<5 岁。ARF 的总发病率为 4.1/10 万。发病率最低的是 2000 年（2.26/10 万），发病率最高的是 2006 年（5.58/10 万）。
我们的数据表明，ARF 在工业化国家并未消失，仍会导致严重的遗留风湿性心脏病。儿科医生应常规考虑链球菌性咽炎和 ARF 的诊断，以降低长期发病率和死亡率。
