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风湿热——新的诊断标准。

Rheumatic fever - new diagnostic criteria.

作者信息

Szczygielska Izabela, Hernik Elżbieta, Kołodziejczyk Beata, Gazda Agnieszka, Maślińska Maria, Gietka Piotr

机构信息

Clinic of Developmental Age Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.

Early Arthritis Clinic, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.

出版信息

Reumatologia. 2018;56(1):37-41. doi: 10.5114/reum.2018.74748. Epub 2018 Feb 28.

Abstract

Rheumatic fever (RF) is an autoimmune disease associated with group A β-hemolytic streptococcal infection, in the course of which the patient develops carditis, arthritis, chorea, subcutaneous nodules and erythema marginatum. Rheumatic fever diagnosis is based on the Jones criteria, developed in 1944, then revised twice by the American Heart Association (AHA), in 1992 and recently in 2015. The last revision of the Jones criteria consists mainly in the supplementation of the major criteria with echocardiographic examination, the introduction of a concept of subclinical carditis and the isolation of low, medium and high risk populations among the patients. AHA recommends that all the patients with suspected RF undergo Doppler echocardiographic examination after the Jones criteria have been verified, even if no clinical signs of carditis are present.

摘要

风湿热(RF)是一种与A组β溶血性链球菌感染相关的自身免疫性疾病,在此过程中患者会出现心脏炎、关节炎、舞蹈病、皮下结节和边缘性红斑。风湿热的诊断基于1944年制定的琼斯标准,该标准随后于1992年和最近的2015年由美国心脏协会(AHA)进行了两次修订。琼斯标准的最新修订主要包括通过超声心动图检查补充主要标准、引入亚临床心脏炎的概念以及在患者中区分低、中、高风险人群。AHA建议,在琼斯标准得到验证后,所有疑似风湿热的患者都应接受多普勒超声心动图检查,即使没有心脏炎的临床体征。

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