Liang Yunmei, Yu Dingle, Lu Qinghua, Zheng Yuejie, Yang Yonghong
Department of Pediatrics, Beijing Chaoyang Hospital Affiliated to the Capital Medical University, Beijing, China.
Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen, China.
Front Cardiovasc Med. 2023 May 23;10:1183606. doi: 10.3389/fcvm.2023.1183606. eCollection 2023.
The incidences of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), which were leading causes of death in children in the 1920s, have decreased substantially. Considering the recent resurgence of scarlet fever and increased incidence of streptococcal pharyngitis in children, an investigation of the current status of ARF and RHD may be worthwhile.
To summarize the prevalence trends, pathogenic factors, and prevention strategies for ARF and RHD in children.
A selective search of literature published between January 1920 and February 2023 was done in PubMed, using the terms "acute rheumatic fever", "rheumatic heart disease", "group A ", "pharyngitis", "pharyngeal tonsillitis", "scarlet fever", "impetigo", "obstructive sleep apnea syndrome" and "child".
Overcrowded homes and inadequate sanitation led to recurrent group A streptococcal infection, and the causal relationship between group A streptococcal infection and ARF/RHD was well established. Streptococcal infectious diseases, such as group A streptococcal pharyngeal tonsillitis, SF, impetigo, and obstructive sleep apnea syndrome, were associated with the occurrence of ARF and RHD. ARF and RHD were still prevalent in young people of developing countries and economically poor populations of high-income countries. Universal disease registration systems were critical to locating disease outbreaks, tracking disease transmission, and identifying high-risk populations. Four-level prevention strategies were effective in reducing the incidence and mortality of ARF and RHD.
Registry and preventive measures for ARF and RHD should be strengthened in areas of dense population; poor sanitation; resurgence of SF; and high incidence of streptococcal pharyngitis, impetigo, and obstructive sleep apnea syndrome.
急性风湿热（ARF）和风湿性心脏病（RHD）在20世纪20年代曾是儿童死亡的主要原因，其发病率已大幅下降。鉴于近期猩红热卷土重来以及儿童链球菌性咽炎发病率上升，对ARF和RHD的现状进行调查或许是值得的。
总结儿童ARF和RHD的流行趋势、致病因素及预防策略。
在PubMed上对1920年1月至2023年2月发表的文献进行选择性检索，使用的检索词为“急性风湿热”“风湿性心脏病”“A组”“咽炎”“咽扁桃体炎”“猩红热”“脓疱病”“阻塞性睡眠呼吸暂停综合征”和“儿童”。
居住环境拥挤和卫生条件差导致A组链球菌反复感染，A组链球菌感染与ARF/RHD之间的因果关系已得到充分证实。A组链球菌性咽扁桃体炎、猩红热、脓疱病和阻塞性睡眠呼吸暂停综合征等链球菌感染性疾病与ARF和RHD的发生有关。ARF和RHD在发展中国家的年轻人以及高收入国家经济贫困人群中仍然普遍存在。通用的疾病登记系统对于发现疾病暴发、追踪疾病传播以及识别高危人群至关重要。四级预防策略对于降低ARF和RHD的发病率和死亡率是有效的。
在人口密集、卫生条件差以及猩红热卷土重来、链球菌性咽炎、脓疱病和阻塞性睡眠呼吸暂停综合征发病率高的地区，应加强ARF和RHD的登记及预防措施。
