Robles G, Nava Zavala A, Reyes P A
Departamento de Inmunologia, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Arch Inst Cardiol Mex. 1995 Mar-Apr;65(2):115-9.
Streptococcal throat infection is a sine qua non for the development of rheumatic fever (RF) in genetically susceptible people. Demonstration of such infection is not easy. In overt RF less than 10% of patients still carry streptococci in their throat and immunologic methods are required to identify antibodies against streptococcal products (SP). Humoral response against SP was studied in children and adults with and without RF. Antistreptolysin O (ASO) showed a non-gaussian distribution, and reference value was established as percentile. Adults have a 97 percentile of 227, in children 90 percentile was 451. When RF was present all cases, except one, showed higher values. When antibodies against SP besides ASO were sought by an agglutination test (Streptozyme tm), people below 15 years of age showed low titers in 15 out of 28 cases. In contrast, high titers were the rule in children suffering RF. High ASO titer correlated with high Streptozyme value. These methods are capable to recognize an specific immune response against Group A Beta hemolytic streptococci, and are valuable tools in the diagnosis of RF.
对于具有遗传易感性的人群而言，链球菌性咽喉感染是风湿热（RF）发病的必要条件。证实这种感染并非易事。在显性风湿热患者中，不到10%的患者咽喉部仍携带链球菌，因此需要采用免疫学方法来鉴定抗链球菌产物（SP）的抗体。对有或无风湿热的儿童和成人针对SP的体液反应进行了研究。抗链球菌溶血素O（ASO）呈非高斯分布，并将参考值确定为百分位数。成人的第97百分位数为227，儿童的第90百分位数为451。当存在风湿热时，除1例之外的所有病例ASO值均更高。当通过凝集试验（Streptozyme tm）检测除ASO之外的抗SP抗体时，28例15岁以下人群中有15例滴度较低。相比之下，患风湿热的儿童中高滴度则较为常见。高ASO滴度与高Streptozyme值相关。这些方法能够识别针对A组β溶血性链球菌的特异性免疫反应，是诊断风湿热的重要工具。
