Vashistha V M, Kalra A, Kalra K, Jain V K
Department of Pediatrics, S.N. Medical College, Agra.
Indian Pediatr. 1993 Jan;30(1):53-6.
A total number of 8449 school children, in the 5-15 years old, group were examined clinically for evidence of valvular lesions and confirmed by roentgenographic electrocardiographic and echocardiographic findings. Twelve children (0.14%) were suffering from rheumatic heart disease (RHD). The disease was significantly more (p < 0.05) prevalent in the higher age group of 11-15 years as compared to younger children. Boys (0.18%) were affected more than girls (0.09%). The disease was more frequent among children belonging to economically backward group (0.34%) and those living in large families (0.28%). Children living in the slums had significantly (p < 0.05) higher prevalence (0.41%) than those residing in urban areas (0.06%). Only 3 out of 12 (25%) were previously diagnosed cases and remaining were diagnosed for the first time. Past history of rheumatic activity was seen in 41.67% cases. Mitral valve involvement was most frequent, being detected in 10 (83.33%) cases. Majority of cases (58.33%) had the development of symptomatic RHD within 2 years of having suffered from RF. Our study helped to detect the hitherto undiagnosed cases of RHD and showed that its prevalence was higher in older children and those from urban slums.
对8449名5至15岁的学童进行了临床检查,以寻找瓣膜病变的证据,并通过X线、心电图和超声心动图检查结果进行确诊。12名儿童(0.14%)患有风湿性心脏病(RHD)。与年幼儿童相比,11至15岁的较高年龄组中该疾病的患病率显著更高(p<0.05)。男孩(0.18%)受影响的人数多于女孩(0.09%)。该疾病在经济落后群体的儿童(0.34%)和大家庭中的儿童(0.28%)中更为常见。居住在贫民窟的儿童患病率(0.41%)显著高于城市地区的儿童(0.06%)(p<0.05)。12名患儿中只有3例(25%)是先前诊断过的病例,其余为首次诊断。41.67%的病例有风湿活动史。二尖瓣受累最为常见,10例(83.33%)被检测到。大多数病例(58.33%)在患风湿热(RF)后2年内出现有症状的RHD。我们的研究有助于发现此前未被诊断的RHD病例,并表明其在年龄较大的儿童和城市贫民窟儿童中的患病率较高。