儿童风湿热及风湿性心瓣膜病85例临床分析

为观察儿童风湿热及风湿性心瓣膜病临床动态变化趋势,分析本院90年代诊治的85例风湿热及心瓣膜病发生状况、临床特点和治疗预防复发情况。结果示本组风湿热造成急性心瓣膜炎占77.65%,首诊慢性心瓣膜病占22.35%,其中三分之二患儿以往无急性风湿热病史。首次发病复发率为14.12%,风湿活动复发常以不同程度心力衰竭（心衰）症状就诊,激素抗风湿治疗能够迅速缓解急性心脏炎和改善心功能。1例反复风湿活动顽固性心力衰竭接受二尖瓣置换术效果甚佳。结果表明,减少儿童风湿性心瓣膜病形成不仅要控制急性风湿热,而且需要及时发现潜隐的风湿活动。

Clinical analysis of 85 children with rheumatic fever and rheumatic valvular disease of heart

To observe the clinical trends of rheumatic fever and rheumatic valvular disease of heart (VDH) , the clinical date including incidence , features, treatment , prevention and recurrence were analyzed in 85 children with rheumatic fever and rheumatic VDH which were diagnosed during 1990 years. The results showed that there was the incidences of 77. 65% of acute rheumatic valvulitis and of 22. 35% of chronic VDH induced by rheumatic fever, respectively. Among them, no previous history of acute rheumatic fever was confirmed in two of third of these patients. The recurrence rate was 14.12% after first episode. These patients with recurrent rheumatic fever usually went to hospital for the attack of heart failure at different extent. Corticosteroids was effect to release the symptoms of acute carditis and to improve the heart function rapidly. One case with recurrent active rheumatism and intractable heart failure got satisfactory recovery after the operation of mitra replacement. It is concluded that it is very important that not only the acute rheumatic fever shall be controlled in time but also the latent active rheumatism shall be also detected early, the formation of childhood rheumatic VDH can be hence expected to decrease.