小儿急性风湿热的实验室与心脏器械检查及分析

通过有关实验室与心脏器械检查，以发现急性风湿热(ARF)诊断的新指标。方法对114例 ARF患儿，检查抗链球菌溶血素“O”(ASO)，其中60例做了咽部A组β溶血性链球菌快速鉴定(GABHSRA)， 且对二者阳性率进行对比；将114例的肌酸激酶同功酶(CK-MB)、多普勒超声心动图，与健康儿童对比。 结果ARF患儿GABHSRA阳性率为90％(54/60)，显著高于ASO阳性率65.8％(75/114)。114例ARF患儿 CK-MB升高者46.5％，α-羟丁酸脱氢酶升高者32.7％；超声心动图左房增大者23.7％，左室扩大者16.7％，右 室扩大者7.1％；二尖瓣增厚者13.2％，主动脉瓣增厚者8.8％；多普勒超声心动图检查二尖瓣返流者29.8％， 主动脉瓣返流者9.6％，与健康儿童相比，差异均有显著性意义。34例有二尖瓣返流患儿中29例二尖瓣返流流 速时间积分增大。结论GABHSRA、心肌酶和多普勒超声心动图检查有助于ARF的诊断与病情了解。

The laboratory and cardiac equipment examination and analysis of acute rheumatic fever in children

Objective To find new diagnostic index of acute rheumaticfever(ARF) by the lab and cardiac equipment examination in children. Methods Group A β-haemolytic streptococcus rapid assay (GABHSRA), ASO, CK-MB, α- HBDH, Doppler echocardiography were performed in 114 children with ARF. Results GABHSRA was positive in 90% of ARF,CK-MB was elevated in 46. 5%, α-HBDH was elevated in 32.7% of the children with ARF. According to the examination of 114 ARF by Doppler echocardiography, enlargement of LA, LV, RV was 23.7%, 16. 7% and 7. 1% respectively. Thickening of mitral valve and aortic valve was 13.2% and 8. 8% respectively. Regurgitation of mitral valve and aortic valve was 29.8% and 9.3% respectively. Mitral valve regurgitation velocity time interval was increased in 28 patients among 34 patients with mitral regurgitation. Conclusions GABHSRA, CK-MB, α-HBDH and Doppler echocardiography examination is useful in the diagnosis and helpful to the recognization of the carditis of patients with ARF.