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目的 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 6 0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 % (5 4/6 0 ) ,显著高于ASO阳性率 6 5 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 2 3 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 2 9 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 2 9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
Purpose To pass laboratory and cardiac device inspections to find new indicators of acute rheumatic fever (ARF) diagnosis. Methods A total of 114 children with ARF were tested for anti-streptolysin “O” (ASO), 60 of them were used for the rapid identification of β-hemolytic streptococcus in Group A (GABHSRA), and the positive rate of the two was compared 114 patients with creatine kinase isoenzyme (CK MB), Doppler echocardiography, compared with healthy children. Results The positive rate of GABHSRA in ARF children was 90% (54/60), which was significantly higher than that of ASO (65/75). 114 cases of ARF children CK MB increased 46 5%, α-hydroxybutyrate dehydrogenase elevated 32 7%; echocardiography left atrial enlargement of 23.7%, left ventricular enlargement of 16 7%, right Room enlargement 7 1%; mitral valve thickened 13 2%, aortic valve thickening 8 8%; Doppler echocardiography examination of mitral regurgitation were 29.8%, aortic valve regurgitation 96%, compared with healthy children, the differences were significant. In 34 cases of mitral regurgitation in children with 29 cases of mitral regurgitation flow time integral increased. Conclusions GABHSRA, myocardial enzymes and Doppler echocardiography are helpful for the diagnosis and condition of ARF