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急性风湿热(ARF)和风湿性心脏病(RHD)是许多发展中国家儿童和青少年心脏病的主要原因。ARF的血清学诊断一般限于检测近期链球菌感染的一些标记,例如抗链球菌O和抗-DNAse抗体升高。目前认为,位于A组链球菌表面而且血清型各种各样的M蛋白含有可诱发ARF的决定簇。与风湿热发病和肾炎发病相关的M蛋白可分别分为Ⅰ类及Ⅱ类。美国的一项研究表明ARF病人血清中的Ⅰ类M蛋白抗体比对照组高,说明这可能用作ARF的诊断标记。可惜该项研究没有对A组链球菌的感染程度作出评估,因此,这类抗体的升高是因感染A组链球菌所致,而与ARF的出现无关。病人与方法调查澳大利亚土著、沙特和泰国的RHD和ARF患者以及对照者血清中Ⅰ类抗体水平。这些地区是全球ARF和BHD的高发区,澳大利亚土著的RHD现病率是24/
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are the leading causes of heart disease in children and adolescents in many developing countries. Serological diagnosis of ARF is generally limited to detecting some markers of recent streptococcal infections, such as increased anti-streptococcal O and anti-DNAse antibodies. It is currently believed that a large number of serotype M proteins are located on the surface of group A streptococci and contain determinants that induce ARF. M protein associated with the onset of rheumatic fever and nephritis can be divided into class I and class II, respectively. A US study showed that patients with ARF serum class I M protein antibody than the control group, indicating that this may be used as a diagnostic marker for ARF. Unfortunately, the study did not assess the extent of infection in group A streptococci. Therefore, the increase of such antibodies was due to infection with group A Streptococcus, but not to the presence of ARF. PATIENTS AND METHODS Investigate serum levels of class I antibodies in indigenous, Saudi and Thai RHD and ARF patients and controls. These areas are high incidence of global ARF and BHD, the prevalence of indigenous RHD in Australia is 24 /