小儿急性风湿热的实验室与心脏器械检查及分析

摘要

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。%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.