不典型风湿活动临床表现的研究

Study to clinical manifestations of atypical rheumatism activity

目的:探讨风湿性心脏病不典型风湿活动的临床表现,以指导治疗和判断预后。方法:选择风湿性心脏病伴风湿活动患者60例,分析其临床表现、辅助检查和实验室检查情况。结果:风湿性心脏病不典型风湿活动临床表现以心悸(58%)、气促(67%)、心动过速(75%)和第一心音减弱(55%)为主,心脏超声心动图表现为心脏增大(43%)和瓣口返流(17%)。实验室检查外周血淋巴细胞促凝血活性(PCA)和抗链球菌多糖抗体(ASP)阳性率较高(分别为75%,72%)。结论:对不典型风湿活动病例,应综合分析其临床表现、辅助检查和实验室结果,力求较准确地判断出风湿活动性。

Objective： To evaluate the clinical expression of rheumatic heart diseases with atypical rheumatism activity. Methods： A total of 60 cases with rheumatic heart diseases accompanied by atypical rheumatism activity were selected. The results of clinical manifestations, assistant and laboratory examinations were analyzed. Results： The clinical manifestations mainly were palpitations （58%）, shortness of breath （67%）, tachycardia （75%） and soft first heart sound （55 % ） ; The cardiac enlargement （43 %） and valve orifice regurgitation （17 %） were main manifest in echocardiography. There were higher positive rates of procoagulant activity （PCA, 75 %） and antibody to streptococcal poly- saccharide （ASP, 72%） in laboratory examinations. Conclusion： The clinical manifestations, assistant examinations and laboratory results must be synthesized in cases with atypical activity rheumatism.