我国风湿性心脏病的流行现状国家“八、五”风湿热课题风湿性心脏病调查报告

An updated epidemiologic status of rheumatic heart disease in China ——A survey report on rheumatic heart disease for the National Eighth Five year Key Project of rheumatic fever investigation

目的掌握我国风湿性心脏病的近期流行状况。方法１９９３～１９９５年对我国东、南、西、北、中六个省、市协作区的５～１８岁学生样本人群进行风湿性心脏病调查。结果据１９９４年调查资料，在２６９５４６人中共发现风湿性心脏病５９例，总患病率为０２２‰，各地患病率从００３‰至０４０‰；农村患病率高于城市；患病率随年龄而增长，而男、女间无明显差异。病例中单纯二尖瓣病变占７３７％，其中单纯二尖瓣狭窄占９２％；诊断时合并风湿活动者占２３７％。结论调查结果显示，我国青少年儿童患病率近１０余年有明显下降，但有些地区仍较高。今后仍有必要对人群风湿性心脏病的流行趋势进行长期监测，并适当进行一些成人风湿性心脏病调查，继续做好防治工作。

Objective To study the incidence of acute rheumatic fever (ARF) and its epidemiologic features among primary and secondary school students in China.Methods By using disease surveillance program, an epidemiologic survey of ARF was carried out in 1992 1995 among 221 621 students aged 5 18 years susceptible to rheumatic fever in five provinces located geographically in the eastern, southern, western, northern and central regions across the mainland. Results The annual incidence of ARF was 20.05 per 10 5 school age children. No recurrence and mortality were found during the surveyed period. ARF was more frequently found at ages 9 17, during autumn, winter and spring in the rural than the urban area. There was significant geographical variation of ARF incidence, which was higher in the south than in the north with the highest in Shichuan Province and the lowest in Guangdong Province.Conclusion China still has comparatively high ARF incidence with certain place of high incidence. The fundamental approach to the control of ARF in China is to launch a broad based primary prophylaxis of rheumatic fever, and more attention should be paid to the rural areas.