风湿热活动性指标的初步探讨

STUDY ON THE ACTIVITY INDEX OF RHEUMATIC FEVER

目的：为了指导风湿热的防治并改善其预后，寻找特异性和敏感性较高的指标以探讨风湿热活动性。方法：采用最具生物活性的Ａ组链球菌壁多糖部分作包被抗原，以ＥＬＩＳＡ法测定抗链球菌壁多糖抗体（ＡＳＰ）ＩｇＧ、ＩｇＭ。结果：风湿性心脏病活动期ＡＳＰＩｇＧ、ＩｇＭ的水平（３６５２±２１９５和２６１９±０７４８）和阳性率（５６１％和７５６％）显著高于正常人、风湿性关节炎和风湿性心脏病静止期（Ｐ＜００５～００００１），后二者ＡＳＰ－ＩｇＧ、ＩｇＭ的水平和阳性率明显高于正常人（Ｐ＜００５～００１）；随治疗ＡＳＰ－ＩｇＭ下降较快（Ｐ＜０００１），ＡＳＰ－ＩｇＭ与反映风湿热活动的传统指标（血沉、Ｃ－反应蛋白等）之间具有正相关性，ＡＳＰ在风湿热活动中的阳性率（８５４％）明显高于ＥＳＲ、ＣＲＰ和ＡＣＬ。

Objective:To improve the prevention,treatment and prognosis of the patients with rheumatic fever,and search for specific and sensitive indexes for detecting the activity of rheumatic fever.Methods:The portion of the polysaccharide with the strongest biology activity was isolated and used as an antigen for detecting serum ASPIgG and IgM with ELISA method.Results:Levels (3652±2195 and 2619±0748) and positive rates (561% and 756%) of serum ASPIgG and IgM in patients with active rheumatic heart disease group are much higher than those of normal controls,rheumatic arthritis and inactive rheumatic disease group (P<005～0000 1).Levels and positive rates of serum ASPIgG and IgM in rheumatic arthritis and inactive rheumatic heart disease patient groups are much higher than those of normal controls (P<005～001),After treatment,level and positive rate of ASPIgM decreased more quickly (P<0001).There was a positive relationship between level of ASPIgM and those of the traditional indexes (ESR and CRP etc.).The positive rate (854%) of ASP was much higher than those of ESR,CRP and ACL. Conclusion:ASP is a more sensitive index for detecting the activity of rheumatic fever.