老年人风湿性心脏瓣膜病67例临床分析

A Clinical Analysis of 67 Cases of Senile Chronic Rheumatic Heart Disease

报道了近30年来我院收治的67例老年风湿性心脏瓣膜病患者的临床状况,提示风湿热的发病率及风心病的患病率在下降,但老年风心病者的住院人数在逐渐增长。他们的临床表现有其特殊性,风湿活动不典型,病情经过缓和,预后较好,可合并存在冠心病,高血压等其他疾病。从本组女性患者的生育史中提示老年风心病者很可能是在青中年以后首次罹患风湿热。在对老年风心病者的处理中应加强抗风湿治疗。

67 senile patients (male 21, female 46)with chronic rheumatic heart disease admitted into our hospital from 1960 to 1991 were investigated. The results showed that hospitalized senile patients with rheumatic heart disease were increasing in number, though both the incidence of rheumatic fever and morbidity of chronic rheumatic heart disease were reduced. The patients were found to have such snecific clinical features as atypical rheumatic fever, moderate clinical course, better prognosis and frequent coexistence with coronary heart disease or hypertension. Inview of that 37 female patients had an uneventful previous delivery history, in which 27 cases had more than five deliveries, it suggests that the initial onset of rheumatic fever is rather after their young or middle age than before. In treating for the senile rheumatic heart disease, as one of the treatment measures, an intensive antirheumatic therapy is particullarly necessary.