儿童心血管系统-Rheumatic Fever英文课件

Rheumaticfever

※Understandtheetiologyandpathologicfeaturesofrheumaticfever.

※Mastertheclinicalmanifestationsanddiagnosticcriterionofrheumaticfever.

※Masterthetreatmentandpreventivemethodsofrheumaticfever.

PurposeandRequirementOutline

RheumaticfeveriscloselyrelatedtoinfectionwithgroupAβ-hemolyticstreptococci.Rheumaticfeverismostfrequentlyobservedinchildrenfrom5~15yearofage.问题？

A组乙型溶血性链球菌感染可诱发风湿热已被公认，但在众多的A组乙型溶血性链球菌感染中为什么只有少数人（0.3%~3%）发生本病？Etiology＊Thestrainofinfectingorganism（感染的菌株）＊Hereditysusceptibilityofhost（宿主的遗传易感性）＊

Socioeconomicstatus、weather（社会经济状况、气候）PathologyProcessofpathologyweredivideintothreestages:Exudation（渗出期）、proliferation（增殖期）、sclerosis（硬化期）.butpathologicalchangesofeachstagecanexistatthesametime.Basicpathologicalchangesareinflammationandcharacteristic“aschoffbodies”（风湿小体）.ClinicalManifestations△Fever△Carditis（心脏炎）△

Polyarthritis（多发性关节炎）△

Erythemamarginatum（环形红斑）△

Subcutaneousnodules（皮下结节）△

Chorea（舞蹈病）﹡Largejoints﹡Multiple、migratory（游走性）ArthritisSubcutaneousNodules（皮下结节）

Itusuallyoccursoverthejoints,scalpandspinalcolumn

Diagnosis☆Ifitisrheumaticfever☆Ifitassociatedwithcarditis☆Judgementforrheumaticactivity表1Jones标准初发风湿热的诊断指标（1992年）下列三种情况可不必严格执行该诊断标准舞蹈病隐匿发病或缓慢发展的心脏炎有风湿病史或现患风湿性心脏病Treatment☆Anti-infectivetherapy☆Anti-inflammatoryagents

﹡aspirin(阿司匹林)

﹡corticosteroids（皮质类固醇激素）☆

ActivetreatmentforcurrentlysymptomaticproblemsPr