Rheumaticfever

※Understandtheetiologyandpathologicfeaturesofrheumaticfever.

※Mastertheclinicalmanifestationsanddiagnosticcriterionofrheumaticfever.

※Masterthetreatmentandpreventivemethodsofrheumaticfever.

PurposeandRequirementOutline

RheumaticfeveriscloselyrelatedtoinfectionwithgroupAβ-hemolyticstreptococci.Rheumaticfeverismostfrequentlyobservedinchildrenfrom5~15yearofage.問題？

A組乙型溶血性鏈球菌感染可誘發風濕熱已被公認，但在眾多的A組乙型溶血性鏈球菌感染中為什么只有少數人（0.3%~3%）發生本??？Etiology＊Thestrainofinfectingorganism（感染的菌株）＊Hereditysusceptibilityofhost（宿主的遺傳易感性）＊

Socioeconomicstatus、weather（社會經濟狀況、氣候）PathologyProcessofpathologyweredivideintothreestages:Exudation（滲出期）、proliferation（增殖期）、sclerosis（硬化期）.butpathologicalchangesofeachstagecanexistatthesametime.Basicpathologicalchangesareinflammationandcharacteristic“aschoffbodies”（風濕小體）.ClinicalManifestations△Fever△Carditis（心臟炎）△

Polyarthritis（多發性關節炎）△

Erythemamarginatum（環形紅斑）△

Subcutaneousnodules（皮下結節）△

Chorea（舞蹈?。┅~Largejoints﹡Multiple、migratory（游走性）ArthritisSubcutaneousNodules（皮下結節）

Itusuallyoccursoverthejoints,scalpandspinalcolumn

Diagnosis☆Ifitisrheumaticfever☆Ifitassociatedwithcarditis☆Judgementforrheumaticactivity表1Jones標準初發風濕熱的診斷指標（1992年）下列三種情況可不必嚴格執行該診斷標準舞蹈病隱匿發病或緩慢發展的心臟炎有風濕病史或現患風濕性心臟病Treatment☆Anti-infectivetherapy☆Anti-inflammatoryagents

﹡aspirin(阿司匹林)

﹡corticosteroids（皮質類固醇激素）☆

ActivetreatmentforcurrentlysymptomaticproblemsPr