風溼熱/Rheumatic fever
中文條目：https://zh.wikipedia.org/wiki/%E9%A2%A8%E6%BA%BC%E7%86%B1
<!-- Definition and symptoms -->
Rheumatic fever, also known as acute rheumatic fever (ARF), is an inflammatory disease that can involve the heart, joints, skin, and brain.[1] The disease typically develops two to four weeks after a throat infection.[2] Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and a characteristic but uncommon non itchy rash known as erythema marginatum. The heart is involved in about half of cases. Permanent damage to the heart valves, known as rheumatic heart disease (RHD), usually only occurs after multiple attacks but may occasionally occur after a single case of ARF. The damaged valves may result in heart failure. The abnormal valves also increase the risk of the person developing atrial fibrillation and infection of the valves.[1]
<!--定義及症狀-->
’’’風濕熱’’’（{{le|Rheumatic fever}}）也稱為’’’急型風濕熱’’’（{{le|acute rheumatic fever, ARF}}），是會侵犯[[心臟]]、[[關節]]、[[皮膚]]和[[腦部]]的[[發炎性疾病]][1]。該疾病會在[[链球菌性咽炎|喉嚨感染]]後的二至四週後發生[2]。臨床症狀包括發燒、多處關節疼痛、{{le|舞蹈症|Chorea|不自主肌肉動作}}，以及會發癢但不常見的皮疹，稱為{{le|風濕性邊緣性皮疹|erythema marginatum}}，超過一半之臨床案例會侵犯心臟。若造成永久心臟瓣膜受損則稱為'''風濕性心臟病'''（{{le|rheumatic heart disease, RHD}}）通常是多次風濕熱後出現，但也有單一次風濕熱後就出現的案例。瓣膜受損會導致[[心臟衰竭]]，瓣膜異常也會增加[[心房顫動]]及[[感染性心內膜炎]]的風險[1]。
<!-- Cause -->
Acute rheumatic fever may occur following an infection of the throat by the bacteria Streptococcus pyogenes.[1] If it is untreated ARF occurs in up to three percent of people.[3] The underlying mechanism is believed to involve the production of antibody against a person's own tissues. Some people due to their genetics are more likely to get the disease when exposed to the bacteria than others. Other risk factors include malnutrition and poverty.[1] Diagnosis of ARF is often based on the presence of signs and symptoms in combination with evidence of a recent streptococcal infection.[4]
<!--原因-->
急性風濕熱可能伴隨[[化膿性鏈球菌]]感染喉嚨後出現[1]。若沒有治療則有多達3%患者有急性風濕熱[3]。一般認為此機制和產生[[抗體]]對抗自身組織有關。有些人因其基因型較容易因暴露到此菌而得此病。危險因子包括[[營養不良]]和貧窮[1]。診斷急性風濕熱可由症狀的出現和其他最近鏈球菌感染之證據來判斷。
<!--上一段的ARF都先改為急性風溼熱了-->
<!-- Prevention and treatment -->
Treating people who have strep throat with antibiotics, such as penicillin, decreases their risk of getting ARF.[5] This often involves testing people with sore throats for the infection, which may not be available in the developing world. Other preventative measures include improved sanitation. In those with ARF and RHD prolonged periods of antibiotics are sometimes recommended. Gradual return to normal activities may occur following an attack. Once RHD develops, treatment is more difficult. Occasionally valve replacement surgery or repair is required. Otherwise complications are treated as per normal.[1]
[[链球菌性咽炎]]的治療可使用[[抗生素]]，如[[盤尼西林]]等，以降低日後誘發風濕熱的風險[5]。在此方面，喉嚨痛的感染篩檢對於風濕熱的事前預防相當重要，然而[[開發中國家]]通常無法實行。其他預防方法包含改善衛生。在風溼熱和風濕性心臟病病程延宕的患者，醫師有時會延長抗生素的使用時間。即便逐漸康復的患者也有再次發生的可能性，一旦風溼熱惡化為風濕性心臟病，則治療上的難度會增加。有時患者會需要{{le|瓣膜移植|Valve replacement}}手術，其他併發症則循一般指引治療[1]。
<!-- Epidemiology -->
Acute rheumatic fever occurs in about 325,000 children each year and about 18 million people currently have rheumatic heart disease. Those who get ARF are most often between the ages of 5 and 14,[1] with 20% of first-time attacks occurring in adults.[6] The disease is most common in the developing world and among indigenous peoples in the developed world.[1] In 2013 it resulted in 275,000 deaths down from 374,000 deaths in 1990.[7] Most deaths occur in the developing world were as many as 12.5% of people affected may die each year.[1] Descriptions of the condition are believed to date back to at least the 5th century BCE in the writings of Hippocrates.[8] The disease is so named because its symptoms are similar to those of some rheumatic disorders.[9]
<!-- 流行病學 -->
每年有三十二萬五千名兒童會得到急性風濕熱，且目前約十八億人有風濕性心臟病。有急性腎衰竭的年齡介於五歲到十四歲，約百分之二十人於成年第一次得到此病。此病常見於[[開發中國家]]的人民和[[已開發國家]]的[[原住民]][1] 。2013年造成二十七萬五千人死亡較於1990年三十七萬四千人低[7]。大部分死亡發生在開發中國家，有12.5%患者因病而過世。病情最早的描述是在西元前五世紀[[希波克拉底]]的著作[8]。此病因其症狀類似一些[[風濕性疾病]]，故稱之[9]。
2015/11/20 已整合到中文維基條目"風溼熱" 的引言頁面