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目的：明确长期慢性咽炎与隐袭性风湿活动所致的风湿性心脏瓣膜病之间的关系。方法：从２３８例慢性咽炎病人中，筛选７６例初次就诊时抗链球菌溶血素Ｏ（ＡＳＯ）在４００ｋＵ／Ｌ～５００ｋＵ／Ｌ，无明确风湿热表现和病史者随访观察，用二步半定量溶血法检测ＡＳＯ，同时检测肌酸激酶同功酶ＭＢ（ＣＫＭＢ）、心室碎裂电位（ＶＦＰ）切迹数（ＮＶＦＰ），并用超声心动图观察心脏瓣膜形态。结果：①７６例中１例在随访第３年患典型风湿热。３２例于随访第１、第２或第３年后ＡＳＯ持续低于４００ｋＵ／Ｌ者，无检出二尖瓣病变。②４３例ＡＳＯ长期在４００ｋＵ／Ｌ～５００ｋＵ／Ｌ，且ＣＫＭＢ、ＮＶＦＰ长期在正常高限者，随访第７年后有１６例发现二尖瓣增厚，但尚无狭窄和关闭不全。③有二尖瓣增厚病变者ＣＫＭＢ、ＮＶＦＰ明显高于无病变者（Ｐ＜００５），但ＡＳＯ水平无显著差异（Ｐ＞００５）。结论：ＡＳＯ、ＣＫＭＢ、ＮＶＦＰ持续在正常高限的长期慢性咽炎病人中，部分存在隐袭性风湿活动，并可由此导致风湿性心脏瓣膜病变。
Objective: To clarify the relationship between long-term chronic pharyngitis and rheumatic heart valvular disease caused by insomnia. Methods: From 238 patients with chronic pharyngitis, 76 patients with anti-streptolysin (ASO) at 400kU / L to 500kU / L were screened from the first visit. There was no definite rheumatic fever and history of follow-up observation. ASO was detected by hemolysis method, meanwhile creatine kinase MB (CKMB) and ventricular fragment potential (VFP) notch number (NVFP) were detected. Cardiac valve morphology was observed by echocardiography. Results: ① One of the 76 cases had typical rheumatic fever at the third year of follow-up. Thirty-two patients with ASO less than 400 kU / L after the first, second or third year of follow-up did not detect mitral valve disease. ②43 cases of long-term ASO 400kU / L ~ 500kU / L, and CK MB, NVFP long-term in the normal high limit, after the first 7 years of follow-up found that 16 cases of mitral valve thickening, but no stenosis and incomplete closure. ③ CK-MB and NVFP in patients with mitral valve thickening were significantly higher than those without disease (P <005), but there was no significant difference in ASO level (P> 005). Conclusion: The long-term chronic pharyngitis patients with ASO, CK-MB and NVFP sustained in the normal high limit, some of which have implicit rheumatic activity and can lead to rheumatic valvular heart disease.