链球菌感染在风湿热中的地位（The status of streptococcal infections in rheumatic fever）.doc

链球菌感染在风湿热中的地位（The status of streptococcal infections in rheumatic fever） The status of streptococcal infections in rheumatic fever 2009-10-17 Yu Buyun Streptococcus rheumatic fever (RF) is the pathogenic factor, although streptococcal infection through above suspicion doubt, but what mechanisms lead to attack of rheumatic fever; recurrent detection of streptococcal infection in diagnosis of rheumatic fever and rheumatic fever should be how to strengthen the prevention and treatment aspects of streptococcal infection, there are still many problems worth discussing. The role in the mechanism of Streptococcus rheumatic fever on the onset of the past, that not all streptococci can induce rheumatic fever in group A hemolytic streptococcus serotype more than 80 M protein, M1, M3, M5 only, M6, M14, M18, M19, M24, M27, M29 and other serotypes have the wind heat induced toxicity. In healthy people, not everyone will attack of rheumatic fever, only some susceptible individuals, such as histocompatibility antigen (HLA) DR4 positive patients have a predisposition to rheumatic fever and rheumatic heart disease, which caused by rheumatism original strains and susceptible hosts is the two RF predisposing factors, they start the role in pathogenesis. As for the infection of the host strain, and the incidence and by what mechanism? In late 60s due to successive Streptococcus antibody and mammalian heart, joint, brain and other cross reactions were found; immune complexes and complement in patients with acute rheumatic fever (ARF) in patients with cardiac tissue deposition; then in the serum of patients with multiple autoimmune measure antibody molecules, over the years has been to the pathogenesis of humoral immune based simulation theory to explain the pathogenesis of RF. In late 80s, due to the further development of cell biology and molecular biology, have more research results show that cellular immune response may play a more important role. Some authors even suggest that the a