对链球菌性咽炎的WHO临床诊断规则的评价

作     者：Rimoin A.W. Hamza H.S. Vince A. 贺莉 

作者机构：Department of Epidemiology UCLA School of Public Health 650 Charles E.Young Drive SouthLos AngelesCA 90095-1772 United States 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第A3期

页      面：35-35页

学科分类：1002[医学-临床医学] 100213[医学-耳鼻咽喉科学] 10[医学] 

主　　题：链球菌性咽炎 WHO 诊断规则 咽部充血 β溶血 队列研究 风湿性心脏病 观察性 年龄组 特异度 

摘      要：Aims: To prospectively assess the WHO clinical decision rule (CDR) for group A beta haemolytic streptococcal (GABHS)-pharyngitis in three countries. Methods: A prospective, observational cohort study in urban outpatient clinics in Rio de Janeiro, Cairo, and Zagreb. There were 2225 children aged 2-12 years with cough, rhinorrhoea, red or sore throat; 1810 of these with sore throat were included in the analysis. Results: The proportion of children presenting with sore throat and found to have GABHS pharyngitis ranged from 24.6% (Brazil) to 42.0% (Croatia). WHO CDR sensitivity was low for all sites in both age groups. In children age 5 or older, sensitivity ranged from 3.8% in Egypt to 10.8% in Brazil. In children under 5, sensitivity was low(0.0-4.6% ) Specificity was high in both age groups in all countries (93.8-97.4% ). Conclusions: In these populations, the current WHO CDR has high specificity, but low sensitivity; it did not detect up to 96.0% of children who have laboratory confirmed GABHS pharyngitis. A CDR with higher sensitivity should be developed for use in regions where rheumatic fever and rheumatic heart disease are still major health problems.