Is the "Rheuphys Ivy" indicator positive is rheumatic disease? Wrong!

Because of the difference of test methods, there is no normal reference value here. Please refer to the normal value on the inspection sheet.01 anti streptolysin O (ASO) hemolysin o is one of the important metabolites of group a hemolytic streptococcus. It is a protein with hemolytic activity and can dissolve red blood cells of human and some animals.at the same time, hemolysin o has antigenicity and can stimulate the body to produce corresponding antibodies, which is called ASO.■ clinical significance ① Aso is commonly known as anti-o.since the infection of group a hemolytic streptococcus is quite common, the low titer of ASO can be detected in normal people, but it is generally below 500 U.② increased Aso is common in upper respiratory tract infections such as acute pharyngitis, which is more common in children, and can also be seen in acute skin and soft tissue infections.③ rheumatic myocarditis, pericarditis, rheumatic arthritis, acute glomerulonephritis, Aso titer increased.the trend of multiple tests is parallel to the disease condition. If it gradually decreases, it indicates that the condition is improved.④ in group A, Aso such as septicemia, bacteremia and endocarditis caused by hemolytic streptococcus could be increased.■ precautions: ① it is not considered that the increase of Aso is rheumatism, which should be considered in combination with clinical symptoms.but among the various pathogenic factors of ASO elevation, it was most closely related to group a hemolytic streptococcus infection.② after human infection with group A Streptococcus haemolyticus, the rise of ASO reached the peak within 4-6 weeks, and then the ASO in serum could rise for months to years.therefore, it is difficult to determine whether it is caused by the recent infection in one examination, and it is necessary to check it repeatedly to observe the dynamic changes.at 4-6 weeks after infection, Aso increased in 80% of patients with rheumatic fever, often accompanied by rapid ESR and leukocytosis, which is helpful for differential diagnosis.the positive rate of anti chain enzyme test (asz) of extracellular products of group a hemolytic streptococcus was higher than that of single test.is helpful for the diagnosis of acute rheumatic fever and acute glomerulonephritis with no increase of ASO. (3) ASO may not increase after Streptococcus infection.02c-reactive protein (CRP) ■ clinical significance: ① CRP in patients with various acute suppurative inflammation, bacteremia, tissue necrosis (such as myocardial infarction, major surgery, burns, severe trauma, etc.), malignant tumor, connective tissue disease, etc., increases when there are organic lesions, while functional diseases are normal, which is helpful to distinguish organic or functional diseases. more than 20 mg / L is the prompt value of medical decision-making level, which strongly suggests the existence of the above-mentioned conditions, and timely diagnosis and treatment should be taken. ② acute rejection of renal transplantation, serum CRP increased. ③ CRP in active stage of acute rheumatic fever can be significantly increased, even up to 200 mg / L. after treatment, CRP can gradually decrease to normal. it has important reference value for the diagnosis and curative effect observation of rheumatic fever. ④ CRP did not increase in viral infection, but increased in bacterial infection, which is of great reference value in the identification of pathogens as bacteria or viruses. If cerebrospinal fluid CRP is measured during meningitis, it is helpful to determine whether bacterial or viral (viral CRP is normal). ■ precautions: ① CRP is a non-specific index, and its significance should be considered in combination with clinical signs and relevant laboratory examination items. ② CRP of pregnant women increased. it can be doubled within 24 hours after major operation. The younger the children, the lower the CRP. attention should be paid to the judgment. 03 rheumatoid factor (RF) ■ clinical significance RF is an autoantibody with variant IgG as target antigen. RF was found in rheumatoid arthritis (RA), systemic lupus erythematosus, scleroderma, autoimmune hemolytic anemia and chronic hepatitis. RF also increased in patients with cryoglobulinemia, tuberculosis and subacute bacterial endocarditis. 04 erythrocyte sedimentation rate (ESR) ■ clinical significance to assist the diagnosis of acute or localized infection and chronic active infection. accelerated physiological ESR: children under 12 years old or over 60 years old, women during menstrual period and from three months of pregnancy to one month after delivery; the increase may be related to physiological anemia or increased fibrinogen content. pathological ESR: 1. Various inflammatory diseases, such as acute bacterial inflammation, rheumatic fever, tuberculosis, etc. ESR is most commonly used to observe the activity and dynamic changes of tuberculosis and rheumatic fever. ESR increased rapidly in the active stage of the disease, and gradually became normal if the lesion became more and more static. 2. Tissue injury and necrosis: ESR can be accelerated by large tissue injury or surgical trauma, or tissue necrosis caused by organ infarction. therefore, ESR results can be used to differentiate functional and organic diseases. for example, ESR is increased in AMI, but normal in angina pectoris. 3. Malignant tumor: the ESR of benign tumor is mostly normal. After surgery, chemotherapy or radiotherapy, ESR tends to be normal gradually, and it can be increased when recurrence or metastasis. Relative or absolute increase of plasma globulin caused by various reasons, such as chronic nephritis, cirrhosis, multiple myeloma, macroglobulinemia, lymphoma, systemic lupus erythematosus, subacute infective endocarditis, Kala Azar, etc. 5. Others: when HB & lt; 90 g / L, ESR can be slightly increased in some anemia patients. in addition, patients with atherosclerosis, diabetes mellitus, nephrotic syndrome and myxedema have high blood cholesterol, and ESR can also be increased. slow ESR: generally, the clinical significance is small, severe anemia, spherocytosis, severe lack of fibrin content, ESR can be slowed down. source: Voice of medicine, editor in charge: Fenghe copyright statement. This article is reprinted, welcome to forward the circle of friends end love me, please give me a good look!