摘要
目的探讨幼年特发性关节炎(JIA)的临床特点、分类及治疗措施。方法总结1994年1月-2005年10月本院儿科收治的228例JIA患儿起病特点、临床症状、体征、家族史及辅助检查资料,以2001年国际风湿病学联盟儿科专家组制订的JIA标准进行分类,并对JIA患儿的临床表现、实验室检查、治疗和转归进行回顾性分析。选取同期本院健康儿童48例作对照。结果本组JIA患儿男151例,女77例。全身型JIA93例,少关节型JIA50例,多关节型JIA51例,与附着点炎性反应相关的关节炎(ERA)34例;临床表现极不典型,以发热、关节病变、皮疹、疲乏、纳差等多见;99例患儿并轻或中度贫血;免疫学检测发现JIA患儿存在着明显的细胞免疫和体液免疫紊乱;70例患儿有心脏损害,主要表现为心肌酶升高、心律失常、心脏结构或心瓣膜病变。结论掌握JIA的临床表现及辅助检查结果有助于明确诊断。全身型JIA最为多见,其次为多关节型JIA。JIA临床表现多样,治疗应依据不同临床分型予以不同治疗方案,则能尽量改善患儿病情,提高患儿学习、生活质量。
Objective To investigate the characteristics of clinical manifestation, classification and therapy of juvenile idiopathic arthritis （JIA）. Methods Two hundred and twenty -eight children with JIA were collected from Jan. 1994 to Dec. 2005 in our hospital and its subgroups were defined by the International League of Associations for Rheumatology （ILAR） classification criteria. A clinical retrospective analysis was carried out. The various subtypes of JIA and their clinical features were described by reviewing their differential diagnosis, complications and outcomes. Results The cases included 151 male and 77 female. Ninety - three cases with systemic JIA, 50 cases with oligoarticular JIA, 51 cases with polyarticular JIA, 34 cases with enthesitis related JIA （ERA）. The JIA children had atypical manifestations. Fever, arthritis, rash, fatigue, gastrointestinal symptoms could usually be seen while 99 cases were complicated with anemia and 70 cases were complicated with heart damage with manifestations of arrhythmia, pathological changes of heart structure or heart valves. There was obvious disorder in the humoral and cellular immunity in JIA children. Conclusions The diagnosis and treatment of JIA could be early decided if the doctors have mastered the manifestation and auxiliary examination. Proper treatment should be given according to the types of JIA to better the outcomes of JIA children and the quality of their lives and study.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第21期1663-1665,共3页
Journal of Applied Clinical Pediatrics
关键词
幼年特发性关节炎
类风湿
儿童
juvenile idiopathic arthritis
rheumatoid
child
