沙利度胺治疗幼年特发性关节炎的效果分析  

Efficacy of thalidomide for treatment of juvenile idiopathic arthritis

作　　者：韩彤昕[1] 李彩凤[1] 王江[1] 邝伟英[1] 周怡芳[1] 

机构地区：[1]北京儿童医院风湿免疫科,北京100045

出　　处：《中国当代儿科杂志》2011年第8期631-634,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的评价沙利度胺治疗幼年特发性关节炎(juvenile idiopathic arthritis,JIA)的临床疗效和安全性。方法 12例传统治疗方案治疗病情无缓解的JIA患儿,应用沙利度胺治疗(每日2 mg/kg),记录治疗前后患儿的症状、体征、实验室指标及沙利度胺治疗的不良反应。结果沙利度胺治疗6个月后,患儿泼尼松用量由每日1.92±0.16 mg/kg降至0.49±0.42 mg/kg(P<0.01),并有4例能停用泼尼松治疗。12例患儿外周血白细胞计数、ESR、CRP、血清铁蛋白(SF)较治疗前均明显下降(P<0.01);8例患儿血红蛋白明显升高(P<0.01)。多关节型JIA患儿平均受累关节数由5个以上降至0～2个(P<0.01),附着点炎症型患儿双"4"字征转阴,Schober's征转阴。治疗过程中未出现严重不良反应。结论沙利度胺对JIA有显著的临床疗效,可以作为传统治疗方案无效后的治疗措施。Objective To evaluate the efficacy of thalidomide in the treatment of juvenile idiopathic arthritis（JIA）. Methods Twelve children with JIA who did not respond to conventional treatment were administered with thalidomide（2 mg/kg daily）.The symptoms,signs,and laboratory test results were compared before and after treatment.The thalidomide-related side effects were observed. Results The average dosage of prednisone was reduced from 1.92±0.16 mg/kg·d to 0.49±0.42 mg/kg·d in the 12 patients 6 months after thalidomide treatment（P0.01）.Four patients did not need prednisone treatment any more.White blood cell count,erythrocyte sedimentation rate（ESR）,C reactive protein（CRP） and serum ferritin（SF） significantly decreased after treatment in all of 12 patients（P0.01）.Hemoglobin level increased to normal in 8 patients after treatment（P0.01）.The number of affected joints decreased from 5 before treatment to zero to 2 after treatment in patients with polyarticular JIA（P0.01）.Signs of hip involvement and Schober′s sign turned negative in enthesitis-related cases.No thalidomide-related side effects were observed. Conclusions Thalidomide is effective in the treatment of JIA in children who do not respond to conventional treatment.

关 键 词：幼年特发性关节炎 沙利度胺 儿童 

分 类 号：R725.9[医药卫生—儿科]