幼年型类风湿病患儿的远期随访与分析  

Long term following-up of juvenile rheumatoid arthritis

作　　者：刘瀚旻 王美若[1] 王泽蓉[1] 华益民[1] 周同甫[1] 金仲和[1] 

机构地区：[1]四川大学华西医学中心附属二院儿科,成都610041

出　　处：《中国实用儿科杂志》2001年第8期467-469,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　探讨幼年型类风湿病患儿的远期预后。方法　对 65例幼年型类风湿病患儿进行门诊、信函或电话随访 ,随访时间为 8～ 1 2 2个月 ,以了解患儿关节的改变及生活质量的情况。结果　 65例患儿的分型情况 :全身型 4 4例 ;多关节型 1 6例 ,其中类风湿因子阳性 5例 ,阴性 1 1例 ;少关节型 5例 ,为类风湿因子阴性。本组死亡 2例为全身型 ,死因分别为化脓性脑膜炎和双侧大叶性肺炎。治疗中 ,自行加减药物、未正规抗类风湿治疗者占 60 % ( 3 9/ 65)。 3 5例患儿能正常生活学习。主要并发症 :①关节畸形 1 8例 ,出现于病程的 5～ 4 8个月 ;最常见的畸形关节为膝关节、踝关节。②生长发育迟缓 3 6例 ,患儿出现程度不一的骨质疏松和身高不增。结论　幼年类风湿病的预后与成人类风湿病相比并不乐观 ,早期正规抗类风湿治疗是延缓关节畸形发生的关键 ,同时要加强对患儿生长发育的监控和干预 ,指导家长用药。Objective To investigate the long term prognosis of juvenile rhematoid arthritis(JRA).Methods\ The deterioration of joints and the living states of the patients were followed up in 69 patients with JRA in clinic,by mail of telephone call for 8～122 weeks.Results\ The types of the patients:44 cases belonged to systemic type and 16 polyarticular type,of which 5 with rhematoid factor(RF)positive,while 11 negative.2 patients with systemic type died of infection.The main complications were joint destruction(18 cases)and physical retardation(36 cases).Conclusions\ The prognosis of JRA was not optimistic as compared to adults.Regular and continuous trentment earlier attached great importance in avoiding joint destruction.Adquate guidance should be given to the patients to insure the normal growth of the patients.

关 键 词：幼儿疾病 类风湿性关节炎 JRA 生长发育 预后 远期随访 

分 类 号：R725.932.2[医药卫生—儿科]