幼年特发性关节炎成人后的临床特点及生物制剂治疗  

Clinical characteristics and biological treatment of adult patient with juvenile idiopathic arthritis

作　　者：魏士雄 黎苏佳 刘毅[1,2] WEI Shi-xiong;LI Shu-jia;LIU Yi(Department of Rheumatology, West China Hospital, Sichuan University, Chengdu, 610041,China;West China Clinical Medical College of Sichuan University, Chengdu, 610041, China)

机构地区：[1]四川大学华西医院风湿免疫科,成都610041 [2]四川大学华西临床医学院,成都610041

出　　处：《北京大学学报（医学版）》2020年第6期1014-1022,共9页Journal of Peking University:Health Sciences

基　　金：国家重点研发计划项目(2016YFC0906201);四川大学华西医院“优秀学科1.3.5项目”。

摘　　要：目的:探讨幼年特发性关节炎(juvenile idiopathic arthritis,JIA)成人后的临床特点及生物制剂治疗。方法:选择2009年1月1日至2019年1月1日在四川大学华西医院风湿免疫科住院治疗既往病史有JIA诊断的358例患者,对纳入符合条件的90例病例的基本信息、临床症状、诊断指标、治疗方案、门诊随诊(住院患者要求门诊随诊治疗)和诊疗过程等信息进行回顾性分析。观察不同年龄、不同病程的幼年特发性关节炎成人后的临床特点和使用生物制剂治疗6个月的门诊情况。结果:按年龄分为≤26岁组(42例)和>26岁组(48例),在实验室检查[项目包括类风湿因子(rheumatoid factor,RF)、抗核抗体(anti-nuclear antibody、ANA)、抗中性粒细胞抗体(anti-neutrophil antibody,ANCA)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、C-反应蛋白(C-reactive protein CRP)、白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin 6,IL-6)、血红蛋白(hemoglobin,HGB)、白细胞计数(white blood cell count,WBC)、人类白细胞抗原-B27(human leukocyte antigen-B27,HLA-B27)、补体3(complement 3,C3)等]、并发症、治疗和预后上,≤26岁组较>26岁组总体病症轻,即年龄越大,炎症等症状发作时越重、并发症越多、治疗效果越差、预后越差,且差异有统计学意义(P<0.05)。按病程分为≤19年组(46例)和>19年组(44例),在实验室检查(RF、ANA、ANCA、ESR、CRP、IL-1β、IL-6、HGB、HLA-B27、C3等)、并发症、治疗和预后上,病程≤19年组较病程>19年组总体病症轻,即病程越长炎症等症状发作时越重、并发症越多、治疗效果越差、预后越差,差异有统计学意义(P<0.05)。门诊6个月生物制剂治疗发现,生物制剂能改善患者部分临床症状,延缓疾病进一步发展,与非生物制剂治疗组(48例)相比,生物制剂组(42例)受益,且差异有统计学意义(P<0.05)。结论:成人后的JIA虽然被诊断为结缔组织病,但仍然有随着病Objective:To explore the clinical characteristics and biological treatment of juvenile Idiopathic arthritis(JIA)after adulthood.Methods:Selected 358 patients with previous medical history diagnosed by JIA who were hospitalized in the Department of Rheumatology and Immunology,West China Hospital of Sichuan University from January 1,2009 to January 1,2019.Perform retrospective analysis of basic information,clinical symptoms,diagnostic indicators,treatment plans,outpatient follow-up(inpatients require outpatient follow-up treatment)and diagnosis and treatment process of 90 eligible cases included,and observe different ages and different courses of disease.The clinical characteristics of young and middle-aged idiopathic arthritis in adults and the outpatient situation of using biological agents for 6 months.Results:According to age,they were divided into≤26 years old group(42 cases)and>26 years old group(48 cases).Under examination[rheumatoid factor(RF),anti-nuclear antibody(ANA),anti-neutrophil antibody(ANCA),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),interleukin-1β(IL-1β),interleukin 6(IL-6),hemoglobin(HGB),white blood cell count(WBC),human leukocyte antigen-B27(HLA-B27),complement 3(C3),etc.],concurrent in terms of symptoms,treatment and prognosis,the≤26-year-old group was generally lighter than the>26-year-old group;that was,the older the age,the heavier the onset of inflammation and other symptoms,the more complications,the worse the treatment effect,and the worse the prognosis,and there were statistical differences academic significance(P<0.05).According to the course of disease,they were divided into≤19 years group(46 cases)and>19 years group(44 cases).In terms of examination(RF,ANA,ANCA,ESR,CRP,IL-1β,IL-6,HGB,HLA-B27,C3,etc.),complications,treatment and prognosis,the course of disease≤19 years group was compared with the disease course>19 years group Overall mild;that was,the longer the course of the disease,the more severe the onset of symptoms such as inflammation,the more compli

关 键 词：成人 风湿免疫科 幼年特发性关节炎 临床特点 结缔组织病 

分 类 号：R593[医药卫生—内科学]