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目的 探讨幼年特发性关节炎 (JIA)临床特点及治疗。方法 总结 2 8例JIA患儿的临床表现、实验室和影像学检查结果 ,以国际风湿病学联盟 (ILAR)儿科专家组新的分类标准讨论稿 (加拿大埃得蒙顿 ,2 0 0 1)进行分析。结果 全身型JIA 7例 ,用非甾体类消炎药 (NSAIDs)治疗 ,3例有效 ,2例部分效应 ,2例无效 ;部分效应和无效者加用糖皮质激素治疗 ,其中 1例联合甲氨蝶呤 (MTX)治疗。少关节型JIA 2例 ,以NSAIDs治疗。多关节型JIA类风湿因子 (- ) 4例 ,多关节型JIA类风湿因子 (+) 2例 ,用NSAIDs联合MTX治疗 ,以MTX维持治疗。与附着点炎症相关性关节炎 13例 ,以NSAIDs联合柳氮磺吡啶 (SASP)治疗 ,其中 2例加用MTX ,2例并发虹膜睫状体炎加用糖皮质激素 ,以SASP维持治疗。结论 JIA中 ,与附着点炎症相关性关节炎最为多见 ,其次为全身型JIA ;治疗应依据临床分型 ,联合用药并注意个体化 ;MTX对各型JIA均有较好疗效。
Objective To investigate the clinical features and treatment of juvenile idiopathic arthritis (JIA). Methods The clinical manifestations, laboratory and imaging findings of 28 children with JIA were summarized and discussed in a new classification standard by the International Association of Rheumatology (ILAR) Pediatric Panels (Edmonton, Canada, 2001) Analyze. Results Seventeen patients with systemic JIA were treated with non-steroidal anti-inflammatory drugs (NSAIDs), 3 were effective, 2 were partial and 2 were ineffective. Some patients were ineffective and corticosteroid. One patient was treated with methyl ammonia Pterin (MTX) treatment. 2 cases of less articular JIA, with NSAIDs treatment. 4 cases of polyarticular JIA rheumatoid factor (-), 2 cases of polyarticular JIA rheumatoid factor (+), NSAIDs combined with MTX and MTX maintenance treatment. Thirteen patients with inflammation associated with attachment sites were treated with NSAIDs combined with sulfasalazine (SASP). Two of them were treated with MTX and two patients with iridocyclitis plus glucocorticoid were treated with SASP. Conclusions JIA is the most common inflammation associated with attachment points, followed by systemic JIA. The treatment should be based on clinical classification and combination therapy and should be individualized. MTX has good efficacy on all types of JIA.