摘要： 目的 分析78例非全身型幼年特发性关节炎 （JIA） 患儿的临床特点，为儿童JIA临床诊治提供依据。方法 收集2013年1月至2020年1月中国医科大学附属盛京医院小儿风湿免疫科住院治疗的78例初诊非全身型JIA病例资料，包括一般情况、实验室检查及治疗等，并对其临床特点进行分析。结果 78例患儿中，男女比例为0.66︰1，少关节型JIA 10例，多关节型JIA 45例，与附着点炎症相关的关节炎23例。少关节型JIA患儿多为幼儿期发病，炎症指标 （C反应蛋白及红细胞沉降率） 可无明显升高。多关节型JIA多为学龄前期和学龄期发病，与附着点炎症相关的JIA患儿多为青春前期和青春期发病，二者炎症指标均有明显升高，前者可有贫血表现。大部分患儿关节症状为关节活动障碍 （59.0%），其次为关节肿胀 （33.3%）。影像学常见表现为关节积液 （71.8%） 及滑膜增生 （79.5%），同时，30.8%的患儿有骨质破坏。55例 （70.5%） 患儿初诊时即使用生物制剂治疗，多关节型JIA及与附着点炎症相关的JIA患儿使用生物制剂较未使用患儿的关节活动障碍好转时间明显缩短 （P< 0.05）。结论 不同类型JIA患儿的一般情况、关节症状及炎症指标等临床特点存在差异。应用生物制剂可缩短部分患儿关节活动障碍好转时间。

78例非全身型幼年特发性关节炎临床特点分析

王兴伟¹, 王秀丽¹, 赵成广¹, 于书源², 杜悦¹

1. 中国医科大学附属盛京医院小儿肾脏风湿免疫科, 沈阳 110004;
2. 东北大学医学与生物信息工程学院生物医学工程系, 沈阳 110819

收稿日期:2022-05-09出版日期:2023-05-30发布日期:2023-05-26
通讯作者:杜悦E-mail:duy@sj-hospital.org
作者简介:王兴伟 (1995-),女,医师,硕士研究生.
基金资助:辽宁省民生科技计划联合计划(2021JH2/1030115)


关键词: 幼年特发性关节炎, 生物制剂, 临床特点
Abstract: Objective To analyze the clinical characteristics of 78 children with non-systemic juvenile idiopathic arthritis (JIA),to provide more evidence for the diagnosis and treatment of JIA. Methods The clinical characteristics of 78 children newly diagnosed with non-systemic JIA hospitalized at the Department of Rheumatology,Shengjing Hospital of China Medical University,from January 2013 to January 2020,were analyzed considering the aspects of general situation,laboratory examination and treatment. Results The male-to-female ratio was 0.66:1 among the 78 patients 10 patients with oligarticular JIA,45 patients with polyarticular JIA,and 23 patients with arthritis associated to attachment inflammation. The incidence of JIA in children with oligarticular JIA occurred mostly in early childhood,and the inflammatory indexes (CRP and ESR) were not significantly increased. Multiarticular JIA mostly occurs in early school age and school age,and arthritis associated with attachment inflammation mostly occurs in early youth and adolescence. Inflammatory indexes of both JIA and JIA were significantly increased,and JIA may be accompanied with anemia. Most (59.0%) of the joint symptoms were joint mobility disorders,followed by joint swelling (33.3%). Joint effusion (71.8%),synovial hyperplasia (79.5%),and bone destruction (30.8%) were the common imaging findings. Fifty-five children (70.5%) were treated with biologics at the time of initial diagnosis. Children with multiarticular JIA and arthritis associated with attachment inflammation were treated with biologics in a shorter time than those without biologics (P< 0.05). Conclusion Differences in general conditions,joint symptoms,and inflammatory indicators were noted among different types of children with JIA. The application of biological agents can shorten the recovery time of joint movement disorders in some children.
Key words: juvenile idiopathic arthritis, biological agent, clinical feature
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