激素治疗难治性全身型幼年特发性关节炎39例

Thirty-Nine Children with Refractory Systemic Juvenile Idiopathic Arthritis Treated by Glucocorticoid

目的观察难治性全身型幼年特发性关节炎(JIA)患儿的临床特点及糖皮质激素的治疗价值。方法全身型JIA患儿39例采用不同剂量糖皮质激素治疗,分为小剂量组:0.5～1.0mg/(kg.d);大剂量组:1.0～1.5mg/(kg.d)。观察二组治疗10、20d后活动性指标变化,并判定疗效。结果二组使用糖皮质激素10d后总有效率分别为58.8%、72.7%,使用20d后总有效率分别为76.5%、90.9%。二组控制体温疗效无明显差异;控制压痛关节数、肿胀关节数、ESR和CRP白疗效大剂量组明显优于小剂量组(Pa<0.05)。结论糖皮质激素对控制全身型JIA的短期疾病活动性有明显疗效,且在一定剂量范围内疗效随剂量增加而明显。

Objective To investigate clinical characteristics of refractory systemic juvenile idiopathic arthritis （JIA） and the efficiency of glucocorticoid in therapy on this kind of disease. Methods Thirty - nine children with systemic JIA were divided into low dose group 0.5 - 1.0 mg/（ kg · d） and high dose group 1.0 - 1.5 mg/（ kg · d）. And the efficiency was observed by change of active index after 10 and 20 days. Results The effective power was58.8% and72.7% after 10 days, respectively. After20 days, the power was 76. 5 % andg0.9%, respectively. The power in high dose group was significantly higher than that in low dose group. It had no difference in statistical analysis for efficiency of 2 kind of glucocorticoid dosage to control fever, but it had obvious difference to control arthralgia, arthrocele, erythrocyte sedimentation rate （ESR） ,C -reactive protein（CRP）. Conclusion Glucocorticoid therapy is very effective to control the activity of disease in patients with systemic JIA.