幼年类风湿性关节炎患儿远期随访与分析

目的：探讨幼年类风湿关节炎患儿的远期预后。方法：对65例幼年类风湿关节炎患儿进行门诊、信函或电话随访，随访时间为5—57个月，了解忠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43例；多关节型16例，其中类风湿因子阳性5例，阴性11例；少关节型5例，为类风湿因子阴性。本组死亡2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％（39／5）35例患儿能正常生活学习。主要并发症：①关节畸形18例，出现于病程的5～48个月；最常见的畸形关节为膝关节、踝关节。②生长发育迟缓36例，忠儿出现程度不一样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，指导家长规范用药。

Objective To investigate the long term prognosis of juvenile rheumatoid arthritis（JRA）. Methods thedeterioration 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 5-57weeks. Results The types of the patients ： 44 cases belonged to systemic type and 16 polyarticular type,of which 5 with rheumatoid factor （RF） positive , while 11 negative. 2 patients with systemic type died of infection. The main complications were joint destruction（18cases） had physical retardation（36cases）. 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.