2013年美国风湿病学会关于幼年特发性关节炎治疗建议（2011年版）的更新（摘译）

2013 update of the 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis （ selected translation ）

2013年美国风湿病学会（ACR）对2011年幼年特发性关节炎（JIA）治疗建议进行了更新，着重阐述了全身型幼年特发性关节炎（SOJIA）的治疗。该更新根据SOJIA的临床表现特点将其分为3个表型：（1）具有全身症状合并关节炎表现的SOJIA；（2）具有关节炎表现但不合并全身症状的SOJIA；（3）具有巨噬细胞活化综合征（MAS）特征表现的SOJIA。按照SOJIA不同表型，推荐了相应的治疗参考方案，包括初始和后续治疗，并列出疗效不确切或不适宜使用的药物。对于SOJIA合并MAS的诊疗未明确阐述，但随着未来对该问题的深入研究，将会有更好的诊疗策略呈现。

The American College of Rheumatology （ACR） updated the 2011 recommendations for juvenile idiopathic arthritis （JIA） in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis （SOJIA）. According to the clinical feature of the SOJIA, the subtype is developed to 3 phenotypes ： （ 1 ） phenotype of systemic JIA with active systemic features and varying degrees of synovitis ; （2） phenotype of systemic JIA without active systemic features and with varying degrees of active synovitis ; （ 3 ） phenotype of systemic JIA with features concerning for macrophage activation syndrome （MAS）. The treatment recommendation was made according each phenotype, including initial therapeutic options and therapeutic options for continued disease activity. And uncertain or inappropriate options for continued disease were listed alphabetically. Development of treatment recommendations for children with SOJIA and features of MAS is particularly challenging. However, it is anticipated that in the near future, with research of the disease process, the better recommendation may be made.