Oen Kiem
Department of Pediatrics and Child Health, University of Manitoba, RR149-Rehabilitation Centre, 800 Sherbrook Street, Winnipeg, Canada, R3A 1M4.
Best Pract Res Clin Rheumatol. 2002 Jul;16(3):347-60.
Prediction of the long-term outcome for patients with juvenile idiopathic arthritis requires assessment of disability, psychosocial and socioeconomic function. Measures for the first have evolved from Steinbrocker functional classifications to validated self-administered questionnaires. The proportion of patients with severe disability has decreased during the past three decades but significant numbers of patients enter adulthood with some disability detected with the newer measures. Despite careful study, few early predictors of a poor outcome have been identified. The most consistent are early age at onset, persistent fever and thrombocytosis in patients with systemic juvenile idiopathic arthritis. Reports of psychosocial and socioeconomic outcomes are controversial and further analyses of these spheres are required. An increased risk of osteoporosis and osteopenia has been reported in adults with juvenile idiopathic arthritis. The most significant problem faced by patients during adulthood is persistent disease activity as disability, radiographic damage and the risk of osteoporosis all increase with increasing duration of disease.
预测青少年特发性关节炎患者的长期预后需要评估残疾情况、心理社会功能和社会经济功能。评估残疾情况的方法已从斯坦布鲁克功能分类发展到经过验证的自我管理问卷。在过去三十年中，严重残疾患者的比例有所下降，但仍有相当数量的患者成年后仍存在一些残疾，这些残疾可通过更新的测量方法检测出来。尽管进行了仔细研究，但几乎没有发现不良预后的早期预测因素。最一致的因素是全身型青少年特发性关节炎患者发病年龄早、持续发热和血小板增多。关于心理社会和社会经济结果的报告存在争议，需要对这些领域进行进一步分析。据报道，青少年特发性关节炎成年患者骨质疏松和骨质减少的风险增加。患者成年后面临的最重大问题是疾病持续活动，因为残疾、影像学损伤和骨质疏松风险均随着疾病持续时间的增加而增加。
