Packham J C, Hall M A
Oxford Regional Paediatric Rheumatology Unit, Wexham Park Hospital, Slough SL2 4HL, UK.
Rheumatology (Oxford). 2002 Dec;41(12):1428-35. doi: 10.1093/rheumatology/41.12.1428.
To examine the clinical and functional outcome of adults with juvenile idiopathic arthritis (JIA) using the recent World Health Organization/International League Against Rheumatism (ILAR) classification.
Two hundred and fifty-nine adults with long-standing JIA (average disease duration 28.3 yr) were eligible for the study; 246 (95%) attended for an interview, clinical examination and notes review and 231 (89.2%) returned a comprehensive functional and psychosocial self-assessment questionnaire.
Of all patients, 43.3% had active arthritis clinically and 54.4% on laboratory measures (C-reactive protein). Clinical inflammation was less common in systemic-onset JIA. The percentage of all patients with severe disability (Health Assessment Questionnaire score >1.5) was 42.9. Uveitis occurred frequently in the oligoarticular-onset and enthesitis-related subsets. Over 30% of the extended oligoarticular group with uveitis developed glaucoma compared with none of the enthesitis group.
Adults with JIA often have significant levels of disability, often related to continuing active disease over prolonged periods. There is a clear need for good transition from paediatric to high-quality adult rheumatology care.
采用世界卫生组织/国际抗风湿病联盟（ILAR）最新分类法，研究成年幼年特发性关节炎（JIA）患者的临床及功能转归。
259例患有长期JIA的成年人（平均病程28.3年）符合研究条件；246例（95%）接受了访谈、临床检查及病历回顾，231例（89.2%）返回了一份全面的功能及心理社会自我评估问卷。
所有患者中，43.3%临床有活动性关节炎，54.4%实验室检查（C反应蛋白）显示有活动性。全身型JIA中临床炎症较少见。所有严重残疾患者（健康评估问卷评分>1.5）的比例为42.9%。葡萄膜炎在少关节起病型和附着点炎相关亚型中频繁发生。葡萄膜炎的扩展性少关节组中超过30%发生了青光眼，而附着点炎组无一例发生。
成年JIA患者常存在严重残疾，这往往与疾病长期持续活动有关。显然需要从儿科向高质量的成人风湿病护理进行良好的过渡。
