北欧国家青少年特发性关节炎的发病率。一项基于人群的研究，特别参考国际风湿病联盟（ILAR）和欧洲抗风湿病联盟（EULAR）标准的有效性。

Incidence of juvenile idiopathic arthritis in the Nordic countries. A population based study with special reference to the validity of the ILAR and EULAR criteria.

作者信息

Berntson Lillemor, Andersson Gäre Boel, Fasth Anders, Herlin Troels, Kristinsson Jon, Lahdenne Pekka, Marhaug Gudmund, Nielsen Susan, Pelkonen Pirkko, Rygg Marite

机构信息

Department of Pediatrics, Falun Hospital, SE-791 82 Falun, Sweden.

出版信息

J Rheumatol. 2003 Oct;30(10):2275-82.

PMID:14528529

Abstract

OBJECTIVE

To find the incidence of juvenile arthritis according to the ILAR and EULAR criteria within defined areas in the Nordic countries, and to study the validity of the ILAR and EULAR criteria from this perspective.

METHOD

A longitudinal, prospective, population based study with patients enrolled according to the ILAR and EULAR criteria. Twenty doctors in Iceland, Norway, Sweden, Denmark, and Finland collected data from the incidence cases within their catchment areas over a period of 1.5 years, beginning July 1, 1997. Clinical and serological data from the first year of the disease were collected.

RESULTS

In the whole group of 315 patients, the incidence rate was 15 per 100,000 children/year (95% CI 13-17) according to the ILAR criteria, varying from 7 (1-13) in Iceland, 19 (7-31) and 23 (10-36) from 2 different regions in Norway, and 9 (5-12) and 16 (9-23) from 2 different areas in Denmark, to 15 (12-18) in Sweden and 21/100,000/year (15-26) in the Helsinki region in Finland. An early peak in distribution for age of onset was found in girls but not in boys. The number of antinuclear antibody (ANA) positive children in the whole group, made up of children who had undergone at least one analyzed ANA test, was 123/315 (39%). Girls were ANA positive in 83/197 (42%) and boys in 40/118 (34%). Uveitis developed in 27/315 (8.6%) children during the first 6 months of the disease.

CONCLUSION

Incidence rates of juvenile arthritis for areas within the Nordic countries were in accord with previous data. The ILAR criteria present slightly higher incidence rates, with a shorter disease duration for inclusion, compared to the EULAR criteria. Patients in one subgroup in either of the criteria sets do not necessarily belong to the expected subgroup in the other set of criteria; e.g., for juvenile ankylosing spondylitis (EULAR) and enthesitis related arthritis (ILAR). Our epidemiological findings are a reminder to be aware of possible new subgroups in children with juvenile arthritis.

摘要

目的

依据国际风湿病联盟（ILAR）和欧洲抗风湿病联盟（EULAR）标准，确定北欧特定地区青少年关节炎的发病率，并从这一角度研究ILAR和EULAR标准的有效性。

方法

一项基于人群的纵向前瞻性研究，根据ILAR和EULAR标准招募患者。冰岛、挪威、瑞典、丹麦和芬兰的20名医生在1997年7月1日起的1.5年时间内，收集了其辖区内发病病例的数据。收集了疾病第一年的临床和血清学数据。

结果

在315例患者的整个队列中，根据ILAR标准，发病率为每年每10万名儿童15例（95%可信区间13 - 17），冰岛为7例（1 - 13），挪威两个不同地区分别为19例（7 - 31）和23例（10 - 36），丹麦两个不同地区分别为9例（5 - 12）和16例（9 - 23），瑞典为15例（12 - 18），芬兰赫尔辛基地区为每年21/10万例（15 - 26）。发病年龄分布中女孩有一个早期高峰，男孩则没有。在整个队列中，至少进行过一次抗核抗体（ANA）检测的儿童中，ANA阳性儿童有123/315例（39%）。女孩中ANA阳性的有83/197例（42%），男孩中为40/118例（34%）。27/315例（8.6%）儿童在疾病的前6个月发生了葡萄膜炎。

结论

北欧国家各地区青少年关节炎的发病率与先前数据一致。与EULAR标准相比，ILAR标准的发病率略高，纳入的疾病持续时间较短。在任何一组标准中的一个亚组患者不一定属于另一组标准中的预期亚组；例如，青少年强直性脊柱炎（EULAR）和附着点炎相关关节炎（ILAR）。我们的流行病学研究结果提醒人们要注意青少年关节炎患儿中可能存在的新亚组。