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[类风湿关节炎的治疗时机窗]

[Window of opportunity for treatment of rheumatoid arthritis].

作者信息

Fukuda Takaaki

机构信息

Center for Rheumatic Diseases, Kurume University Medical Center.

出版信息

Nihon Rinsho. 2007 Jul;65(7):1276-81.

Abstract

Rheumatoid arthritis (RA) is an autoimmune disorder of unknown etiology characterized by symmetric, erosive synovitis. Joints become eroded in the first 2 years of early RA. But the subsequent course of radiological progression is highly variable and cannot be easily explained. Their disability correlates with signs and symptoms of inflammation and it correlates more closely with articular damage. TNF blockers (infliximab and etanercept) affect signs and symptoms as well as radiographic progression of RA. They are among the most effective therapies for RA. Early diagnosis and early appropriate treatment of RA are thought to be key to controlling progress of disease and preventing further joint and tissue damage. The concept of "window of opportunity" exists from the notion that early institution of therapy for RA is more effective in preventing joint damage, decreasing functional disability, and inducing clinical remission.

摘要

类风湿关节炎(RA)是一种病因不明的自身免疫性疾病,其特征为对称性、侵蚀性滑膜炎。在早期类风湿关节炎的头两年,关节就会受到侵蚀。但随后的放射学进展过程差异很大,难以轻易解释。患者的残疾与炎症的体征和症状相关,且与关节损伤的关联更为密切。肿瘤坏死因子阻滞剂(英夫利昔单抗和依那西普)可影响类风湿关节炎的体征、症状以及影像学进展。它们是治疗类风湿关节炎最有效的疗法之一。类风湿关节炎的早期诊断和早期适当治疗被认为是控制疾病进展、防止进一步关节和组织损伤的关键。“机会窗”这一概念源于这样一种观念,即早期对类风湿关节炎进行治疗在预防关节损伤、减少功能残疾以及诱导临床缓解方面更为有效。

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