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[荷兰全科医生学院关于风湿性多肌痛和颞动脉炎的实践指南]

[Dutch College of General Practitioner's practice guideline on polymyalgia rheumatica and temporal arteritis].

作者信息

Eizenga Wietze H, Hakvoort Louwe, Dubbeld Peter, Geijer Roeland M M, Goudswaard A N Lex

机构信息

Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht, The Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2010;154:A1919.

Abstract

The practice guideline for general practitioners (GPs) on polymyalgia rheumatica and temporal arteritis was published in February 2010 by the Dutch College of General Practitioners. This guideline provides GPs with recommendations for the diagnosis and treatment of polymyalgia rheumatica. After other disorders have been excluded, the diagnosis of 'polymyalgia rheumatica' is made in patients over the age of 50 who have bilateral pain in the neck and shoulder girdle and/or hip girdle that has lasted for longer than 4 weeks, morning stiffness that lasts longer than 60 minutes and an ESR > 40 mm in the first hour. After the diagnosis is made treatment with prednisone or prednisolone 15 mg per day is started. This dosage is diminished very gradually according to a uniform treatment schedule during a period of 3 months, thereafter depending on the clinical course. The practice guideline pays attention to the diagnosis and management of temporal arteritis only when it occurs concurrently with polymyalgia rheumatica.

摘要

荷兰全科医生学院于2010年2月发布了针对全科医生的风湿性多肌痛和颞动脉炎实践指南。本指南为全科医生提供了风湿性多肌痛的诊断和治疗建议。排除其他疾病后,对于年龄超过50岁、颈部和肩胛带及/或髋部双侧疼痛持续超过4周、晨僵持续超过60分钟且第一小时血沉>40mm的患者,可诊断为“风湿性多肌痛”。确诊后,开始使用泼尼松或泼尼松龙,每日15mg进行治疗。根据统一的治疗方案,在3个月的时间内非常缓慢地减少该剂量,此后根据临床病程调整。该实践指南仅在颞动脉炎与风湿性多肌痛同时发生时关注其诊断和管理。

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