Departamento de Pediatria, Faculdade de Medicina de Botucatu, Sao Paulo, Brazil.
Clin Exp Rheumatol. 2011 Sep-Oct;29(5):871-7. Epub 2011 Oct 31.
Evaluate damage in oligoarticular JIA, estimating its frequency, risks and probability over time.
A cross-sectional and retrospective analysis of Juvenile Arthritis Damage Index (JADI) scoring, with both articular and extraarticular components, active joint count, disability index by CHAQ and Steinbrocker class, physician's global assessment, child's pain and overall well-being visual analogue scale (VAS), was conducted in patients with oligoarticular JIA. Damage risk factors were estimated by univariate analysis and by generalised linear model. The probability of damage over time was estimated by survival analysis and damage progression rates were calculated by hazard function.
Seventy-five JIA cases were assessed, 89.3% persistent and 10.7% extended oligoarthritis, with median follow-up duration 1.7 years (IQR 1.3-3.1). Damage occurred in 38.7%. JADI-A correlated moderately only with the number of limited joints (rs= 0.50, p<0.0001). Female sex (OR 3.5, 95% CI 1.0-11.6), DMARD use (OR 3.9, 95%CI 1.0-15.0) and knee involvement (OR 4.2, 95%CI 1.3-13.5) were significantly associated with joint damage, whereas only joint steroid injection was associated with extraarticular damage (OR 5.9, 95% CI 1.8-19.3). Damage probability at 5 years was 50% for JADI-A, and 57% for JADI-E. Calculated hazard rates each year were 16.1% and 16.3%, for JADI-A and JADI-E, respectively.
Sex, DMARD use and knee involvement were associated with joint damage, whereas only joint steroid injection was associated with extraarticular damage, which progressed at stable rates over ten years.
评估少关节炎型幼年特发性关节炎（JIA）的损害情况，评估其频率、风险和随时间推移的概率。
对少关节炎型 JIA 患者的少年关节炎损害指数（JADI）评分（包括关节和关节外成分）、活跃关节计数、CHAQ 残疾指数和 Steinbrocker 分级、医生总体评估、患儿疼痛和整体健康状况视觉模拟量表（VAS）进行了横断面和回顾性分析。采用单因素分析和广义线性模型评估损害风险因素。采用生存分析估计随时间的损害概率，并通过危险函数计算损害进展率。
共评估了 75 例 JIA 病例，89.3%为持续性少关节炎，10.7%为扩展型少关节炎，中位随访时间为 1.7 年（IQR 1.3-3.1）。38.7%发生了损害。JADI-A 仅与有限关节数中度相关（rs=0.50，p<0.0001）。女性（OR 3.5，95%CI 1.0-11.6）、DMARD 使用（OR 3.9，95%CI 1.0-15.0）和膝关节受累（OR 4.2，95%CI 1.3-13.5）与关节损害显著相关，而仅关节类固醇注射与关节外损害相关（OR 5.9，95%CI 1.8-19.3）。JADI-A 为 5 年的损害概率为 50%，JADI-E 为 57%。每年的危险率分别为 JADI-A 的 16.1%和 JADI-E 的 16.3%。
性别、DMARD 使用和膝关节受累与关节损害相关，而仅关节类固醇注射与关节外损害相关，10 年内损害进展稳定。
