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[老年类风湿关节炎:10例报告]

[Rheumatoid arthritis in the elderly: ten cases report].

作者信息

Ben Dhaou Besma, Boussema Fatma, Aydi Zohra, Baili Lilia, Kochbati Samir, Rokbani Lilia

机构信息

Hopital Habib Thameur, Tunisie.

出版信息

Tunis Med. 2012 Jun;90(6):442-5.

Abstract

BACKGROUND

The occurrence of rheumatoid arthritis (RA) in elderly is frequent. If the reality of a real difference in clinical presentation between younger and older subjects is discussed, the central point remains that the prognosis is not better for the elderly. Finally, conventional treatment is as effective and safe as in younger patients, and the same stringent targets for management of the PR used for young subjects must be applied in the elderly.

AIM

To identify the characteristics of RA in the elderly in its epidemiological, clinical, radiological, evolutive and therapeutic.

METHODS

We conducted a retrospective study of RA in the elderly aged 65 and over, we've compiled ten cases hospitalized over a period of 4 1/2 years in the service of Internal Medicine, Habib Thameur Hospital (Tunis).

RESULTS

There were 8 women and 2 men. The average age was 70.6 years. The onset of arthritis and the disease was progressive in seven cases. An inflammatory syndrome was present in seven cases. Rheumatoid factor was positive in eight cases. Five patients were classified as stage III and IV according to the radiological classification of Steinbrocker. The treatment was based on painkillers and anti-inflammatory drugs in all cases. Long-term treatment was initiated in seven patients. The outcome was favorable in all cases.

CONCLUSION

Late-onset RA is a heterogeneous framework in which multiple clinical forms deserve to be individualized and should reflect this diversity, rather than approach to the problem of global RA after 60 years.

摘要

背景

老年人中类风湿关节炎(RA)的发病率很高。如果讨论年轻和老年患者在临床表现上是否存在真正差异这一现实问题,核心要点仍然是老年人的预后并不更好。最后,传统治疗与年轻患者一样有效且安全,并且对于老年患者必须应用与年轻患者相同的严格类风湿关节炎管理目标。

目的

确定老年类风湿关节炎在流行病学、临床、放射学、病情演变及治疗方面的特征。

方法

我们对65岁及以上的老年类风湿关节炎患者进行了一项回顾性研究,收集了在突尼斯哈比卜·塔梅尔医院内科4年半期间住院的10例病例。

结果

有8名女性和2名男性。平均年龄为70.6岁。7例患者关节炎及疾病起病呈渐进性。7例患者存在炎症综合征。8例类风湿因子呈阳性。根据斯坦布鲁克放射学分类,5例患者被归类为III期和IV期。所有病例的治疗均基于止痛药和抗炎药。7例患者开始了长期治疗。所有病例的预后均良好。

结论

晚发性类风湿关节炎是一个异质性框架,其中多种临床形式值得个体化,应体现这种多样性,而不是采用60岁后整体类风湿关节炎的处理方法。

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