Ostring Genevieve Tyra, Singh-Grewal Davinder
Department of Paediatrics, Waitakere Hospital, Auckland, New Zealand; The School of Medicine, Paediatrics, The University of Auckland, Auckland, New Zealand.
J Paediatr Child Health. 2013 Sep;49(9):E405-12. doi: 10.1111/jpc.12218. Epub 2013 May 6.
Juvenile idiopathic arthritis results in significant pain and disability in both children and adults. Advances in treatment resulting in improved long-term outcomes have occurred; however, an emphasis on early and aggressive diagnosis and management hopes to improve outcomes further. Juvenile idiopathic arthritis remains a clinical diagnosis of exclusion, but further research may delineate biological markers associated with the disease and its subtypes. Therapy for patients includes intra-articular steroid injections, disease modifying agents such as methotrexate and biological agents. Biological agents have provided exciting new therapeutic options in the last decade; however, long-term side effects of modulating the immune system are not yet fully understood. Systemic steroids may also be required but their long-term use is avoided. Uveitis needs to be screened for in all of those with the diagnosis. Multidisciplinary team care is required in managing these young people.
青少年特发性关节炎会给儿童和成人带来严重疼痛和残疾。治疗方面已取得进展，长期疗效有所改善；然而，强调早期积极诊断和管理有望进一步改善治疗效果。青少年特发性关节炎仍然是一种排除性临床诊断，但进一步研究可能会明确与该疾病及其亚型相关的生物标志物。患者的治疗方法包括关节内注射类固醇、使用甲氨蝶呤等改善病情的药物以及生物制剂。在过去十年中，生物制剂提供了令人振奋的新治疗选择；然而，调节免疫系统的长期副作用尚未完全明确。可能也需要使用全身性类固醇，但应避免长期使用。所有确诊患者均需筛查葡萄膜炎。管理这些年轻人需要多学科团队护理。
