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青少年类风湿性关节炎的治疗(作者译)

[Treatment of juvenile rheumatoid arthritis (author's transl)].

作者信息

Casado de Frías E, Valverde Moreno F, López-Ibor B, Elosegui J, Miranda M, Vázquez L

出版信息

An Esp Pediatr. 1981 Jul;15(1):48-62.

PMID:7316291
Abstract

A revision of the treatment of the juvenile chronic arthritis (JCA) is made, Salicylates, still in use, require control of the salicylate level in order to obtain a higher efficiency and to prevent toxicity. New drugs appeared in the last years (by-products of propionic acid, tolmetin acid, fenclofenic...), are useful as an alternative for salicylates and with very little toxicity. Steroid therapy has to be reserved for serious systemic illness only, and slow acting drugs as antimalarials, gold and pencillamine, were only used in those cases with severe persistant activity and in cases of corticosteroid dependents. Use of the immunosuppressive therapy, is justified only in exceptional cases. Immunostimulants (transfer factor, Levamisol) are still in experimental phase. Presentation of the last five years' experience of the Pediatric Department is given. It concerns 25 cases of JCA, 5 systemic forms, 9 polyarticular and 11 forms of pauci-articular. Therapy is based on the predominant use of aspirin and on steroid therapy for the system forms. The efficiency of the treatment is not easy to evaluate regarding consideration of the unpredictable evaluation of the illness.

摘要

对青少年慢性关节炎(JCA)的治疗方法进行了修订。仍在使用的水杨酸盐需要控制水杨酸盐水平,以提高疗效并预防毒性。近年来出现的新药(丙酸衍生物、托美丁酸、氯苯芬酸……)可作为水杨酸盐的替代品,且毒性很小。类固醇疗法仅应保留用于严重的全身性疾病,而抗疟药、金制剂和青霉胺等慢作用药物仅用于那些具有严重持续性活动的病例以及皮质类固醇依赖的病例。免疫抑制疗法仅在特殊情况下才合理。免疫刺激剂(转移因子、左旋咪唑)仍处于实验阶段。介绍了儿科过去五年的经验。涉及25例JCA,5例全身型、9例多关节型和11例少关节型。治疗主要基于阿司匹林的大量使用以及对全身型采用类固醇疗法。考虑到疾病评估的不可预测性,治疗效果不易评估。

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