Wallace C A, Sherry D D, Mellins E D, Aiken R P
Department of Pediatrics, University of Washington, Seattle.
J Rheumatol. 1993 Jan;20(1):118-22.
Forty-nine children with a polyarticular course of juvenile rheumatoid arthritis treated with methotrexate (MTX) for at least one year were analyzed to identify clinical characteristics that would predict remission of arthritis after MTX treatment. Twenty-two children (45%) had remission of arthritis after a mean of 13.6 months of treatment and did not differ from the 27 with persistently active arthritis regarding years of disease before starting MTX, age starting MTX, maximum MTX dose, disease onset type, presence of radiographic joint destruction, concomitant treatment with hydroxychloroquine, sulfasalazine or prednisone, or presence of rheumatoid factor or antinuclear antibodies. Higher dose MTX, earlier treatment, genetic markers, and a standardized route of therapy may yield important information in future studies.
对49例接受甲氨蝶呤（MTX）治疗至少一年的多关节型幼年类风湿关节炎患儿进行分析，以确定可预测MTX治疗后关节炎缓解的临床特征。22例患儿（45%）在平均13.6个月的治疗后关节炎缓解，在开始MTX治疗前的病程年数、开始MTX治疗的年龄、MTX最大剂量、疾病起病类型、影像学关节破坏的存在情况、同时使用羟氯喹、柳氮磺胺吡啶或泼尼松治疗、类风湿因子或抗核抗体的存在情况等方面，与27例持续活动性关节炎患儿并无差异。更高剂量的MTX、更早的治疗、遗传标志物以及标准化的治疗途径可能会在未来研究中产生重要信息。
