Prieur A M
Department of Pediatrics, Hôpital Necker Enfants Malades, Paris, France.
J Rheumatol Suppl. 1993 Apr;37:2-4.
Although pediatric rheumatology became a specialty during the mid 1970s, a number of clinical, research and therapeutic issues still need to be addressed. New entities need to be clearly defined and definite diagnostic criteria established. Research has identified the involvement of cytokines and genetic factors in juvenile chronic arthritis (JCA), while synthetic histone peptides will allow more thorough research into antinuclear antibodies. No satisfactory drug therapy exists for the treatment of chronic rheumatic disease, though the use of local injections of triamcinolone hexacetonide has modified the prognosis of pauciarticular JCA. Joint replacement requires special consideration, as prostheses need to be constructed according to individual requirement. Finally, the psychological impact of JCA must not be underestimated.
尽管小儿风湿病学在20世纪70年代中期成为一门专业学科，但仍有一些临床、研究和治疗问题需要解决。新的病症需要明确定义，并建立明确的诊断标准。研究已经确定细胞因子和遗传因素与青少年慢性关节炎（JCA）有关，而合成组蛋白肽将有助于更深入地研究抗核抗体。尽管使用曲安奈德己酸酯局部注射改善了少关节型JCA的预后，但目前尚无令人满意的药物疗法来治疗慢性风湿性疾病。关节置换需要特别考虑，因为假体需要根据个体需求定制。最后，JCA对心理的影响绝不能被低估。
