Prieur A M
Unité fonctionnelle de Rheumatologie Pédiatrique, Hôpital des Enfants Malades, Paris, France.
J Rheumatol Suppl. 1993 Apr;37:32-4.
Juvenile chronic arthritis (JCA) is a heterogeneous disease, treated with systemic or local corticosteroid therapy. Systemic corticosteroids are indicated in systemic JCA only when nonsteroidal antiinflammatory drugs have failed or cause side effects or if there is evidence of severe pericarditis. Intravenous pulses of methylprednisolone produce little benefit. Corticosteroid therapy must be tapered slowly, and it may take a long time to reach an alternate day regimen. Side effects are the most worrying problem with daily therapy, particularly growth arrest. Some cases of polyarticular JCA with severe functional impairment and unresponsive to other therapies may benefit from systemic corticosteroids. The most powerful drug for the treatment of joints is triamcinolone hexacetonide, which produces excellent responses in two-thirds of knee joint cases treated. Local corticosteroid therapy is also indicated for chronic iridocyclitis.
青少年慢性关节炎（JCA）是一种异质性疾病，采用全身或局部皮质类固醇疗法进行治疗。全身用皮质类固醇仅在非甾体抗炎药治疗失败或引起副作用，或有严重心包炎证据时才用于全身型JCA。静脉注射甲基强的松龙脉冲疗法收效甚微。皮质类固醇治疗必须缓慢减量，可能需要很长时间才能达到隔日疗法。副作用是每日治疗最令人担忧的问题，尤其是生长停滞。一些多关节型JCA伴有严重功能障碍且对其他治疗无反应的病例，可能会从全身用皮质类固醇治疗中获益。治疗关节最有效的药物是曲安奈德己酸酯，在三分之二接受治疗的膝关节病例中产生了良好的效果。局部皮质类固醇疗法也适用于慢性虹膜睫状体炎。
