幼年特发性关节炎229例的诊断和分型

目的了解我国北方地区幼年特发性关节炎（JIA）各型发病比率,对JIA的诊断和分类标准使用提供参考意见。方法对2000年1月-2001年12月本院住院的慢性关节炎患儿,用2004年修订的JIA分类标准进行回顾性分析。结果229例中以JIA分类标准分析诊断成立者196例。JIA 196例中全身型55例（28%）;少关节型21例（10.7%）;多关节型11例（5.6%）,其中类风湿因子（RF）阳性3例,RF阴性8例;与附着点炎性反应相关关节炎（ERA）106例（54%）;未分类3例（1.5%）;未见到银屑病性关节炎,无少关节扩展型。结论我国北方地区JIA全身型、ERA发病比率明显高于国外,而少关节型比率较国外明显降低,多关节型略少于国外。JIA诊断分类标准优于幼年类风湿关节炎。

Diagnostic Criteria and Classification in 229 Children with Juvenile Idiopathic Arthritis

Objective To analyze the patients with chronic arthritis and get the message of the proportion of juvenile rheumatoid arthritis(JIA) in the northern area of our country and provide information for applying the new classification of JIA.Method Retrospective analysis chronic arthritis cases from Jan.2000 to Dec.2001 in hospital by using the separate criteria of JIA revised in 2004.Results There were 196 in 229 cases with chronic arthritis which could be diagnosed as JIA.Subtypes of JIA cases included 55 patients with systemic arthritis(28%);21 patients with oligoarthritis(10.7%);11 patients with polyarthritis(5.6%),consist of 3 patients with rheumatoid factor negative(RF ),8 patients(2.1%) with rheumatoid factor positive(RF-);enthesitis related arthritis(ERA) 106 patients(54%);and undifferentiated arthritis 3 patients(1.5%).No psoriaticarthritis.No extended oligoarthitis.Conclusions The disease incidences of systemic arthritis and ERA are obviously higher in the northern area of our country than that in abroad,and the incidence of oligoarthritis is significant lower,the incidence of polyarthritis is not so many as that in abroad.The definition of JIA is better than juvenile rheumatoid arthritis.