类风湿关节炎的治疗进展

类风湿关节炎(RA)在全世界约有0.5‰～1%人群受累.随着时间进展,RA由于持续的炎症,关节周围组织受累及关节畸形导致严重的残疾.由于不能治愈,治疗的目的只是控制潜在的炎症过程,维持或改善关节功能.RA的治疗一直是人们研究的热点.随着对RA发病机制的深入研究,20世纪末提出了治疗RA的新策略[1],使许多患者病情得到缓解.除此之外,还有生物治疗以及正在探索中的干细胞移植等.总之,RA的治疗正在不断发展、不断完善.     

类风湿关节炎的诊断与治疗

<正>类风湿关节炎(rheumatoid arthritis,RA)是以对称性多关节炎为主要临床表现的异质性、系统性、自身免疫性疾病。本病呈全球性分布,是造成人类丧失劳动力和致残的主要原因之一。我国RA的患病率略低于0.5%~1%的世界平均水平,为0.32%~0.36%[1]。     

类风湿关节炎的早期诊断及治疗

类风湿关节炎是一种主要累及关节的全身性慢性疾病,女性发病是男性的３倍,类风湿关节炎的患病率为０３％～１５％,成年人发病率为２／万～４／万。由于类风湿关节炎累及的关节是以关节结构进行破坏为形式发展的,随着患病关节数的增加、滑膜容量的增大,对以后的药...     

类风湿关节炎的早期诊断

类风湿关节炎的早期诊断上海光华医院主任医师倪立青类风湿关节炎是一种慢性反复发作的全身性疾病。多发生于青壮年，２０一２５岁发病者占８０％，女性患者为男性的２一３倍。该病的第一次发作多在冬春季节。大约１５％呈急性发作，多数起病缓慢，呈隐袭发病。刘于类风湿...     

类风湿关节炎诊断和治疗的免疫学研究

本文首先从临床免疫学检验的角度以三个层次论述RA的诊断。(1)免疫分子水平的检验:包括RF、6-磷酸葡萄糖异构酶抗原、血清中补体受体2、血浆中hs—CRP、ESR、C3、C4、IgM、IgA、IgG.抗聚丝蛋白抗体谱、滑液蛋白质组的微阵列芯片(2)外周免疫细胞代谢水平的检验:外周血单个核细胞(PBMCs)存在组蛋白H3赖氨酸4三甲基化水平显著改变。(3)细胞因子角度IL-6水平及其基因多态性。再论述以英夫利昔和依那西普对RA的免疫学治疗。本文结论:RA的诊断中应按照ACR标准同时以免疫学指标为参考,免疫学治疗是RA综合治疗的一个不可或缺的手段之一,同时应积极发现对疗效判定具有指示意义的免疫指标,并检测之。     

类风湿关节炎患者的治疗与自我保健

类风湿关节炎是一种慢性全身性疾病,主要侵及各处关节,呈多发性和对称性的慢性关节炎症,同时机体非关节器官或组织亦可受累,发病年龄在25～35岁间,女性比男性多见,其比率约为2:1,本病多见于温带及寒带地区,热带地区较少见.早期表现为受累关节出现疼痛、肿胀、活动困难及晨僵等;晚期症状则为关节畸形和强直、功能丧失等.……     

类风湿关节炎的药物治疗

<正>类风湿关节炎是一种常见的慢性炎性关节疾病,它可见于任何年龄的人,发病高峰在30～50岁。临床表现为多关节炎,主要累及手足小关节,病情迁延反复。类风湿关节炎的病因及发病机理不十分清楚,当前国内外应用的药物尚不能根治类风湿关节炎,但早期、正规治疗能使绝大多数患者病情得到缓解,不致影响日常生     

类风湿关节炎的药物治疗

<正>类风湿关节炎是一种病因不明的自身免疫性疾病,发病人群以中青年女性居多。近年来随着我国进入老龄化社会,老年类风湿关节炎患者也逐渐增多。类风湿关节炎几乎累及人体所有的脏器,而且目前无法根治,因此有"不死的癌症"之说。但只要通过早期积极的治疗,还是可以获得很好的疗效。治     

类风湿关节炎及其止痛治疗

常常会有类风湿关节炎患者提出案例中的问题,类风湿关节炎究竟是一种什么样的疾病?仅仅是一种关节疼痛吗?止痛药物的使用是否是越多越好?使用止痛药时都有哪些注意事项呢?     

类风湿关节炎治疗有新药

俗话说“十老九聋”。可我年过花甲却耳聪目明，半点不聋。事物都有它的两面性，不聋的老人有不聋的烦恼。譬如，早晨7点多钟了，儿子和媳妇还把房门关得紧紧的。儿子小声说：“起床吧，快到上班时间了!”媳妇说：“半年没发工资，上鬼的班，睡!”尽管声音很小，我还是听得清清楚楚。于是，我在客厅的沙发上自言自语地评论起来：“越有的越奔，越没有的越困。”没想到这话像锥子一样锥到儿媳妇身上了，房内马上就有了动静：踢鞋、摔梳子，接着是气呼呼地出门，走出院子，听她扔砖头般地扔来一句：“人老像精怪，越老越变态!”为这，儿媳妇半个月不跟我说话。儿子是个“妻管炎”，有理无理，他同老婆“保持高度的一致”。我叫他管管老婆，他没好气地顶撞道：“我本来在管，还要你多什么嘴，你这是机构重叠，政出多门!”     

类风湿关节炎患者健康管理服务研究进展

类风湿关节炎(rheumatoid arthritis, RA)是一种常见的以关节破坏为特征的慢性炎症性自身免疫病,但在临床实践中,RA患者因缺乏就医条件及合适的健康管理服务,导致治疗达标率低。健康管理是对个体或群体的健康实现全面、全过程的健康保健服务。其中,慢性病健康管理能有效改善慢性病的治疗效果。而整合型卫生服务通过调整服务方式和协同机制,能在不增加或少增加卫生总投入的前提下,有效提高整体的卫生服务效率和服务质量。此文系统梳理国内外RA健康管理服务进展及慢性病整合型卫生服务经验,有望为开展RA患者健康管理提供思路。     

Current management of rheumatoid arthritis

Although rheumatoid arthritis is usually a chronic polyarthritis, it progresses in a wide variety of ways often with organ involvement. It is characterized by periods of exacerbation and remission. Successful management, which must be tailored to individual patients' requirements, involves a multidisciplinary approach coordinated by the physician. Counselling, physiotherapy, occupational therapy, adequate drug therapy and surgery all play a part.     

Current management of rheumatoid arthritis.

Rheumatoid arthritis (RA) is usually a relentlessly progressive disease leading to joint damage and disability. While the long-term value of disease-modifying drugs is still questioned, the quality of life of RA patients has improved, possibly reflecting the earlier more aggressive and multifaceted approach to management and/or the innate attenuation in the disease over recent years.     

Advances in the medical management of rheumatoid arthritis

New treatments, such as leflunomide and biologic therapy, are making an important impact on the management of rheumatoid arthritis. This article reviews the efficacy of these agents, the use of combination therapy, and the importance of early treatment with a disease-modifying antirheumatic drug.     

Case management for patients with rheumatoid arthritis

Mary was in her mid-20s when a long day of shopping made her feet hurt so much that she sought the care of a podiatrist. Radiographs showed no abnormalities in her bones, so it was not until several months later, when her hands became swollen and painful, that she was diagnosed with rheumatoid arthritis (RA) by her primary care physician.     

Atherogenic lipid profiles and its management in patients with rheumatoid arthritis

Cardiovascular morbidity and mortality are enhanced in rheumatoid arthritis, which might be due to an increased prevalence of cardiovascular risk factors such as dyslipidemia. The dyslipidemia observed in RA appears to be dependent on disease activity, ie, a higher disease activity is associated with lower total cholesterol levels and even more depressed high density lipoprotein levels, leading to a higher (ie, unfavorable) atherogenic index. It appears that this dyslipidemia is already present long before the clinical onset of rheumatoid arthritis. Antirheumatic drug treatment with disease modifying antirheumatic drugs as well TNF-blocking agents has, in general, favorable, albeit moderate, effects on the lipid profile. Therefore, it is unlikely that the observed beneficial effects of antirheumatic drug treatment on cardiovascular morbidity and cardiovascular mortality in rheumatoid arthritis is mediated through effects on the lipid metabolism. Management of dyslipidemia in rheumatoid arthritis should be part of a general cardiovascular risk management. Hence, in addition to the assessment of the lipid profile, other cardiovascular risk factors should be determined and appropriate treatment installed when indicated. Lower treatment thresholds should be considered in view of the enhanced cardiovascular risk in rheumatoid arthritis and guidelines should be developed based on epidemiological data.     

Nutritional management of rheumatoid arthritis: a review of the evidence

Rheumatoid arthritis (RA) is a debilitating disease and is associated with increased risk of cardiovascular disease and osteoporosis. Poor nutrient status in RA patients has been reported and some drug therapies, such as nonsteroidal anti‐inflammatory drugs (NSAIDs), prescribed to alleviate RA symptoms, may increase the requirement for some nutrients and reduce their absorption. This paper reviews the scientific evidence for the role of diet and nutrient supplementation in the management of RA, by alleviating symptoms, decreasing progression of the disease or by reducing the reliance on, or combating the side‐effects of, NSAIDs. Supplementation with long‐chain n‐3 polyunsaturated fatty acids (PUFA) consistently demonstrates an improvement in symptoms and a reduction in NSAID usage. Evidence relating to other fatty acids, antioxidants, zinc, iron, folate, other B vitamins, calcium, vitamin D and fluoride are also considered. The present evidence suggests that RA patients should consume a balanced diet rich in long‐chain n‐3 PUFA and antioxidants. More randomized long‐term studies are needed to provide evidence for the benefits of specific nutritional supplementation and to determine optimum intake, particularly for n‐3 PUFA and antioxidants.