幼年型类风湿性关节炎的关节外病变及对策

目的：探讨幼年型类风湿性关节炎（JA）关节外病变的临床特点及对策。方法：总结分析我院1997－1999年住院并确诊为JRA的123例病人的关节外表现和对策。男49例，女74例，多关节型32例，少关节型46例，全身型45例。结果：JRA的关节外病变发生的频率依次为：发热86．2％，浅表淋巴结肿大61．6％，贫血61．0％，皮疹45．5％，肝脏肿大22．8％，心脏增大14．6％，心包积液13．8％，中枢神经系统受累5．7％，肺间质病变4．9％，胸腔积液4．1％，少见的关节外症状有小颌畸形2例，眼部损害3例，皮下结节1例。与病情活动性相关的实验室检查指标中血沉、C反应蛋白、血小板多数增高。JRA的系统损害通常为自限性，但可复发，针对这些关节外损害可使用激素，一般在数周或数月内即可减停。结论：临床对JRA的关节外表现应予重视。

Extra-articular pathologic changes of juvenile rheumatoid arthritis

Objective To detect the extra-articular changes of juvenile rheumatoid arthritis (JRA ). Methods One hundred and twenty three cases JRA in-patients were analyzed retrospectively, including 49 male cases, 74 female cases; 32 cases had polyartic-ular-onset disease, 46 cases with hypoarticular-onset disease, 45 cases with systemic-onset disease. Results JRA patients had several extra-articular manifestations including fever (86. 2 %), lymphadenopathy (61. 6 %), anemia(61.0 %), rash(45.5 %), hepatomegaly (22.8 %), hydropericardium (13.8 %) , central nervous involvement (5.7 %) .pulmonary interstitial lesion (4.9 %), thoracic hydrops (4. 1 %), 2 cases with gnathic deformity, 3 cases with ocular damages, 1 case with subcutaneous nodules; the eryhrocyte sedimentation rate,C-reactive protein and platelet, were elevated in the related laboratory indexes of disease activity . The systemic manifestations were generally self-restricted but might recur . The administration of corticosteroid for JRA patients including severe systemic disease , and prednisone was usually discontinued after weeks or months. Conclusion Extra-articular manifestations of JRA patients should be paid special attention in clinical practice.