2013年美国风湿病学会关于幼年特发性关节炎治疗建议(2011年版)更新的解读

摘要

2011年美国风湿病学会(ACR)发表了幼年特发性关节炎(JIA)治疗建议,将其分为5种亚型进行讨论.2013年ACR对该建议进行更新,着重于全身型幼年特发性关节炎(SOJIA)治疗的阐述.根据全身型该亚型的临床表现特点将其分为3个表型,并首次提出具有巨噬细胞活化综合征特征表现的概念.针对全身型亚型的临床表现评分应用不同的治疗方案,并指出该治疗推荐适用于具有一般临床表型的病例,而非罕见表现病例或难治性全身型关节炎患儿.%The American College of Rheumatology (ACR) published treatment recommendations for juvenile idiopathic arthritis (JIA) in 2011.The recommendations meant as a guide to health care providers caring for JIA children with dividing JIA into 5 distinct subtypes.The ACR updated the 2011 recommendations in 2013 and focused on the treatment of systemic-onset juvenile idiopathic arthritis (SOJIA).According to the clinical feature of the SOJIA,the subtybe is developed to 3 phenotypes.And the conception was firstly addressed that systemic JIA with features concerning for macrophage activation syndrome(MAS).Different treatment options was applied for clinical manifestations score,and these recommendations offered guidance for providers caring for children with the most common phenotypes associated with systemic JIA,rather than exceptional cases with unusual disease manifestations or refractory disease.