关节炎,幼年型类风湿

摘要： 目的:总结幼年特发性关节炎(JIA)累及踝关节的MRI表现,分析其与红细胞沉降率(ESR)和C反应蛋白(CRP)的相关性。方法:回顾性分析60例(共60个踝关节)临床确诊为JIA且踝关节受累的患儿,均行MRI平扫及增强扫描。对滑膜增生、关节积液、骨髓水肿、腱鞘炎4个征象进行半定量评价,收集初诊患儿的首次ESR、CRP数据。对踝关节受累的MRI评分与实验室指标行相关性分析。结果:60例中,滑膜增生56例,关节积液54例,骨髓水肿40例,腱鞘炎10例。受累踝关节影像表现以滑膜增生和关节积液为主,骨髓水肿以跟骨、距骨受累为主。滑膜增生、关节积液、骨髓水肿、腱鞘炎的评分标准分别为0~10、0~5、0~24、0~1分。滑膜增生与关节积液评分呈明显正相关(r=0.723,P0.05)。结论:JIA累及踝关节MRI表现为滑膜增生、关节积液、骨髓水肿、腱鞘炎,以滑膜增生、关节积液为主,ESR、CRP是临床反映病情严重程度的指标,MRI对滑膜增生和关节积液评分可间接反映病变严重程度。

摘要： 葡萄膜炎是幼年特发性关节炎最常见的关节外并发症,通常隐匿起病,多为慢性前葡萄膜炎.治疗不及时或不充分可引起多种眼部并发症影响视力,甚至致盲.对于难治性或严重的幼年特发性关节炎相关的葡萄膜炎应及早全身应用免疫抑制剂.虽然甲氨蝶呤是首选药物,但近些年肿瘤坏死因子α抑制剂因其能有效控制炎症、避免眼部并发症发生及减少免疫抑制剂和糖皮质激素的使用等多方面优势,已成为治疗葡萄膜炎的新选择.然而,目前就肿瘤坏死因子α抑制剂应用时机、减量及停药时间及并发症管理等临床问题尚无国际统一的指南规范.深入了解肿瘤坏死因子α印制剂治疗幼年特发性关节炎相关性葡萄膜炎的应用现状及进展具有重要的临床意义.

摘要： 系统性回顾分析17例全身型幼年特发性关节炎并发巨噬细胞活化综合征患儿的临床特点,总结护理经验.护理要点:针对性地加强巡视,先于实验室诊断报告确诊前识别疾病进展的特异性临床表现,协助医生预见性判断并采取紧急治疗措施;做好重症患儿急救护理挽救患儿生命;血浆置换清除细胞因子、炎症介质、血浆内毒素;做好用药护理及时处理不良反应.本组病例全部好转出院,目前门诊随访病情稳定.

摘要： 目的 研究全身型幼年特发性关节炎(SoJIA)合并肺间质病变(ILD)的临床特征及预后.方法 收集2010年10月至2019年12月期间温州医科大学附属第二医院儿童风湿科住院确诊SoJIA患儿75例,分析SoJIA合并ILD的临床表现、影像学特征及预后.结果 75例SoJIA中合并ILD 12例(占16％),其中男性6例,女性6例,平均发病年龄(7.9±2.6)岁.12例均有发热,伴关节炎10例,以大关节多见,按发生率高到低依次为膝、髋、肩关节;起病初无关节受累2例,随访过程中一直无关节症状出现.同时具备发热、皮疹、关节炎三联征9例(75％).ILD相关的临床表现大多数为非特异性表现,其中咳嗽8例(75％),呼吸急促7例(58％),胸痛3例(25％),肺部查体闻及爆裂音4例(33％),肺动脉高压1例(8％).实验室检查炎性指标均明显升高,其中CRP为(235±112) mg/L,ESR为(39±25) mm/1 h,血清铁蛋白(SF)为(1312±384)ng/ml,血清淀粉样蛋白A(SAA)为(212±101) mg/L.胸部高分辨率CT(HRCT)表现为网状/线状影12例,实变影7例,小叶间隔增厚5例,磨玻璃影4例,蜂窝状1例.ILD发生在SoJIA早期(病程≤6个月)的4例(占33％),出现在病程中晚期(＞6个月)的8例(占67％),但均出现在SoJIA的活动期.12例全部应用糖皮质激素治疗,大剂量激素(＞1 mg·kg-1·d-1)为11例,其中行甲泼尼龙针冲击治疗2例.均同时应用慢作用抗风湿药或免疫抑制剂治疗,同时需使用两联以上的5例(42％).肺损害发生前曾使用过生物制剂的1例,其余11例之前未使用过生物制剂,在诊断SoJIA合并ILD后有4例应用托珠单抗.12例患儿中合并巨噬细胞活化综合征(MAS)7例,发生2次及以上MAS占25％.完全缓解或部分缓解10例,死亡2例,死因均为呼吸衰竭.结论 SoJIA合并ILD起病隐匿,与原发疾病活动状态有关,HRCT对早期诊断非常重要.治疗中病情容易反复,容易合并MAS,死亡率高,需引起广大临床医师的高度重视.

摘要： 目的 分析全身型幼年特发性关节炎(SOJIA)合并巨噬细胞活化综合征(MAS)患儿细胞因子谱,探讨其在早期诊断MAS中的临床意义.方法 回顾性分析浙江省台州医院2013年1月至2018年3月157例SOJIA患儿的临床资料,其中合并MAS 15例(SOJIA合并MAS组),未合并MAS 142例(单纯SOJIA组).采用流式细胞微球芯片技术检测患儿外周血白细胞介素(IL)-2、IL-4、IL-6、肿瘤坏死因子(TNF)-α和干扰素(IFN)-γ.分析MAS患儿细胞因子谱的特点.结果 SOJIA合并MAS组IL-10和IFN-γ明显高于单纯SOJIA组[40.5 (7.9,236.9) ng/L比4.1(2.0,98.7)ng/L和55.8(18.5,500.0)ng/L比4.4(1.4,30.1)ng/L],差异有统计学意义(P＜0.01);两组IL-2、IL-4、IL-6和TNF-α比较差异无统计学意义(P＞0.05).Pearson相关性分析结果显示,SOJIA合并MAS患儿IL-10与IFN-γ呈正相关(r=0.638,P=0.011).受试者工作特征曲线分析结果显示,IFN-γ预测MAS的曲线下面积(AUC)为0.991,95％ CI0.974～ 1.000,最佳临界值18.45 ng/L,灵敏度为92.5％,特异度为95.1％;IL-10预测MAS的AUC为0.944,95％ CI0.893～ 0.996,最佳临界值7.75 ng/L,灵敏度为91.7％,特异度为81.7％.结论 SOJIA患儿IL-10和IFN-γ明显升高有助于MAS的早期诊断.

摘要： 目的 研究全身型幼年特发性关节炎(SoJIA)的临床表现、实验室检查特征和诊断及治疗措施.方法 选取苏州大学附属儿童医院从2011年4月至2016年12月住院确诊的66例SoJIA病儿作为所研究的对象,对其发病特点、临床特征与辅助检查、治疗方法等方面展开研究与分析.结果 JIA病儿无特异性的临床表现,所有病儿均有发热,2/3以上的病儿可出现关节炎及皮疹症状.JIA无特殊的辅助检查手段,炎性因子的升高如C反应蛋白、血沉,免疫球蛋白、铁蛋白、D?二聚体等可有不同程度异常.大多数病儿经过初始治疗后,症状能够得到有效的控制,部分病儿病情可出现反复,需采用免疫抑制剂或生物制剂治疗;8例确诊巨噬细胞活化综合征(MAS)的病儿均采取个体化的治疗方案,1例病儿死亡,其余病儿症状均缓解.结论 SoJIA若是呈现持续发热不退或热退后复起、肝功能异常、多个系统的损伤以及血清铁蛋白明显升高时要考虑MAS的可能,早期诊断、积极的联合治疗,是降低MAS死亡率的重要措施.

摘要： 目的 探讨幼年特发性关节炎(JIA)患儿的心理社会功能及相关危险因素.方法 选取2017年2月至12月在空军军医大学第一附属医院临床免疫科就诊及住院的79例JIA患儿进行量表测评.其中,患儿的人口统计学资料、疾病资料采用自行设计的问卷收集,疾病活动度采用JA-DAS-27进行测评;疼痛程度采用视觉模拟量表(VAS)进行测评;心理社会功能采用“儿童抑郁量表(CDI)”和“儿童多维焦虑量表(MASC)”进行测评,所有的统计资料采用SPSS 17.0软件完成.结果 共回收患儿人口统计学问卷、疾病资料问卷、CDI和MASC有效问卷各79份,合计316份.患儿CDI总分(15.22±9.56)分,其中,快感缺乏维度[(4.57±3.63)分]分值最高,低自尊维度[(1.75±1.57)分]分值最低;MASC总分为(39.15±21.12)分,其中,伤害逃避维度[(13.09±5.57)分]分值最高,分离焦虑维度[(7.68±5.66)分]分值最低.多元线性逐步回归分析筛选疼痛程度、疾病活动度、激素副作用以及疲劳程度4个因素是影响JIA患儿心理社会功能的主要因素.结论 JIA患儿的心理社会功能不令人满意,提示在临床诊疗过程中除了加强药物治疗积极诱导缓解病情外,还应尽早采取心理干预等联合治疗.%Objective To investigate the psychosocial functioning and risk factors of children with juvenile idiopathic arthritis (JIA).Methods A total of 79 children with JIA were selected from the inpatients and outpatients in the department of clinical immunology,a top-grade hospital in Xi'an from February to December,2017.Their demographic and disease data were collected by self-designed questionnaires.Disease remission was confirmed by using the JADAS-27 and pain intensity by visual analogue scale (VAS).The Children's Depression Inventory (CDI) and Multidimensional Anxiety Scale for Children (MASC) were rated by the children themselves.All data were analyzed with SPSS 17.0.Results A total of 316 effective questionnaires were collected,including 79 demographic questionnaires,disease questionnaires,CDI and MASC respectively.(1) The total scores of CDI were 15.22 ± 9.56.The highest scores were found for the subscale of "lack of happiness" (4.57 ± 3.63),while the lowest for the subscale of "low self-esteem" (1.75 ± 1.57).The total scores of MASC were 39.15 ±21.12.The highest scores were found for the subscale of "Injury avoidance" (13.09 ± 5.57) while the lowest for the subscale of "separation anxiety" (7.68 ± 5.66).(2) Multiple stepwise linear regression analysis showed that pain,disease activity,hormonal side effects and fatigue were the main risk factors of the psychosocial functioning of the children with JIA.Conclusions The psychosocial functioning of children with JIA was not satisfied.It suggested that we should not only take the appropriate clinical treatment to control the disease but also take combined therapy such as psychological intervention as early as possible.

摘要： Objective To compare the positive rate of anti-mutant citrulline vimentin (MCV) antibody and anti-cyclic citrullinated peptide (CCP) antibody in serum of patients with rheumatoid arthritis (RA) and juvenile idiopathic arthritis (JIA).To investigate the diagnostic value and significance of anti-MCV and antiCCP antibody in these two diseases.Methods Anti-CCP and anti-MCV antibodies were detected by enzymelinked immunosorbent assay (ELISA).The serum samples were from 113 patients with JIA,632 patients with RA,102 adult without RA and 56 children without RA.Chi-square test and multiple comparisons were used for statistical analysis.Results ① In RA patients,the sensitivity,specificity and area under the receiver operating characteristic curve (ROC curve) of anti-MCV antibody was 90.2％,91.2％,0.919;the sensitivity,specificity and area under the ROC curve of anti-CCP antibody was 92.6％,93.1％ and 0.934.In JIA,the specificity of antibodies was 98.2％,the sensitivity was low.Area under the ROC curve of anti-MCV antibody was 0.579.Area under the ROC curve of anti-CCP antibody was 0.561.② The positive rate of anti-MCV antibody in RA was 90.2％,which was higher than that of JIA (16.8％) (P＜0.01).The positive rate of anti-CCP antibody in RA was 92.2％,which was higher than that of JIA (14.2％) (P＜0.01).The positive rates of antiMCV antibody in JIA with RF-negative polyarthrosis,RF-positive polyarthrosis,systemic type,oligo-joint type,attachment points,unclassified was 11.8％,69.2％,14.3％,17.4％,3.6％,0.The positive rate of anti-CCP was 11.8％,61.5％,14.3％,13.0％,0 and 0 prespectively.For anti-MCV antibody,the chi-square values in patients with RA between RF-negative polyarthrosis,RF-positive olyarthrosis,systemic type,oligo-joint type,attachment points,unclassified arthritis were 160.2,4.02,34.4,102.0,165.1 and 57.0 respectively.There were significant differences between RA and all types of JIA (P＜0.05).The positive rate of anti-CCP antibody in patients with RA between RF-negative polyarthrosis,RF-positive polyarthrosis,systemic type,iligo-joint type,attachment points,unclassified arthritis were 192.3,11.9,44.0,139.4,212.5 and 71.9.There were significant differences between RA and all types of JIA (P＜0.05).Conclusion The diagnostic value of anti-MCV and anti-CCP antibodies is high in RA.Anti-MCV and anti-CCP antibody have certain diagnostic value of JIA.The positive rates of anti-MCV and anti-CCP antibody in the types in JIA are lower than those of RA patients.%目的 比较分析RA和幼年特发性关节炎(JIA)患者血清中抗突变型瓜氨酸波形蛋白(MCV)抗体、抗CCP抗体阳性率,探讨抗MCV抗体及抗CCP抗体对2种疾病的诊断价值.方法 收集632例RA患者、113例JIA患儿、102例其他成人风湿病患者及56例非JIA患儿临床及实验室资料.采用ELISA法检测抗MCV抗体、抗CCP抗体.采用x2检验、多重比较进行统计学分析.结果 ①在RA患者中,抗MCV抗体的敏感度、特异度、受试者工作特征曲线(ROC)曲线下面积分别为90.2％、91.2％、0.919;抗CCP抗体的敏感度、特异度、ROC曲线下面积分别为92.6％、93.1％、0.934.在JIA患儿中,2种抗体的特异度均为98.2％,敏感度均较低;抗MCV抗体ROC曲线下面积为0.579,抗CCP抗体ROC曲线下面积为0.561.②抗MCV抗体在RA患者中的阳性率为90.2％,高于JIA患儿(16.8％)(P＜0.01);抗CCP抗体在RA患者中的阳性率为92.2％,高于JIA患儿(14.2％)(P＜0.01).③JIA患儿中,抗MCV抗体在RF阴性多关节型阳性率为11.8％,RF阳性多关节型为69.2％,全身型为14.3％,少关节型为17.4％,附着点炎相关型为3.6％,未分类为0％.抗CCP抗体在RF阴性多关节型阳性率为11.8％,RF阳性多关节型为61.5％,全身型为14.3％,少关节型为13.0％,附着点炎相关型为0,未分类为0.在抗MCV抗体中,RA患者与RF阴性多关节型JIA患儿间(x2=160.2),与RF阳性多关节型间(x2=4.02),与全身型间(x2=34.4),与少关节型间(x2=102.0),与附着点相关型间(x2=165.1),与未分类间(x2=57.0)比较差异均有统计学意义(P＜0.05).在抗CCP抗体中,RA患者与RF阴性多关节型JIA患儿间(x2=192.3),与RF阳性多关节型间(x2=1 1.9),与全身型间(x2=44.0),与少关节型间(x2=139.4),与附着点相关型间(x2=212.5),与未分类间(x2=71.9)比较差异均有统计学意义(P＜0.05).结论 抗MCV抗体、抗CCP抗体对RA的诊断价值较高,对JIA具有一定的诊断价值.抗MCV抗体、抗CCP抗体在各型JIA患儿中阳性率均低于RA患者.

摘要： 目的 2016年EULAR/ACR/儿童风湿病国际试验组织(PRITO)联合提出了全身型幼年特发性关节炎(sJIA)合并巨噬细胞活化综合征(MAS)新的分类标准,由于AOSD和sJIA的发病机制和临床表现类似,本研究旨在了解这一分类标准在评估AOSD合并MAS的临床价值.方法 本研究采集了169例在上海交通大学医学院附属仁济医院住院治疗的AOSD患者.使用2016年sJIA合并MAS分类标准将AOSD患者分为AOSD合并MAS及AOSD无MAS组,使用x2检验、Mann-Whitney U检验、二元Logistic分析比较2组患者之间的临床特点差异,使用Kaplan-Meier和COX回归分析影响2组患者预后的因素.结果 根据sJIA合并MAS分类标准,169例AOSD患者中共有56例(33.1％)合并MAS.AOSD合并MAS患者中脾脏肿大及心包炎/心肌炎的发生率高于AOSD无MAS的患者[42.9％与14.2％,OR值(95％CI)为4.50(2.13,9.51),P＜0.01;10.7％与0.9％,OR值(95％CI)为13.21(1.56,113.57),P＜0.01],肝损害的发生率更高[67.8％与11.5％,OR值(95％CI)为0.18(7.26,36.33),P＜0.01].AOSD合并MAS患者中有62.5％(35/56)接受了大剂量激素,5.4％ (3/56)接受了激素冲击治疗,48.2％(27/56)使用了静脉丙种球蛋白,26.8％(15/56)使用了钙调磷酸酶抑制剂.AOSD合并MAS患者病死率高达8.9％(5/56),显著高于AOSD无MAS患者的1.8％(2/113)(OR=5.44,P＜0.05),满足sJIA合并MAS分类标准提示预后不良(OR=5.44,P=0.041),且血小板计数≤181×109/L(OR=12.17,P=0.002),ALT＞48 U/L(OR=9.43,P=0.040)高度提示AOSD患者预后不良.结论 sJIA合并MAS分类标准有助于早期识别危重AOSD患者,提示MAS诊断,而且简便易行,适于临床使用.AOSD患者中符合sJIA合并MAS分类标准的患者病情更加严重,需要更大剂量的糖皮质激素和更积极的免疫抑制治疗,这类患者预后较差.%Objective In 2016,European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR)/Pediatric rheumatology international trials organization (PRINTO) released the classification criteria for macrophage activation syndrome (MAS) in patients with systemic juvenile idiopathic arthritis (sJIA).Due to the similarities of both clinical manifestations and pathogenesis between adult-onset Still dsease (AOSD) and sJIA,we hope to evaluate the 2016 sJIA-AMS classification in AOSD patients.Methods A total of 169 AOSD patients who were hospitalized in Renji Hospital were enrolled in this study.AOSD patients were divided into AOSD with MAS and AOSD without MAS,using the 2016 sJIA-MAS criteria.The data of the two groups were analyzed by Chi-square test,Mann-Whitney U test and binary Logistic analysis,and factors influencing the prognosis of patients were analyzed by Kaplan-Meier and COX regression analysis.Results According to sJIA-MAS criteria,56 AOSD patients with MAS were identified in all the 169 AOSD cases.In AOSD patients,the incidence of splenomegaly and pericarditis/myocarditis was significantly higher in patients with MAS than in AOSD without MAS [42.9％ vs 14.2％,OR(95％CI)=4.50(2.13,9.51),P＜0.01;10.7％ vs 0.9％,OR(95％CI)=13.21 (1.56,113.57),P＜0.01],also the incidence of liver dysfunction was higher in AOSD with MAS [67.8％ vs 11.5％,OR(95％CI)=0.18(7.26,36.33),P＜0.01].Among the AOSD with MAS,62.5％(35/56) of these patients received large-dose glucocorticoid therapy,5.4％ (3/56) received the glucocorticoid pulse therapy,48.2％(27/56) were treated with IVIG,and 26.8％(15/56) were treated with calcium phosphatase inhibitors.The mortality rates of AOSD with MAS was 8.9％(5/56),which was significantly higher than 1.8％(2/113) (OR =5.44,P＜0.05),the mortality rate of the AOSD without MAS.Patients who fulfilled the sJIA-MAS criteria suggested poor prognosis (OR=0.041,P=5.44),and the platelet count ≤ 181× 109/L (OR=12.17,P=0.002),alanine aminotransferase ＞48 U/L (OR=9.43,P=9.040) were also highly suggestive of poor prognosis.Conclusion The 2016 sJIA-MAS classification criteria are particularly valuable for early recognization of MAS in AOSD patients,and convenient to use.AOSD patients fulfilled sJIA-MAS criteria are more severe,and require larger doses of glucocorticoid and more immunosuppression therapy compared to patients without MAS,and the prognosis of these patients is also poor.

摘要： Objective To explore the expression of inflammasomes (NLRP3,NLRP12) and related signal proteins in the peripheral blood mononuclear cells (PBMCs) of patients with juvenile idiopathic arthritis (JIA).Methods Samples of children with definite diagnosis of active JIA in Guangzhou Women and Childrens' Medical Center were collected retrospectively.Fifty-five cases were included,among whom 30 were systemic type and 25 were joint type.Blood samples of 22 healthy controls were collected at the same time.Peripheral blood single nuclear cell (PBMCs) were separated and DNA were extracted and reverse transcription (RT) to cDNA.Fluorescent quantitative polymerase chain reaction (PCR) was used to detect NLRP3,NLRP12,ASC,and capase-1 in groups and the difference in their expression between groups were analyzed.Enzyme linked immunosorbent assay (ELISA) was utilized to test plasma levels of interleukin (IL)-6 IL-1,IL-4,IL-10,and their correlation were analyzed.Results The expression of NLRP3,NLRP12,ASC,Capase-1 in the case group (general-group and joint-group) were higher than those in the control group (P＜0.05),but there was no significant difference in the expression levels between groups (P＞0.05).The IL-1 concentration of the case group (body-type group,joint-group) was higher than the control group (P=0.001,U=l) (P=0.001,U=14),however,the level of IL-4 of the case group (body-type group,joint-group) was not significantly different from the control group (U=662,P=0.13) (U=823,P=0.535),IL-I0 of the systemic group was higher than that of the control group (U=750,P=0.023),while there was no difference between groups (U=672,P=0.212).There were no significant difference in the levels of IL-1 (U=658,P=0.408),IL-4 (U=475,P=0.068),IL-10 (U=475,P=0.195) between groups.The NLRP3 mRNA relative expression levels of the case group and the ASC (r=0.44,P=0.013 4) was significant,in addition,IL-1 (P=0.001,R=0.58),erythrocyte sedimentation rate (ESR) (r=0.415,P=0.039),C reactive protein (CRP) (r=0.438,P=0.046) were positively correlated with NLRP12 relative mRNA expression level and ASC (r=0.583 7,P=0.007),CRP (r=0.46,P=0.031 6),ESR (r=0.003,P=0.56),CD8+ T (r=0.414,P=0.036).Conclusion The abnormal expression of JIA inflammasomes in peripheral blood mononuclear cells (NLRP3,NLRP12) may be associated with juvenile idiopathic arthritis.%目的 探究炎症小体(NLRP3、NLRP12)及相关信号蛋白在幼年特发性关节炎(JIA)PBMCs中的表达分析.方法 分别采集在广州市妇女儿童医疗中心确诊的55例活动期JIA患儿(病例组:全身型组30例,关节型组25例);健康对照组22名外周血标本,分离PBMCs及血清,提取并逆转录为cDNA;荧光定量PCR检测NLRP3、NLRP 12、凋亡相关斑点样蛋白(ASC)、capase-1组间表达差异,计算标准化后的2-ΔΔt值,EHSA法检测血浆IL-1、IL-4、IL-10表达,组间比较用非参数检验(Kruskal-Wallis检验),NLRP3、NLRP12与ASC、IL-1、II4、IL-10,T细胞、B细胞NK细胞绝对计数用Pearson法进行相关性分析.结果 NLRP3、NLRP12、ASC、Capase-1在病例组(全身型组和关节型组)均较对照组高表达(P＜0.05),病例组组间表达水平差异无统计学意义(P＞0.05).病例组(全身型组、关节型组)IL-1浓度较对照组高(U=1,P=0.001)(U=14,P=0.001);病例组(全身型组、关节型组)IL-4浓度与对照组差异无统计学意义(U=662,P=0.13) (U=823,P=0.535),全身型组IL-10浓度较对照组升高(U=750,P=0.023),而关节型组差异则无统计学意义(U=672,P=0.212);全身型组与关节型组IL-1(U=658,P=0.408),IL-4(U=475,P=0.068),IL-10(U=475,P=0.195)差异无统计学意义.病例组NLRP3 mRNA相对表达量与ASC(r=0.44,P=0.013 4)、IL-1(r =0.58,P=0.001)、ESR (r=0.415,P=0.039)、CRP(r =0.438,P=0.046)呈正相关,病例组NLRP12 mRNA相对表达量与ASC(r=0.5 837,P=0.007)、CRP(r=0.46,P=0.031 6)、ESR(r=0.003,P=0.56)、CD8+T(r=0.414,P=0.036)呈正相关.结论 JIA PBMCs炎症小体(NLRP3、NLRP12)异常表达可能与幼年特发性关节炎急性炎症有关,炎症小体或许能成为JIA新的治疗靶标.

摘要： 本发明涉及一种治疗幼年型类风湿性关节炎的中药，由以下重量配比的药材制备而成：阿利藤3份、灯盏细辛4份、土千年健0.5份、沙冬青1份、地血香4份、紫荆皮2份、透骨香5份、胃友4份、鹿藿0.5份、丝棉木1份、虎掌草3份、鸢尾4份、桂花跌打0.5份、半截叶2份、琴叶榕1.5份、七角白蔹3份、马尿烧1份、蒙自木蓝25份、柘树茎叶13份、捆仙丝25份、鞭打绣球0.3份、五香血藤15份、果上叶5份、黄花远志1份、走游草3份、银线草1份。临床实验证明，本发明能够安全有效治疗幼年型类风湿性关节炎。

摘要： 本发明涉及新型的类风湿性关节炎的检查方法、及用于该检查方法的类风湿性关节炎检查用试剂盒。本发明涉及的类风湿性关节炎的检查方法的特征在于，包括测定受试动物的血浆中或血清中的踝蛋白量的步骤。该测定例如可利用使用了与踝蛋白结合的抗体的免疫学手段进行。本发明涉及的类风湿性关节炎检查用试剂盒用于在上述检查方法中使用，例如，包含固定有与踝蛋白结合的抗体的固相载体。

摘要： 本发明涉及一种治疗风湿性关节炎和类风湿性关节炎的风湿祛痛药物及制备方法。①取苍术、威灵仙和姜黄、独活、羌活分别蒸馏提取挥发油；②苍术、威灵仙的药渣与红花加水煎煮提取；③将姜黄、独活、羌活的药渣与黄柏、鸡血藤加水煎煮提取；④药渣乙醇提取；⑤将步骤②和步骤③中的滤液加入步骤①蒸馏后的水溶液，浓缩至浸膏，备用；⑥蜂房、乳香（炒）加入乙醇提取，浓缩至稠膏状；⑦金钱白花蛇、蕲蛇、乌梢蛇、土鳖虫、没药（炒）、全蝎、蜈蚣、地龙、桂枝九味原料药粉碎，过筛，备用；将步骤④、⑤、⑥所得稠膏合并，取步骤⑦生药粉干混，再加入上述浸膏湿混，混匀，制成颗粒，喷入挥发油，闷润，分装，即得。具有有效成分的提取率增高的特点。

摘要： 本发明提供没有副作用、能够使类风湿性关节炎的免疫异常正常化的类风湿性关节炎抑制剂、预防剂及治疗剂。本发明是作为有效成分含有来自于裸藻的物质的类风湿性关节炎抑制剂、预防剂或治疗剂。可以作为通过改善类风湿性关节炎的免疫异常来控制类风湿性关节炎的活动性的抗风湿药使用。另外，可以用于没有接受类风湿性关节炎的确诊的生物体用途。可以从类风湿性关节炎的确诊前到接受确诊后的任意的时间点，对生物体持续施用。来自于裸藻的物质是选自裸藻的藻体、来自于所述裸藻的裸藻淀粉、对该裸藻淀粉实施碱处理及中和处理而得的水溶性的非晶裸藻淀粉、以及实施以超高压使所述裸藻淀粉水溶液从细孔喷嘴中喷出后与被碰撞物碰撞的处理而得的乳液裸藻淀粉中的至少一种物质。

摘要： 本发明涉及一种治疗幼年型类风湿性关节炎的中药，由以下重量配比的药材制备而成：阿利藤3份、灯盏细辛4份、土千年健0.5份、沙冬青1份、地血香4份、紫荆皮2份、透骨香5份、胃友4份、鹿藿0.5份、丝棉木1份、虎掌草3份、鸢尾4份、桂花跌打0.5份、半截叶2份、琴叶榕1.5份、七角白蔹3份、马尿烧1份、蒙自木蓝25份、柘树茎叶13份、捆仙丝25份、鞭打绣球0.3份、五香血藤15份、果上叶5份、黄花远志1份、走游草3份、银线草1份。临床实验证明，本发明能够安全有效治疗幼年型类风湿性关节炎。

摘要： 本发明公开了二亚苯基碘鎓氯化物用于类风湿关节炎模型造模的用途、类风湿关节炎模型造模方法。本发明发现，二亚苯基碘鎓氯化物可以有效提高类风湿关节炎模型的诱导效率，Ⅱ型胶原诱导1次结合二亚苯基碘鎓氯化物增强对模型鼠的类风湿关节炎的诱导效率显著优于传统Ⅱ型胶原诱导多次。本领域技术人员知道，二亚苯基碘鎓氯化物NADPH氧化酶的抑制剂，可以通过抑制电子传递和活性氧产生发挥抗炎作用。而在本发明中，二亚苯基碘鎓氯化物发挥的作用是强化类风湿关节炎，这种技术效果是让本领域技术人员意料不到的。

摘要： 本发明涉及新型的类风湿性关节炎的检查方法、及用于该检查方法的类风湿性关节炎检查用试剂盒。本发明涉及的类风湿性关节炎的检查方法的特征在于，包括测定受试动物的血浆中或血清中的踝蛋白量的步骤。该测定例如可利用使用了与踝蛋白结合的抗体的免疫学手段进行。本发明涉及的类风湿性关节炎检查用试剂盒用于在上述检查方法中使用，例如，包含固定有与踝蛋白结合的抗体的固相载体。

摘要： 本发明涉及一种治疗风湿性关节炎和类风湿性关节炎的风湿祛痛药物及制备方法。①取苍术、威灵仙和姜黄、独活、羌活分别蒸馏提取挥发油；②苍术、威灵仙的药渣与红花加水煎煮提取；③将姜黄、独活、羌活的药渣与黄柏、鸡血藤加水煎煮提取；④药渣乙醇提取；⑤将步骤②和步骤③中的滤液加入步骤①蒸馏后的水溶液，浓缩至浸膏，备用；⑥蜂房、乳香（炒）加入乙醇提取，浓缩至稠膏状；⑦金钱白花蛇、蕲蛇、乌梢蛇、土鳖虫、没药（炒）、全蝎、蜈蚣、地龙、桂枝九味原料药粉碎，过筛，备用；将步骤④、⑤、⑥所得稠膏合并，取步骤⑦生药粉干混，再加入上述浸膏湿混，混匀，制成颗粒，喷入挥发油，闷润，分装，即得。具有有效成分的提取率增高的特点。

摘要： 本发明涉及一种治疗风湿性关节炎和类风湿性关节炎的风湿祛痛药物及制备方法。①取苍术、威灵仙和姜黄、独活、羌活分别蒸馏提取挥发油；②苍术、威灵仙的药渣与红花加水煎煮提取；③将姜黄、独活、羌活的药渣与黄柏、鸡血藤加水煎煮提取；④药渣乙醇提取；⑤将步骤②和步骤③中的滤液加入步骤①蒸馏后的水溶液，浓缩至浸膏，备用；⑥蜂房、乳香（炒）加入乙醇提取，浓缩至稠膏状；⑦金钱白花蛇、蕲蛇、乌梢蛇、土鳖虫、没药（炒）、全蝎、蜈蚣、地龙、桂枝九味原料药粉碎，过筛，备用；将步骤④、⑤、⑥所得稠膏合并，取步骤⑦生药粉干混，再加入上述浸膏湿混，混匀，制成颗粒，喷入挥发油，闷润，分装，即得。具有有效成分的提取率增高的特点。

摘要： 本发明涉及一种中药制剂，即一种治疗风湿性关节炎、类风湿性关节炎的抗风湿药酒及制备方法。它由青风藤、海风藤、穿山龙、狗脊、郁金原料制成。具有祛风湿、通络止痛、止咳平喘、强筋骨之功效，其工艺为：精选药物、除去杂质、药物浸泡、过滤、蒸馏、静置沉降、精滤、成品灌装。组方从人体整体出发，采用辩证施治，本着标本兼治的原则，且药借酒力增强药物疗效。与现有治疗风湿性关节炎、类风湿性关节炎的药物相比，具有疗程短、见效快、治愈率高、不易复发、无副作用且价格低的特点，因是酒剂服用方便、患者易接受，对上述疾病的预防、治疗及预防复发具显著优势。