2013年风湿免疫病学主要临床进展

被引：13

作者：

郭惠芳

高丽霞

机构：

[1] 河北医科大学第二医院免疫风湿科

来源：

临床荟萃 | 2014年 / 29卷 / 03期

关键词：

风湿性疾病; 关节炎; 生物制剂; 临床方案;

D O I：

暂无

中图分类号：

R593.21 [风湿热];

学科分类号：

100201 [内科学];

摘要：

风湿免疫病学科是内科领域最年轻的学科,但也是发展速度最快的学科之一。每年都有多种疾病治疗指南得到更新。2013年,类风湿关节炎(RA)新的治疗指南仍将传统合成改变病情抗风湿药物(csDMARDs)作为一线治疗方案,不再推荐生物制剂作为一线治疗,而是作为csDMARDs治疗反应不佳的RA患者的二线选择。应用生物制剂治疗前后均应高度重视结核病筛查与预防性治疗。关节超声、磁共振成像检查有助于诊断不典型RA、预测进展型未分化炎症性关节炎、了解疾病活动度、评估预后和治疗反应等。侵蚀性关节炎有了明确定义。部分系统性红斑狼疮(SLE)患者有望接受少或无激素治疗,生物制剂在SLE中的应用也初显端倪。尽管SLE患者预后显著改善,但心血管疾病、抑郁症、骨质疏松和骨折等合并症患病率显著增高。放射学阴性中轴型脊柱关节炎(SpA)概念的提出和系统性硬化病(SSc)分类标准的更新,显著提高了SpA和SSc的早期诊断率。"达标治疗"方案成为高尿酸血症和痛风的目标治疗策略,特别是反复发作的痛风患者血尿酸水平应长期控制在300μmol/L以下。

引用

页码：282 / 286

页数：5

共 11 条

[1]

高尿酸血症和痛风治疗的中国专家共识.[J]..中华内分泌代谢杂志.2013, 11

[2]

肿瘤坏死因子拮抗剂应用中结核病预防与管理专家共识.[J]..中华风湿病学杂志.2013, 08

[3]

Elevated risk of clinical fractures and associated risk factors in patients with systemic lupus erythematosus versus matched controls: a population-based study in the United Kingdom [J].

Bultink, I. E. M. ;

Harvey, N. C. ;

Lalmohamed, A. ;

Cooper, C. ;

Lems, W. F. ;

van Staa, T. P. ;

de Vries, F. .

OSTEOPOROSIS INTERNATIONAL, 2014, 25 (04) :1275-1283

[4]

Familial Risks and Heritability of Rheumatoid Arthritis: Role of Rheumatoid Factor/Anti–Citrullinated Protein Antibody Status; Number and Type of Affected Relatives; Sex; and Age.[J].Thomas Frisell;Marie Holmqvist;Henrik K?llberg;Lars Klareskog;Lars Alfredsson;Johan Askling.Arthritis & Rheumatism.2013, 11

[5]

Long-Term Drug Survival of TNF Inhibitor Therapy in RA Patients: A Systematic Review of European National Drug Registers.[J].Anamika Arora;Anadi Mahajan;Dean Spurden;Helen Boyd;Duncan Porter;Ronald F. van Vollenhoven.International Journal of Rheumatology.2013,

[6]

Vitamin D in Systemic Lupus Erythematosus Modest Association With Disease Activity and the Urine Protein-to-Creatinine Ratio [J].

Petri, Michelle ;

Bello, Kayode J. ;

Fang, Hong ;

Magder, Laurence S. .

ARTHRITIS AND RHEUMATISM, 2013, 65 (07) :1865-1871

[7]

Risk Factors in Cardiovascular Disease in Systemic Lupus Erythematosus [J].

Angelica Sinicato, Nailu ;

da Silva Cardoso, Priscila Aparecida ;

Appenzeller, Simone .

CURRENT CARDIOLOGY REVIEWS, 2013, 9 (01) :15-19

[8]

2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative [J].

van den Hoogen, Frank ;

Khanna, Dinesh ;

Fransen, Jaap ;

Johnson, Sindhu R. ;

Baron, Murray ;

Tyndall, Alan ;

Matucci-Cerinic, Marco ;

Naden, Raymond P. ;

Medsger, Thomas A., Jr. ;

Carreira, Patricia E. ;

Riemekasten, Gabriela ;

Clements, Philip J. ;

Denton, Christopher P. ;

Distler, Oliver ;

Allanore, Yannick ;

Furst, Daniel E. ;

Gabrielli, Armando ;

Mayes, Maureen D. ;

van Laar, Jacob M. ;

Seibold, James R. ;

Czirjak, Laszlo ;

Steen, Virginia D. ;

Inanc, Murat ;

Kowal-Bielecka, Otylia ;

Mueller-Ladner, Ulf ;

Valentini, Gabriele ;

Veale, Douglas J. ;

Vonk, Madelon C. ;

Walker, Ulrich A. ;

Chung, Lorinda ;

Collier, David H. ;

Csuka, Mary Ellen ;

Fessler, Barri J. ;

Guiducci, Serena ;

Herrick, Ariane ;

Hsu, Vivien M. ;

Jimenez, Sergio ;

Kahaleh, Bashar ;

Merkel, Peter A. ;

Sierakowski, Stanislav ;

Silver, Richard M. ;

Simms, Robert W. ;

Varga, John ;

Pope, Janet E. .

ANNALS OF THE RHEUMATIC DISEASES, 2013, 72 (11) :1747-1755

[9]

Biologic and oral disease-modifying antirheumatic drug monotherapy in rheumatoid arthritis [J].

Emery, Paul ;

Sebba, Anthony ;

Huizinga, Tom W. J. .

ANNALS OF THE RHEUMATIC DISEASES, 2013, 72 (12) :1897-1904

[10]

Neuropathic Pain in Ankylosing Spondylitis: A Psychophysics and Brain Imaging Study [J].

Wu, Qi ;

Inman, Robert D. ;

Davis, Karen D. .

ARTHRITIS AND RHEUMATISM, 2013, 65 (06) :1494-1503

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