目的:确定诊断时系统性幼年特发性关节炎(sJIA)病程的潜在预测因子。
方法:这项回顾性观察研究是在2009年4月至2023年10月在我院诊断为sJIA的患者中进行的。sJIA患者病程与人口统计学的关系,临床,分析实验室检查结果和并发症。
结果:在51例诊断为sJIA的患者中,26例(51%)患者患有单环,7(13.7%)多环和18(35.2%)持续性病程。3例(5.8%)患者的病程持续,持续性关节炎在随访期间出现了全身表现的耀斑。关节炎的存在,多关节受累,诊断时髋关节受累与持续病程相关(p=0.009,p=0.003,p=0.003).诊断时浆膜炎和较高的白细胞和中性粒细胞计数与单环疾病病程相关(p=0.034,p=0.002,p=0.008)。然而,巨噬细胞活化综合征(MAS)与病程无显著相关性(p=1)。
结论:患有多关节炎和髋关节受累的系统性JIA患者在发病时可能会发展为持续的病程。虽然MAS是sJIA的重要并发症,在这项研究中没有发现它对病程的影响。
OBJECTIVE: To identify potential predictors of the disease course of systemic juvenile idiopathic arthritis (sJIA) at the time of diagnosis.
METHODS: This retrospective observational study was conducted in patients diagnosed with sJIA in our hospital between April 2009 and October 2023. The relationship between the disease course of sJIA patients and demographic, clinical, laboratory findings and complications were analyzed.
RESULTS: Of the 51 patients diagnosed with sJIA, 26 (51%) patients had monocyclic, 7 (13.7%) polycyclic and 18 (35.2%)
persistent disease course. 3 (5.8%) patients had a
persistent disease course with
persistent arthritis developed flares with systemic manifestations during follow-up. The presence of arthritis, polyarticular involvement, and hip involvement at the time of diagnosis were associated with
persistent disease course (p=0.009, p=0.003, p=0.003). Serositis and higher white blood cell and neutrophil counts at the time of diagnosis were associated with a monocyclic disease course (p=0.034, p=0.002, p=0.008). However, no significant correlation was found between macrophage activation syndrome (MAS) and disease course (p=1).
CONCLUSIONS: Systemic JIA patients with polyarthritis and hip involvement at disease onset may develop a
persistent course. Although MAS is an important complication of sJIA, its effect on the course of the disease was not found in this study.