Long-term outcome in patients with juvenile idiopathic arthritis
Long-term outcome in patients with juvenile idiopathic arthritis
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DOI：
10.1002/art.10444
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发表时间：
2002-09-01
影响因子：
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通讯作者：
Zink, A
中科院分区：
文献类型：
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作者：
Minden, K;Niewerth, M;Zink, A
客观的。描述幼年特发性关节炎 (JIA) 的长期结果。方法。 1978 年至 1988 年间转诊至儿科风湿病中心的所有幼年特发性关节炎患者均经过鉴定并被邀请接受评估。来自东柏林的人群队列中的幼年特发性关节炎患者也被纳入其中。结果评估考虑了身体功能和结构的变化（例如死亡率、关节异常、疾病活动）、个人水平的活动（健康评估问卷）以及社会参与（例如流动性、教育和职业背景）。结果。在 260 名符合条件的患者中，有 215 名 (83%) 接受了评估。发病时的 JIA 亚型包括少关节炎 (40%)、多关节炎 (14%)、系统性关节炎 (14%)、银屑病关节炎 (1%)、附着点炎相关关节炎 (15%) 和其他关节炎 (16%)。中位随访时间为 16.5 年。该队列中没有发生死亡。随访时，大约一半的患者患有活动性疾病和/或不同程度的身体结构变化。大约三分之一的患者认为自己的功能受到限制。患者表现出良好的社会融合：与年龄匹配的人群相比，很少有行动问题的报道，患者的教育成就较高，失业率较低。基于人群的队列和基于转诊的队列之间没有发现结果存在显着差异。结论。尽管大约一半的 JIA 患者在病程超过 15 年后身体功能和/或结构或多或少有明显的变化，但只有不到 10% 的患者严重残疾或残疾。由于幼年特发性关节炎常常持续到成年，因此需要长期随访和护理。
Objective. To describe the long-term outcome of juvenile idiopathic arthritis (JIA).Methods. All patients with JIA referred to a pediatric rheumatology center between 1978 and 1988 were identified and invited to undergo an assessment. Patients with JIA from a population-based cohort from East Berlin were included. The outcome assessment considered changes in body function and structure (e.g., mortality, joint abnormalities, disease activity), activities at the individual level (Health Assessment Questionnaire), and participation in society (e.g., mobility, educational and vocational background).Results. Of 260 eligible patients, 215 (83%) were evaluated. Subtypes of JIA at disease onset included oligoarthritis (40%), polyarthritis (14%), systemic arthritis (14%), psoriatic arthritis (1%), enthesitis-related arthritis (15%), and other arthritis (16%). Followup was conducted after a median of 16.5 years. No deaths occurred in this cohort. At followup, approximately half of the patients had active disease and/or changes in body structures to a variable extent. Approximately one-third of patients rated themselves as being functionally limited. Patients demonstrated good social integration: few mobility problems were reported, and the educational achievements of patients were higher and their rate of unemployment was lower compared with the age-matched population. No significant differences in outcome were found between the population-based and the referral-based cohorts.Conclusion. Even though approximately half of the JIA patients had more or less distinctive changes in body function and/or structure after a disease duration of > 15 years, fewer than 10% were severely disabled or handicapped. Because JIA often persists into adulthood, long-term followup and care are necessary.