老年发病的类风湿关节炎诊治进展
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摘要
<正>类风湿关节炎(rheumatoid arthritis,RA)是一种病因不明的慢性、进行性、全身炎症性疾病,全球患病率约为0.3%～1.2%[1]。根据患者的发病年龄可将该病分为2类:一类是老年发病的类风湿关节炎(elderly-onset rheumatoid arthritis,EORA),即60岁及以上发病的RA;另一类是年轻起病的类风湿关节炎(younger-onset rheumatoid arthritis,YORA),指在60岁以前的青壮年时期发病的RA。2者在临床表现、实验室检查、治疗方法及预后等方面都有所不同[2]。随着社会的老龄化,EORA的发病越来越多,在
引文
[1]Kourilovitch M,Galarza-Maldonado C,Ortiz-Prado E.Diagnosis and classification of rheumatoid arthritis[J].J Autoimmun,2014,48-49:26-30.
[2]Soubrier M,Mathieu S,Payet S,et al.Elderly-onset rheumatoid arthritis[J].Joint Bone Spine,2010,77(4):290-296.
[3]Rasch EK,Hirsch R,Paulose-Ram R,et al.Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States:effect of different methods of case classification[J].Arthritis Rheum,2003,48(4):917-926.
[4]Horiuchi AC,Pereira LHC,Kahlow BS,et al.Rheumatoid arthritis in elderly and young patients[J].Rev Bras Reumatol Engl Ed,2017,57(5):491-494.
[5]栗占国,张奉春,鲍春德.类风湿关节炎[M].北京:人民卫生出版社,2009:99.
[6]周武威,黄坚毅.老年发病的类风湿关节炎患者的临床特点分析[J].中国继续医学教育,2013,5(1):21-22.
[7]黄海诗,李敏,任婕.老年与中青年类风湿关节炎的临床特征比较分析[J].中国慢性病预防与控制,2010,18(6):613-614.
[8]邵继东,贺玉杰.78例老年类风湿关节炎临床特点分析[J].河南医学研究,2017,26(4):634-635.
[9]Turkcapar N,Demir O,Atli T,et al.Late onset rheumatoid arthritis:clinical and laboratory comparisons with younger onset patients[J].Arch Gerontol Geriatr,2006,42(2):225-231.
[10]王莎莎,沈鹰.老年类风湿关节炎的临床诊治要点[J].中国老年学杂志,2013,33(15):3809-3811.
[11]Mueller RB,Kaegi T,Finckh A,et al.Is radiographic progression of late-onset rheumatoid arthritis different from young-onset rheumatoid arthritis?Results from the Swiss prospective observational cohort[J].Rheumatology(Oxford),2014,53(4):671-677.
[12]Jung SM,Kwok SK,Ju JH,et al.Risk factors associated with inadequate control of disease activity in elderly patients with rheumatoid arthritis:Results from a nationwide KOrean College of Rheumatology BIOlogics(KOBIO)registry[J].PLo S One,2018,13(10):e0205651.
[13]潘福敏,王善金,麻彬,等.颈椎病性眩晕的临床治疗[J].中国矫形外科杂志,2016,24(9):785-788.
[14]杨喜梅,薛苗,孟磊,等.老年类风湿关节炎患者颈椎失稳的影响因素[J].中国老年学杂志,2017,37(23):5918-5919.
[15]钟俊涛,蒋宏辉,刘鸿军,等.不同年龄类风湿关节炎患者临床特征分析[J].吉林医学,2013,34(36):7623.
[16]Del Rincón I,Williams K,Stern MP,et al.Association between carotid atherosclerosis and markers of inflammation in rheumatioid arthritis patients and healthy subjects[J].Arthritis Rheum,2003,48(7):1833-1840.
[17]李青,李雪,王永福.老年类风湿关节炎68例临床特点分析[J].中国实用医药,2013,8(4):45-46.
[18]杨润薇,姜津霞.老年类风湿关节炎临床特点分析[J].浙江临床医学,2016,18(1):118-119.
[19]李博,胡秋侠,叶志中,等.抗环瓜氨酸肽抗体及类风湿因子在老年起病的类风湿关节炎中的意义[J].实用医学杂志,2010,26(1):67-68.
[20]陈立忠,韩宏妮,段英春.老年类风湿关节炎临床特点和治疗(附21例临床分析)[J].医学信息(中旬刊),2011,24(6):2350-2351.
[21]耿学丽,陈向华,宗春光,等.老年类风湿关节炎患者血清MMP-13、s ICAM-1、IL-10的检测[J].中国老年学杂志,2015,35(9):2490-2492.
[22]Wang J,Zhao Q.Expression of CCR3,SOX5 and LC3 in patients with elderly onset rheumatoid arthritis and the clinical significance[J].Exp Ther Med,2017,14(4):3573-3576.
[23]Suzuki T,Yoshida R,Okamoto A,et al.Semiquantitative evaluation of extrasynovial soft tissue inflammation in the shoulders of patients with polymyalgia rheumatica and elderly-onset rheumatoid arthritis by power doppler ultrasound[J].Biomed Res Int,2017,2017:4272560.
[24]Wakura D,Kotani T,Takeuchi T,et al.Differentiation between polymyalgia rheumatica(PMR)and elderly-onset rheumatoid arthritis using 18F-fluorodeoxyglucose positron emission tomography/computed tomography:Is enthesitis a new pathological lesion in PMR?[J].PLo S One,2016,11(7):e0158509.
[25]张榕,吴春玲,李舒帆,等.雷公藤多甙联合来氟米特治疗老年活动性类风湿关节炎的疗效[J].中国老年学杂志,2011,31(12):2194-2196.
[26]Takai C,Kobayashi D,Ito S,et al.The treatment of patients with elderly-onset rheumatoid arthritis at Niigata Rheumatic Center[J].Nihon Ronen Igakkai Zasshi,2018,55(2):251-258.
[27]Innala L,Berglin E,M觟ller B,et al.Age at onset determines severity and choice of treatment in early rheumatoid arthritis:a prospective study[J].Arthritis Res Ther,2014,16(2):R94.
[28]Boots AM,Maier AB,Stinissen P,et al.The influence of ageing on the development and management of rheumatoid arthritis[J].Nat Rev Rheumatol,2013,9(10):604-613.
[29]Singh JA,Saag KG,Bridges SL Jr,et al.2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis[J].Arthritis Rheumatol,2016,68(1):1-26.
[30]Smolen JS,LandewéR,Bijlsma J,et al.EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs:2016 update[J].Ann Rheum Dis,?2017,76(6):960-977.
[31]Jin XM,Lee J,Choi NK,et al.Utilization patterns of disease-modifying antirheumatic drugs in elderly rheumatoid arthritis patients[J].J Korean Med Sci,2014,29(2):210-216.
[32]Sugihara T,Ishizaki T,Hosoya T,et al.Structural and functional outcomes of a therapeutic strategy targeting low disease activity in patients with elderly-onset rheumatoid arthritis:a prospective cohort study(CRANE)[J].Rheumatology(Oxford),2015,54(5):798-807.
[33]Radovits BJ,Kievit W,Fransen J,et al.Influence of age on the outcome of antitumour necrosis factor alpha therapy in rheumatoid arthritis[J].Ann Rheum Dis,2009,68(9):1470-1473.
[34]K觟ller MD,Aletaha D,Funovits J,et al.Response of elderly patients with rheumatoid arthritis to methotrexate or TNF inhibitors compared with younger patients[J].Rheumatology(Oxford),2009,48(12):1575-1580.
[35]Bathon JM,Fleischmann RM,Van der Heijde D,et al.Safety and efficacy of etanercept treatment in elderly subjects with rheumatoid arthritis[J].J Rheumatol,2006,33(2):234-243.
[36]Leon L,Gomez A,Vadillo C,et al.Severe adverse drug reactions to biological disease-modifying anti-rheumatic drugs in elderly patients with rheumatoid arthritis in clinical practice[J].Clin Exp Rheumatol,2018,36(1):29-35.
[37]Soubrier M,Lahaye C,Tatar Z.Abatacept for treatment of rheumatoid arthritis:special focus on the elderly[J].Drugs Aging,2018,35(5):379-387.
[38]Zhang J,Xie F,Yun H,et al.Comparative effects of biologics on cardiovascular risk among older patients with rheumatoid arthritis[J].Ann Rheum Dis,2016,75(10):1813-1818.
[2]Soubrier M,Mathieu S,Payet S,et al.Elderly-onset rheumatoid arthritis[J].Joint Bone Spine,2010,77(4):290-296.
[3]Rasch EK,Hirsch R,Paulose-Ram R,et al.Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States:effect of different methods of case classification[J].Arthritis Rheum,2003,48(4):917-926.
[4]Horiuchi AC,Pereira LHC,Kahlow BS,et al.Rheumatoid arthritis in elderly and young patients[J].Rev Bras Reumatol Engl Ed,2017,57(5):491-494.
[5]栗占国,张奉春,鲍春德.类风湿关节炎[M].北京:人民卫生出版社,2009:99.
[6]周武威,黄坚毅.老年发病的类风湿关节炎患者的临床特点分析[J].中国继续医学教育,2013,5(1):21-22.
[7]黄海诗,李敏,任婕.老年与中青年类风湿关节炎的临床特征比较分析[J].中国慢性病预防与控制,2010,18(6):613-614.
[8]邵继东,贺玉杰.78例老年类风湿关节炎临床特点分析[J].河南医学研究,2017,26(4):634-635.
[9]Turkcapar N,Demir O,Atli T,et al.Late onset rheumatoid arthritis:clinical and laboratory comparisons with younger onset patients[J].Arch Gerontol Geriatr,2006,42(2):225-231.
[10]王莎莎,沈鹰.老年类风湿关节炎的临床诊治要点[J].中国老年学杂志,2013,33(15):3809-3811.
[11]Mueller RB,Kaegi T,Finckh A,et al.Is radiographic progression of late-onset rheumatoid arthritis different from young-onset rheumatoid arthritis?Results from the Swiss prospective observational cohort[J].Rheumatology(Oxford),2014,53(4):671-677.
[12]Jung SM,Kwok SK,Ju JH,et al.Risk factors associated with inadequate control of disease activity in elderly patients with rheumatoid arthritis:Results from a nationwide KOrean College of Rheumatology BIOlogics(KOBIO)registry[J].PLo S One,2018,13(10):e0205651.
[13]潘福敏,王善金,麻彬,等.颈椎病性眩晕的临床治疗[J].中国矫形外科杂志,2016,24(9):785-788.
[14]杨喜梅,薛苗,孟磊,等.老年类风湿关节炎患者颈椎失稳的影响因素[J].中国老年学杂志,2017,37(23):5918-5919.
[15]钟俊涛,蒋宏辉,刘鸿军,等.不同年龄类风湿关节炎患者临床特征分析[J].吉林医学,2013,34(36):7623.
[16]Del Rincón I,Williams K,Stern MP,et al.Association between carotid atherosclerosis and markers of inflammation in rheumatioid arthritis patients and healthy subjects[J].Arthritis Rheum,2003,48(7):1833-1840.
[17]李青,李雪,王永福.老年类风湿关节炎68例临床特点分析[J].中国实用医药,2013,8(4):45-46.
[18]杨润薇,姜津霞.老年类风湿关节炎临床特点分析[J].浙江临床医学,2016,18(1):118-119.
[19]李博,胡秋侠,叶志中,等.抗环瓜氨酸肽抗体及类风湿因子在老年起病的类风湿关节炎中的意义[J].实用医学杂志,2010,26(1):67-68.
[20]陈立忠,韩宏妮,段英春.老年类风湿关节炎临床特点和治疗(附21例临床分析)[J].医学信息(中旬刊),2011,24(6):2350-2351.
[21]耿学丽,陈向华,宗春光,等.老年类风湿关节炎患者血清MMP-13、s ICAM-1、IL-10的检测[J].中国老年学杂志,2015,35(9):2490-2492.
[22]Wang J,Zhao Q.Expression of CCR3,SOX5 and LC3 in patients with elderly onset rheumatoid arthritis and the clinical significance[J].Exp Ther Med,2017,14(4):3573-3576.
[23]Suzuki T,Yoshida R,Okamoto A,et al.Semiquantitative evaluation of extrasynovial soft tissue inflammation in the shoulders of patients with polymyalgia rheumatica and elderly-onset rheumatoid arthritis by power doppler ultrasound[J].Biomed Res Int,2017,2017:4272560.
[24]Wakura D,Kotani T,Takeuchi T,et al.Differentiation between polymyalgia rheumatica(PMR)and elderly-onset rheumatoid arthritis using 18F-fluorodeoxyglucose positron emission tomography/computed tomography:Is enthesitis a new pathological lesion in PMR?[J].PLo S One,2016,11(7):e0158509.
[25]张榕,吴春玲,李舒帆,等.雷公藤多甙联合来氟米特治疗老年活动性类风湿关节炎的疗效[J].中国老年学杂志,2011,31(12):2194-2196.
[26]Takai C,Kobayashi D,Ito S,et al.The treatment of patients with elderly-onset rheumatoid arthritis at Niigata Rheumatic Center[J].Nihon Ronen Igakkai Zasshi,2018,55(2):251-258.
[27]Innala L,Berglin E,M觟ller B,et al.Age at onset determines severity and choice of treatment in early rheumatoid arthritis:a prospective study[J].Arthritis Res Ther,2014,16(2):R94.
[28]Boots AM,Maier AB,Stinissen P,et al.The influence of ageing on the development and management of rheumatoid arthritis[J].Nat Rev Rheumatol,2013,9(10):604-613.
[29]Singh JA,Saag KG,Bridges SL Jr,et al.2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis[J].Arthritis Rheumatol,2016,68(1):1-26.
[30]Smolen JS,LandewéR,Bijlsma J,et al.EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs:2016 update[J].Ann Rheum Dis,?2017,76(6):960-977.
[31]Jin XM,Lee J,Choi NK,et al.Utilization patterns of disease-modifying antirheumatic drugs in elderly rheumatoid arthritis patients[J].J Korean Med Sci,2014,29(2):210-216.
[32]Sugihara T,Ishizaki T,Hosoya T,et al.Structural and functional outcomes of a therapeutic strategy targeting low disease activity in patients with elderly-onset rheumatoid arthritis:a prospective cohort study(CRANE)[J].Rheumatology(Oxford),2015,54(5):798-807.
[33]Radovits BJ,Kievit W,Fransen J,et al.Influence of age on the outcome of antitumour necrosis factor alpha therapy in rheumatoid arthritis[J].Ann Rheum Dis,2009,68(9):1470-1473.
[34]K觟ller MD,Aletaha D,Funovits J,et al.Response of elderly patients with rheumatoid arthritis to methotrexate or TNF inhibitors compared with younger patients[J].Rheumatology(Oxford),2009,48(12):1575-1580.
[35]Bathon JM,Fleischmann RM,Van der Heijde D,et al.Safety and efficacy of etanercept treatment in elderly subjects with rheumatoid arthritis[J].J Rheumatol,2006,33(2):234-243.
[36]Leon L,Gomez A,Vadillo C,et al.Severe adverse drug reactions to biological disease-modifying anti-rheumatic drugs in elderly patients with rheumatoid arthritis in clinical practice[J].Clin Exp Rheumatol,2018,36(1):29-35.
[37]Soubrier M,Lahaye C,Tatar Z.Abatacept for treatment of rheumatoid arthritis:special focus on the elderly[J].Drugs Aging,2018,35(5):379-387.
[38]Zhang J,Xie F,Yun H,et al.Comparative effects of biologics on cardiovascular risk among older patients with rheumatoid arthritis[J].Ann Rheum Dis,2016,75(10):1813-1818.