| 彭昭,王迁,康琳.老年类风湿关节炎的研究进展[J].中国临床保健杂志,2024,27(4):443-447. |
| 老年类风湿关节炎的研究进展 |
| Elderly-onset rheumatoid arthritis:an overview |
| 投稿时间：2024-03-10 |
| DOI：10.3969/J.issn.1672-6790.2024.04.003 |
| 中文关键词: 关节炎,类风湿 消炎药,非甾类 抗风湿药 老年人 |
| 英文关键词: Arthritis,rheumatoid Anti-inflammatory agents,non-steroidal Antirheumatic agents Aged 〖FL |
| 基金项目:中国医学科学院医学与健康科技创新工程项目(2021-I2M-1-005)；中国医学科学院基本科研项目(2019PT330004)；中央高水平医院临床科研专项(2022-PUMCH-B-129) |
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| 中文摘要: |
| 类风湿关节炎(RA)是一种常见的以进行性关节破坏为特征的慢性炎症性自身免疫病。老年RA可以分为:发病年龄≥60岁的老年RA(EORA)与青壮年发病的RA(YORA)病情迁延至老年。随着人口老龄化的进展,EORA的发病率在逐年增加,男性更为常见,临床特点及实验室检查均有其独特性。EORA起病急,以全身大关节和近端关节受累为主,且类风湿因子的阳性率较低。此外,EORA患者临床合并症多,给治疗带来了更大的挑战。非甾体抗炎药物在老年患者中使用时不良反应风险增加,而传统合成改善病情的抗风湿药物对EORA和YORA患者有相同的疗效；生物改善病情的抗风湿药物在EORA患者中的安全性和有效性尚缺乏明确的研究证据。该文总结了EORA的流行病学、临床特征、临床并发症及治疗方法,旨在为EORA的有效管理提供科学的参考依据。 |
| 英文摘要: |
| Rheumatoid Arthritis (RA) is a common chronic inflammatory autoimmune disease characterized by progressive joint destruction.The elderly with RA consists of both elderly-onset RA (EORA) that manifests after the age of 60 and individuals diagnosed with RA early (YORA) in life who age naturally to become members of this group.With the progression of population aging,the incidence of EORA is on the rise annually.EORA typically occurs more frequently in males and possesses distinct clinical features and laboratory findings.EORA often presents with an acute onset,predominantly affecting large and proximal joints,and is associated with a lower positivity rate of rheumatoid factors.Additionally,the increased clinical comorbidities in EORA patients pose additional challenges to treatment.The use of non-steroidal anti-inflammatory drugs in elderly patients carries a higher risk of side effects,while conventional synthetic disease-modifying anti-rheumatic drugs have shown similar efficacy in both EORA and YORA patients.However,there is currently a lack of definitive research on the safety and effectiveness of biological disease-modifying anti-rheumatic drugs in EORA patients.Therefore,this study aims to provide a comprehensive overview of the epidemiology,clinical characteristics,comorbidities,and treatment approaches for EORA,offering a more holistic guide for its management. |
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