首页 > 文献资料
-
他克莫司治疗难治性类风湿关节炎疗效观察
类风湿关节炎(rheumatoid arthritis ,RA )是一种以关节破坏为主要表现的常见疾病[1]。其治疗方案近年已日趋成熟,多种慢作用抗风湿药物和(或)细胞毒药物已应用于治疗RA ,并取得了较好的疗效,但仍有部分患者经2种或2种以上改善病情药物(DMARD)联合治疗6个月以上病情仍有活动,此类患者通常称为难治性类风湿关节炎(re‐fractory rheumatoid arthritis ,RRA )。他克莫司(TAC)是一种钙调神经磷酸酶抑制剂,主要通过抑制神经钙蛋白酶从而抑制 T 淋巴细胞免疫应答反应[2],具有免疫抑制的作用。以往的研究中,他克莫司主要应用于肾移植后及各种肾脏疾病。本文旨在探索他克莫司对于RRA患者的疗效。
-
针灸治疗类风湿性关节炎的研究概况
类风湿性关节炎(Rheumatoid Arthritis,RA)是一种以关节滑膜炎症为主的慢性、多发性全身自身免疫性疾病.自1941年该病确定以来,迄今病因尚未完全阐明.中医将其归属于"痹证"范畴,多为风寒湿邪侵犯肌肉、筋脉,流注关节导致经络气血痹阻,痰瘀留着,寒热错杂所致.近年来针灸治疗该病疗效较为显著,本文就其在临床及实验研究的近况概述如下.
-
雷公藤治疗类风湿关节炎细胞和分子生物学机制的研究与进展
雷公藤治疗类风湿关节炎(RA)至今已40余年, 其对RA具有显著疗效[1].现认为[2]RA是易感机体由不明病因激活免疫系统后, 在综合因素作用下, 产生一种以破坏关节为主要特征的自身免疫性疾病, 即便病因不复存在, 但因分子模拟机制作用于自身抗原而发生的自身免疫反应性.
-
中西医结合治疗类风湿关节炎的思考
类风湿关节炎(rheumatoid arthritis,RA)属于中医学"痹证"的范畴,中医治疗痹证有其独特的理论和治疗方法,历代医家积累了丰富的经验.目前临床上RA患者就诊时用药的情况不一,一部分患者发病后即要求使用中药治疗,多数患者就诊时已经经过西医治疗,或使用西药治疗后出现了不良反应,或经西医治疗后疗效不理想转向中医治疗,或使用西医治疗的同时要求配合中医治疗等;部分患者根据病情需要在中医治疗的同时配合西医治疗.
-
雷公藤治疗类风湿关节炎的困境与对策
对类风湿关节炎疗效为突出的中药首推雷公藤, 早记载雷公藤功效的是公元1476年明朝兰茂所著的<滇南本草>, 书中称其"味辛, 性温, 有毒.
-
重视类风湿关节炎治疗的中医证候分类研究
分类学是医学的根本,现代医学的诊断和中医学的证候分类都是对人体健康状态的分类,分类结果决定治疗方法的选择.基于中、西医诊断分类的治疗都对维护人类健康作出了巨大贡献.
-
雷公藤多甙致老年肾病综合征患者急性间质性肾炎一例
IntroductionMulti-glycoside of Tripterygium wilfordii hook f (GTW) ,ex-tracts of the medicinal plant Tripterygium wilfordii hook f,has an established history of use in the treatment of inflammatory and autoimmune diseases including rheumatoid arthritis, systemic lu-pus erythematosus, nephritis and chronic idiopathic urticaria [1.3].The major active component is triptolide, a diterpenoid triep-oxide,which has been shown to have potent immunosuppressive,anti-inflammatory and antiproliferative effects by its inhibitory effect on T lymphocyte proliferation,nuclear factor-kappa B acti-vation and cytokine production such as IL-2,IL-6,TNF-a [4-6].
-
生物制剂在类风湿关节炎的临床应用
类风湿关节炎(rheumatoid arthritis,RA)是一种以关节炎为主要临床表现的慢性炎症性疾病,可引起关节破坏、畸形和功能障碍,以手、足的小关节受累为主,并可累及全身其他系统.早期使用缓解病情抗风湿药(DMARDs)对于延缓关节变形、改善预后起着至关重要的作用.
-
抗突变型瓜氨酸波形蛋白抗体在老年发病类风湿关节炎诊断中的价值
老年起病类风湿关节炎( elderly-onset rheumatoid arthritis,EORA)多指起病年龄超过60岁的类风湿关节炎(RA),诊断沿用美国风湿病学会(ACR) 1987年修订的RA分类标准.
-
滑膜成纤维细胞与类风湿性关节炎相关研究的进展
类风湿性关节炎(rheumatoid arthritis, RA)是一种慢性起病的自身免疫性疾病,其病程终转归往往导致关节破坏,其显著特点是由免疫细胞参与的自身免疫调节紊乱.长期以来,一直认为T细胞、巨嗜细胞及其各自的细胞因子在RA病程中起着关键作用,然而这一学说在近年来受到了强力的挑战,相当一部分学者认为在RA长期的病程中成纤维样细胞(fibroblast-like synoviocytes, FLS)起着主导的作用,这种作用甚至在疾病早期就已经体现出来,而这类滑膜成纤维细胞(rheumatoid arthritis synovial fibro-blasts, RASFs)正是RA区别其他关节炎症的重要标志.
-
幼年型类风湿性关节炎合并急性淋巴细胞白血病1例
幼年型类风湿性关节炎(Juvenile Rheumatoid Arthritis JRA)是原因不明的慢性炎症性疾病,可导致关节以外的病变,国内曾报道可合并骨髓瘤,巨噬细胞活化综合征,但JRA合并急性淋巴细胞白血病(Acute Lymphoblastic Leukemia ALL)尚属罕见,现报道如下:
-
幼年特发性关节炎——国际风湿病学会联盟新分类标准讨论稿
大多数风湿病学专家都认为儿童时期的关节炎是一种异质性疾病.目前,对这一类疾病尚无统一的分类标准. 在美国称为 "幼年类风湿关节炎"(juvenile rheumatoid arthritis,JRA),而在欧洲则称为"幼年慢性关节炎"(Juvenile Chronic Arthritis,JCA).这两者包含的内容亦不一样.美国的分类标准是指全身型关节炎、多关节炎(类风湿因子阳性组、类风湿因子阴性组)和少关节炎及扩展型少关节炎,虽然名为类风湿性关节炎,但其中只有15% 类风湿因子阳性,故这个名称不确切.同时这一分类也不包括幼年强直性脊柱炎.
-
幼年类风湿性关节炎患儿的γ干扰素与白细胞介素4反应的研究
幼年类风湿性关节炎(juvenile rheumatoid arthritis,JRA)的病因和发病机制虽尚未完全明了,但越来越多的研究显示CD+4T细胞功能异常在JRA的发病中起重要作用.有资料提示JRA的免疫损伤主要由I型辅助性T细胞(TH1)介导,但也有人发现不同病期或不同临床亚型其TH细胞优势克隆不同[1-4].
-
伴类风湿关节炎的广泛型侵袭性牙周炎牙周系统治疗一例
广泛型侵袭性牙周炎(generalized aggressiveperiodontitis,GAgP)是一组发生于年轻人群,病变累及全口大多数牙齿,有严重而快速的牙周附着丧失和牙槽骨破坏的牙周疾病,发病率较低.同时伴有类风湿关节炎(rheumatoidarthritis,RA)的GAgP少有报道.笔者于1994年接诊一例伴BA的CAgP患者,经过15年的牙周系统治疗,疗效满意,现报告如下.
-
肿瘤坏死因子拮抗剂在炎性关节炎治疗中的应用
在风湿病学中,炎性关节炎(inflammatory arthritis)特指类风湿关节炎(rheumatoid arthritis,RA)、强直性脊柱炎(ankylosing spondylitis,AS)、银屑病关节炎(psoriatic arthritis,PsA)及幼年类风湿关节炎(juvenile rheumatoid arthritis,JRA)等.这组疾病的病因及发病机制不明,治疗困难,预后较差.研究表明,一些细胞因子活性增强或减弱,细胞因子之间相互促进或抑制的网络性调控失衡是其共同病理特点,因此细胞因子是参与疾病发生发展,造成病理损伤的重要因素之一.
-
磷酸氯喹在风湿病治疗中的安全性
自20世纪50年代以来,抗疟药中的氯喹和羟氯喹一直作为治疗系统性红斑狼疮(SystemicLupus Erythematosus,SLE)和类风湿关节炎(Rheumatoid Arthritis,RA)的重要药物而应用于临床[1,2].
-
75例幼年类风湿关节炎临床早期X线表现
幼年类风湿关节炎(juvenile rheumatoid arthritis,JRA)早期X线改变轻微,常易漏诊.我们对75例JRA的早期X线表现进行了总结,以提高对本病早期表现的认识.
-
Objective To study the expression level of peptidylarginine deiminase 4 (PADI4) and protein tyrosine phosphatase nonreceptor type 22 (PTPN22) in the synovium of rat model of collagen-induced arthritis, and to explore their possible therapeutic role in rheumatoid arthritis.
Methods Thirty-two female Wistar rats weighing 100±20 g were randomly assigned into 3-week collagen-induced arthritis (CIA) model group (n=8), 4-week CIA model group (n=8), 6-week CIA model group (n=8), and the control group (n=8). The body weight changes of each group were recorded. The expression levels of PADI4 and PTPN22 were detected and compared by the methods of immunohistochemical staining and Western blot.
Results Arthritis of rat began to form 14 days after sensitization and the joint swelling reached peak at 28 days. The weights of the rats slowly grew both in CIA model groups and the control group. Immunohistochemical staining results showed that the positive expression of PADI4 and PTPN22 was mainly located in cartilage peripheral mononuclear cells, the cytoplasm of infiltrated cells, and bone marrow cavity. There were significant differences in the optical density of PADI4 and PTPN22 among CIA model groups and the control group (PADI4, 0.2898±0.012, 0.2982±0.022, 0.2974±0.031, 0.2530±0.013 in 3-week CIA model, 4-week CIA model, 6-week CIA model and control groups;PTPN22, 0.2723±0.004, 0.2781±0.010, 0.2767±0.008, 0.2422±0.019;all P<0.05). The expression bands of PADI4 were observed in Western blot 3 weeks after initial immunization, the thickest in the 4th week, and decreased in the 6th week. The expression bands of PTPN2 were observed at all the time points, with no obvious time-dependent trend.
Conclusions PADI4 and PTPN22 are obviously correlated with CIA in rat model. PADI4 is expressed at early stage of the disease, while the expression of PTPN22 sustains throughout the course. -
Objective To investigate if immunological factors associated with rheumatoid arthritis (RA) affect the result of human immunodeficiency virus (HIV) screening by electrochemiluminescence immunoassay (ECLIA) and enzyme-linked immunosorbent assay (ELISA).
Methods 100 RA cases were enrolled from January 2012 to February 2013 into this study. HIV screening was conducted with ECLIA detecting both HIV-1 p24 antigen, HIV-1 and HIV-2 antibodies, with ELISA and colloidal gold method detecting HIV-1 and HIV-2 antibodies. The samples producing positive results were submitted to the Center for Disease Control for confirmation using Western blotting method. The antibody titers of rheumatoid factors (RF) including RF-IgG, RF-IgM, RF-IgA, and CCP-IgG were analyzed by ELISA.
Results The HIV positive-rate determined by ECLIA was significantly higher than that by ELISA and colloidal gold method (P<0.01). The false-positive rate of HIV screening was associated with antibody titers of RF-IgG, RF-IgM, RF-IgA, and CCP-IgG in RA (P<0.01).
Conclusion Immunological factors, including RF and anti-CCP antibody, may influence the screening of HIV by ECLIA, producing false-positive result. -
幼年类风湿性关节炎40例临床分析
幼年类风湿性关节炎(juvenile rheumatoid arthritis,JRA)是指16岁以前发病的以慢性滑膜炎为主要特征并伴有全身多系统损害的儿童关节炎.为一种儿童时期常见的结缔组织病.我院儿科1998年5月~2003年5月收治40例,现报告如下.