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在国家儿童风湿病及眼病数据库中青少年性特发性关节炎中的葡萄膜炎流行病学研究

世界核心医学期刊文摘（眼科学分册） 2006年第5期2卷 45-46页

作者： Heiligenhaus A Niewerth M mingels a 邢咏新(译) Augenabteilung am St. Franziskus-Hospital Hohenzollernring 74 48145 Munster Germany 不详

Background: Uveitis is a frequent and potentially vision-threatening manifestation of juvenile idiopathic arthritis (JIA). There are only a few population-based studies providing data on the frequency and severity of uveitis. Methods: Documentation of patients with JIA was collected in a national database. An analysis of the paediatric rheumatologic and ophthalmologic data collected from all patients that were included in 2002 was performed. Results: Uveitis was documented in 12%of a total of 3271JIA patients: extended oligoarthritis (25%), persistent oligoarthritis (16%), seronegative polyarthritis (4%), seropositive polyarthritis (2%), psoriatic arthritis (10%), enthesitis-related arthritis (ERA) (7%), Systemic arthritis(1%), other arthritis forms (11%) Opthalmologic data were available from 115 uveitis patients (28%). Mean age at onset of uveitis was 5.2 (SD 3.2) years. JIA patients with uveitis were significantly younger at onset of arthritis (3.8 vs. 7.0 years), and were more often girls (74 vs. 63%) or ANA-positive (86 vs. 42%) than the patients without uveitis. Uveitis complications were present in 45%at initial presentation of uveitis. After a mean duration of 5.6 years, complications were noted in 56%, and included band keratopathy (29%), posterior synechiae (27%), cataract (26%), glaucoma (8%), and macula oedema (6%). Final visual acuity was less than 20/50 in 31%and less than 20/200 in 12%of eyes. In patients with uveitis, immunosuppressive or immunomodulatory drugs were used significantly more often than in patients without uveitis (75%vs. 43%). Conclusions: The nationwide data documents the spectrum of uveitis in patients with JIA, the complications and the therapy for uveitis. The high rate of uveitis complications at the time of diagnosis points out the need for early ophthalmologic screening and therapy, and for a close collaboration between ophthalmologist and paediatric rheumatologist.

关键词：特发性关节炎葡萄膜炎青少年性流行病学研究数据库风湿病眼病儿童关节炎患者银屑病性关节炎

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