糖皮质激素在儿童风湿病中应用专家共识(上)

2018-03-08 中华医学会儿科学分会 中华儿科杂志,2018,56(3) :166-173.

糖皮质激素(glucocorticoids, GC)具有广泛的抗炎和免疫抑制作用,是风湿性疾病的基础治疗药物,在风湿性疾病的治疗中广泛应用,一般需要较长时间的应用。GC长期应用会导致身体一系列的不良反应,包括反复感染、高血压、糖尿病、骨质疏松、青光眼或白内障,特别是影响患儿生长发育等,严重降低患儿生活质量。因此,充分发挥GC的治疗作用,而把其不良反应降到最低,一直是儿童风湿病医师所追求的目标。鉴于

中文标题:

糖皮质激素在儿童风湿病中应用专家共识(上)

发布日期:

2018-03-08

简要介绍:

糖皮质激素(glucocorticoids, GC)具有广泛的抗炎和免疫抑制作用,是风湿性疾病的基础治疗药物,在风湿性疾病的治疗中广泛应用,一般需要较长时间的应用。GC长期应用会导致身体一系列的不良反应,包括反复感染、高血压、糖尿病、骨质疏松、青光眼或白内障,特别是影响患儿生长发育等,严重降低患儿生活质量。因此,充分发挥GC的治疗作用,而把其不良反应降到最低,一直是儿童风湿病医师所追求的目标。鉴于此,中华医学会儿科学分会儿童用药委员会、中华医学会儿科学分会免疫学组及《中华儿科杂志》编辑委员会启动了GC在治疗风湿性疾病中应用的专家共识的制定工作。

专家共识启动于2017年3月19日,6位专家分别负责儿童系统性红斑狼疮、幼年型皮肌炎、幼年特发性关节炎(juvenile idiopathic arthritis,JIA)、川崎病、IgA相关性血管炎(IgA-associated vasculitis,IgAV)、儿童系统性血管炎的文献检索(Embase、Cochrane图书馆、Pubmed、万方数据库、CNKI数据库),并撰写初稿。2017年10月19日召开中华医学会儿科学分会免疫学组关于制定该共识的启动会,讨论初稿,成立撰写小组,会后再次查阅文献并对初稿进行修改。将修改后的初稿在网上再次征求学组成员意见,2017年12月15日召开第3次会议,进行面对面讨论,有争议的关键点进行投票裁决。会后撰写人根据讨论意见再次修改稿件。尽管如此,该共识仍会存在不足之处,有待在应用过程中,特别是我国儿童风湿病多中心研究结果来进一步完善。

 

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  1. [GetPortalCommentsPageByObjectIdResponse(id=298033, encodeId=f60d29803376, content=感谢分享.收获颇多, beContent=null, objectType=guider, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=165b2160107, createdName=1202d9b7m55暂无昵称, createdTime=Tue Mar 20 10:11:48 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296124, encodeId=4fba29612442, content=学习了受益匪浅, beContent=null, objectType=guider, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Mar 14 09:01:53 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295820, encodeId=1bcc29582094, content=学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/13/c36860368f59b7f042bac242c6785040.jpg, createdBy=457b1858657, createdName=ms2296823935859672, createdTime=Tue Mar 13 11:16:27 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-20 1202d9b7m55暂无昵称

    感谢分享.收获颇多

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=298033, encodeId=f60d29803376, content=感谢分享.收获颇多, beContent=null, objectType=guider, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=165b2160107, createdName=1202d9b7m55暂无昵称, createdTime=Tue Mar 20 10:11:48 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296124, encodeId=4fba29612442, content=学习了受益匪浅, beContent=null, objectType=guider, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Mar 14 09:01:53 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295820, encodeId=1bcc29582094, content=学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/13/c36860368f59b7f042bac242c6785040.jpg, createdBy=457b1858657, createdName=ms2296823935859672, createdTime=Tue Mar 13 11:16:27 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-14 131****1460

    学习了受益匪浅

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=298033, encodeId=f60d29803376, content=感谢分享.收获颇多, beContent=null, objectType=guider, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=165b2160107, createdName=1202d9b7m55暂无昵称, createdTime=Tue Mar 20 10:11:48 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=296124, encodeId=4fba29612442, content=学习了受益匪浅, beContent=null, objectType=guider, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Wed Mar 14 09:01:53 CST 2018, time=2018-03-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=295820, encodeId=1bcc29582094, content=学习了.谢谢分享, beContent=null, objectType=guider, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/03/13/c36860368f59b7f042bac242c6785040.jpg, createdBy=457b1858657, createdName=ms2296823935859672, createdTime=Tue Mar 13 11:16:27 CST 2018, time=2018-03-13, status=1, ipAttribution=)]
    2018-03-13 ms2296823935859672

    学习了.谢谢分享

    0