治疗类风湿性关节炎,5 类指南推荐药物大盘点

2022-01-06 复兴健康医生端 复兴健康医生端

指南推荐的抗风湿药物盘点!

类风湿性关节炎(RA)是一种慢性、系统性、自身免疫性疾病,好发于中老年女性,全球发病率约为 1%。RA 以慢性侵蚀性关节炎为主要特征,以此造成进行性骨质破坏,最终导致关节畸形和关节功能障碍。控制炎性疾病进展,降低致残率是 RA 最主要的临床问题。
RA 的发病机制尚未完全明确,目前临床治疗 RA 的主要方法有:药物治疗、外科治疗、物理治疗及替代疗法。本文主要就现阶段指南推荐治疗 RA 的药物作一总结。

 

图片

(图片来源:摄图网)

1改善病情的抗风湿药物(Disease-modifying antirheumatic drugs,DMARDs)

这些药物可以减缓类风湿性关节炎的进展,并保护关节和其他组织免受永久性损伤。常见的 DMARDs 包括甲氨蝶呤、来氟米特、羟基氯喹和柳氮磺吡啶。RA 患者一经确诊,应尽早开始DMARDs治疗。
《中国类风湿关节炎诊疗指南》推荐首选甲氨蝶呤单药治疗。存在甲氨蝶呤禁忌时,考虑单用来氟米特或柳氮磺吡啶。副作用各不相同,但可能包括肝损伤、骨髓抑制和严重的肺部感染
2

非甾体类抗炎药(Nonsteroidal anti-inflammatorydrugs,NSAIDs)

NSAIDs 是不含甾体结构的解热镇痛抗炎药,但控制病情方面作用有限,应与 DMARDs 同服。在 RA 的治疗中具有缓解疼痛,减轻炎症的作用。其镇痛作用主要是通过抑制炎症时前列腺素的合成,阻止致痛物质的产生和释放。

常用的 NSAIDs 包括布洛芬塞来昔布胶囊(西乐葆)副作用可能包括胃肠道刺激,心血管系统和泌尿系统的不良反应。

图片

3

糖皮质激素

糖皮质激素,如泼尼松,具有调节免疫和抗炎作用,可减轻炎症和疼痛,减缓关节损伤。常用的此类药物包括甲基强的松龙、强的松、地塞米松等。长期应用激素类药物可引起骨质疏松等副作用,指南推荐在 RA 治疗中应小剂量、短疗程使用,必须同时应用 DMARDs。

图片

 

4生物制剂(Biologic agents)
这类新型的生物靶向制剂又被称为新型 DMARDs 或生物制剂 DMARDs (biologic DMARDs,bDMARDs),bDMARDs 的研发是目前的热门研究领域。其中包括新的 bDMARDs 及生物仿制药,以及口服活性靶向性小分子药。
常用的此类药物包括:
  • 肿瘤坏死因子 α 抑制剂(TNFα-i):如英夫利昔单抗、阿达木单抗、依那西普以及赛妥珠单抗等;
  • 选择性 T 细胞共刺激调节剂:如阿巴西普;
  • 两面神激酶(JAK)抑制剂:如托法替布和巴瑞替尼;
  • 以细胞因子为靶点的生物制剂:包括白介素 1 受体拮抗剂阿那白滞素和白介素 6 受体抑制剂托珠单抗。
其中 TNFα 抑制剂是目前证据较为充分、应用较为广泛的治疗 RA 的 bDMARDs。
这些药物可以靶向作用于部分免疫系统,以减少炎症,减缓关节和组织损伤。主要用于传统 DMARDs 疗效不佳或不耐受的 RA 患者,其有效性已获得确证。但这类型药物的使用也会增加感染的风险。为增加疗效和减少不良反应,这类生物制剂 DMARDs 常与传统 DMARDs 如甲氨蝶呤联合使用,以获得更好的治疗效果。

 

图片

 

5植物药

如雷公藤多苷、白芍总苷、青藤碱等,对缓解关节症状有较好作用,长期控制病情的作用尚待进一步研究证实。其中雷公藤多苷最为常用,应注意其性腺抑制、骨髓抑制、肝损伤等副作用。

图片

RA 的治疗药物市场潜力巨大,在过去的几十年中取得了飞速的发展,尤其生物制剂 DMARDs。在过去的十余年中,生物制剂 DMARD 在 RA 的临床应用中取得了重大突破,在 RA 治疗进展中具有里程碑意义。

相信随着越来越多新型生物制剂的出现,越来越多相关临床研究的完成,风湿学界的医疗人员将能更好地利用这一利器使 RA 治疗更规范,患者的预后更佳。

参考文献:

[1]史曼.类风湿性关节炎的药物治疗进展[J].科学技术创新,2019,(21):17-18.

[2]王静,赵庆杰,卓小斌, 等.类风湿性关节炎的治疗药物研究进展[J].药学实践杂志,2019,37(6):485-490.

[3]中华医学会风湿病学分会.2018中国类风湿关节炎诊疗指南[J].中华内科杂志,2018,57(4):242-251.

[4]方霖楷,黄彩鸿,谢雅,等.类风湿关节炎患者实践指南[J].中华内科杂志,2020,59(10):772-780.

[5]刘霞,王国春.生物制剂在类风湿关节炎的应用进展[J].临床内科杂志,2013,30(10):656-658.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (8)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
    2022-05-06 ms4000001233284480

    收藏

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
    2022-01-18 life_smile

    了解了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
    2022-01-08 lmm397
  4. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
    2022-01-07 1244c0ebm28暂无昵称

    不错不错

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
    2022-01-06 ms3000001138543316

    很棒

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1217443, encodeId=caa9121e44358, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a4aa5730662, createdName=ms4000001233284480, createdTime=Fri May 06 21:28:54 CST 2022, time=2022-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185453, encodeId=91181185453c0, content=了解了, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5861720635, createdName=life_smile, createdTime=Tue Jan 18 05:28:20 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266381, encodeId=498c12663818e, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1334337, encodeId=3656133433e65, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483740, encodeId=e3fa1483e4091, content=<a href='/topic/show?id=55a6100826cc' target=_blank style='color:#2F92EE;'>#风湿性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100826, encryptionId=55a6100826cc, topicName=风湿性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c237911872, createdName=ms1467340776200723, createdTime=Sat Jan 08 01:26:15 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181724, encodeId=67f91181e24e0, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e8212476654, createdName=1244c0ebm28暂无昵称, createdTime=Fri Jan 07 08:46:39 CST 2022, time=2022-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181567, encodeId=3e70118156e20, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9f5f5472733, createdName=ms3000001138543316, createdTime=Thu Jan 06 22:04:17 CST 2022, time=2022-01-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1181504, encodeId=746f1181504a3, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b5d3045764, createdName=729787690, createdTime=Thu Jan 06 20:43:06 CST 2022, time=2022-01-06, status=1, ipAttribution=)]
    2022-01-06 729787690

    学习了

    0

相关资讯

Hepatology:皮质类固醇剂量对免疫检查点抑制剂治疗肝炎的结局影响

免疫检查点是完整T细胞功能所不可缺少的蛋白,当人体需要阻止免疫功能时,这类蛋白会起到重要的抑制T细胞功能的作用。

ARD: 糖皮质激素初治类风湿性关节炎患者的短期剂量和持续时间依赖性糖皮质激素的心血管事件风险

在之前的6个月和1年间隔内,未使用糖皮质激素的RA患者开始使用糖皮质激素后,每日剂量≥5 mg,累积剂量和使用持续时间增加与CVE风险增加有关。

Lancet Rheumatology: 原发性系统性血管炎或风湿性多肌痛患者COVID-19的结果:一项回顾性队列研究

在原发性系统性血管炎和风湿性多肌痛患者中,严重的COVID-19结局与年龄、性别、合并症数量以及治疗方法(包括大剂量糖皮质激素)等多个风险因素相关。

Mayo Clin Proc:糖皮质激素的使用会增加患带状疱疹风险吗?

糖皮质激素可以通过降低细胞介导的免疫力来增加带状疱疹的风险。使用全身性皮质类固醇的人带状疱疹风险高出60%。风险随着剂量的增加而增加。

EBCAM:六味地黄丸联合糖皮质激素治疗儿童原发性肾病综合征的疗效观察

探讨六味地黄丸联合糖皮质激素治疗原发性肾病综合征的临床疗效,详细了解中药汤剂治疗原发性肾病综合征在减少激素副作用方面的具体情况,评价其临床应用效果。

JEADV:外用糖皮质激素降低手部湿疹患者金黄色葡萄球菌的密度

尽管金黄色葡萄球菌在HE中的定植与疾病的严重程度和HE慢性过程中的潜在相关性有很强的相关性,但在HE中的定植一直没有引起注意。在这里,我们清楚地证明了TCS治疗可以显著减少金黄色葡萄球菌的定植。