类风湿关节炎患者实践指南

2022-08-23 风湿免疫科郑医生 风湿免疫科郑医生

RA患者实践指南推荐意见16条

近年来类风湿关节炎(RA)临床专家诊治指南不断更新,在总体原则中特别强调,为提高 RA 临床达标率,需医患携手共同协商诊疗过程中的细节。因此,患者对疾病的认识、对专家诊治指南的理解及配合医生共同做好各项诊疗工作非常重要。本指南从患者关切的问题出发,按照国际规范流程,组成 RA 患者实践指南工作组,提出 RA 患者实践指南推荐意见 16 条。

01RA 是一种慢性、全身性、自身免疫病;

02单纯类风湿因子(RF)阳性不能确诊RA;

03RA 有一定遗传倾向;

04RA 患者行抗环瓜氨酸多肽(CCP)抗体检查可预测关节破坏的严重程度;

05针灸可辅助治疗 RA;

06RA 患者伴焦虑症状可寻求心理干预、药物治疗;

07RA 患者伴睡眠障碍可尝试心理干预或药物治疗、适当运动;

08RA 患者应参加运动锻炼,并根据病情选择合适的运动方式;

09RA 患者应戒烟;

10RA 患者已停用糖皮质激素,并病情持续缓解半年以上,可考虑生物制剂减量;

11甲氨蝶呤在妊娠期、哺乳期禁用,停用 3 个月以上可备孕;

12来氟米特在妊娠期、哺乳期禁用,血中未检测到该药浓度时可备孕;

13RA 患者应补充钙、维生素 D 及双磷酸盐药物预防和/或治疗骨质疏松;

14病情稳定的RA患者行彩色超声检查关节滑膜炎可预测疾病复发;

15RA 患者应重视肝损伤的预防、监测和治疗;

16RA 患者参加病友会将获益良多。

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    2021-11-10 lmm397
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