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| 1 | 难治性类风湿关节炎的临床特点:一项国际问卷调查研究显示文摘目的尽管按照目前欧洲抗风湿联盟(EULAR)的推荐对类风湿关节炎(rheumatoid arthritis,RA)患者进行治疗,难治性RA患者的临床症状却仍然没有得到完全控制,目前EULAR指南主要关注的是RA的早期治疗和药物治疗。本研究的目的在于分析难治性RA患者的临床特点,以及在患者管理中需要探索然而现有EULAR指南并未涉及的问题。方法对多个国家的风湿科医生进行问卷调查,分析难治性RA的临床特点。问卷包括多选题以及开放性问题,从开放性问题的回答中发现需要进一步阐明的问题以及现有EULAR指南需要增加的内容。结果410名受访者完成了调查问卷,关于难治性RA的特点:50%受访者认为基于28个关节评估的疾病活动评分(disease activity score assessing 28 joints,DAS28)>3.2或存在疾病活动的征象;42%受访者认为疲劳是其特点;48%认为至少两种传统合成改变病情抗风湿药(DMARDs)以及使用至少两种生物制剂或靶向合成DMARDs治疗失败;89%认为糖皮质激素不能减量到5 mg/天或泼尼松不能减量到10 mg/天或同等剂量的其他激素。另外,现有EULAR指南中应增加合并症和关节外表现的干预以及多种药物联合治疗等重要内容。结论目前风湿科医生对难治性RA的定义有很大争议。难治性RA患者的很多重要问题目前EULAR指南中均没有涉及。 | Nadia MT Roodenrijs Maria J H de Hair Marlies C van der Goes Johannes WG Jacobs Paco MJ Welsing Désirée van der Heijde Daniel Aletaha Maxime Dougados Kimme L Hyrich Iain B McInnes Ulf Mueller-Ladner Ladislav Senolt Zoltan Szekanecz Jacob Mvan Laar Nagy Gyorgy 黄艳荣(译) 张卓莉(审校) | 2019 | 英国医学杂志中文版2019，22，2： | 1 |
| 2 | Relation be- tween the changes in physical activity and body mass index dur- ing adolescence: a multicentre longitudinal study显示文摘 | KIMM S Y GLYNN N W OBARZANEK E | 2005 | Lancet2005，23，29： | 1 |
| 3 | Etevated NADPH Oxidase Activity Contributes to Oxidative Stress and Cell Death in Huntington's Disease 显示文摘 | VALENCIA A SAPP E KIMM J | 2013 | Human Molecular Genetics2013，22，6： | 1 |
| 4 | Relation between the changes in physical activity and body-mass index during adolescence:a multicentre longitudinal study显示文摘 | Kimm SY Glynn NW Obarzanek E | 2005 | Lancet2005，366，9482： | 1 |
| 5 | Management of bnJbous urethral dis- ruption by blunt external trauma:the sooner, the better显示文摘 | Ku J H Kimm E Jein Y S et aI | 2002 | J Urol2002，60，2： | 1 |
| 6 | Characterization of chloramphenieol acetyltransferase gene by multiplex polymerase chain reaction in multidrug-resistant strains isolated from aquatic environments显示文摘 | YO0 M H HUH M D KIMM E H | 2003 | Aquaculture2003，217，： | 1 |
| 7 | Racial divergencein adiposity during adolescence : The NHLBI Growth and Health Study显示文摘 | KIMM SY BARTON BA OBARZANEK E | 2001 | Pediatrics2001，107，3： | 1 |
| 8 | 2002 Childhood obesity:a new pandemic of the new millennium 显示文摘 | Kimm SY Obarzanek E | 2002 | Pediatrics2002，110，5： | 1 |
| 9 | Childhood obesity:a new pandemic of the new millennium显示文摘 | KIMM SY OBARZANEK E | 2002 | Pediatrics2002，110，5： | 1 |
| 10 | Long-term safety and efficacy of a cholestenol-lowering diet in children with elevatedlow-density lipoprotein cholesterol: seven-year results of the Dietary Intervention Study in Children ( DISC ) 显示文摘 | Obarzanek E Kimm SY Barton BA | 2001 | Pediatrics2001，107，2： | 1 |
| 11 | Relation between the changes in physical activity and body-mass index during adolescence:a multicentre longitudinal study显示文摘 | Kimm SY Glynn NW Obarzanek E | 2005 | Lancet2005，366，9482： | 1 |
| 12 | Relation between the changes in physical ac- tivity and body - mass index during adoles- cence : a multicentre longitudinal study 显示文摘 | Kimm SY Glynn NW Obarzanek E | 2005 | Lancet2005，366，9482： | 1 |
| 13 | Changes in symptom clusters in patients undergoing radiation therapy显示文摘 | Kimm E Jahan T Aouizerat BE | 2009 | Support Care Cancer2009，17，11： | 1 |
| 14 | Validity of the diagnosis of acute myocardial infarction in korean national medical health insurance claims data: the korean heart study ( 1 ) 显示文摘 | Kimm H Yun J E Lee S H | 2012 | Korean circulation jour- nal2012，42，1： | 1 |
| 15 | Low serum bilirubin level as an independent predictor of stroke incidence:a prospective study in Korean men and women显示文摘 | KIMM H YUN J E JO J | 2009 | Stroke2009，40，11： | 1 |
| 16 | Childhood obesity : a new pandemic of the new millennium 显示文摘 | Kimm SY Obarzanek E | 2002 | Pediatrics2002，110，5： | 1 |
| 17 | Low serum bilirubin level as an independent predictor of stroke incidence : a prospective study in Korean men and women显示文摘 | Kimm H Yun J E Jo J | 2009 | Stroke2009，40，11： | 1 |
| 18 | Childhood obesity: a new pandemic of the new millennium 显示文摘 | Kimm SY Obarzanek E | 2002 | Pediatrics2002，110，5： | 1 |
| 19 | Development of a new xenoestrogen screening system using fission yeast Schizosaccharomyces pombe 显示文摘 | Yoo E J Jang YK Kimm HS | 2002 | Mol Cells2002，13，1： | 1 |
| 20 | Long-term safety and efficacy of a cholesterol-lowering diet in children with elevated low-density lipoprotein cholesterol: seven-year results of the Dietary Intervention Study in Children (DISC)显示文摘 | Obarzanek E Kimm SY Barton BA | 2001 | Pediatrics2001，107，2： | 1 |
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