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目的探讨甲氨蝶呤联合激素或非甾体类抗炎为治疗幼年类风湿性关节炎的疗效。方法小剂量强的松、萘普生治疗的同时或症状改善后予甲氨蝶呤 10 mg/m 2静脉滴注 ,每周 1次 ;在体温正常 ,全身症状和关节肿痛消失后 ,激素开始减量 ,在 3～ 6个月减完停药 ;对激素依赖型用至 1年 ,同时停用萘普生 ,续用甲氨蝶呤 1～ 3年。结果 9例中 8例在用药期间病情稳定 ,无反复 ,1例因出院后未坚持治疗而复发。现有 5例已停药 1～ 2年 ,无复发 ,2例激素在减量 ,2例在单用氨甲蝶呤治疗。随访 9例 ,治疗期间每月复查 1次血常规、尿常规、血沉、肝功能 ,均未发现异常 ,生长发育正常。结论本治疗方法用药剂量小 ,间隔时间长 ,安全有效 ,同时小儿对甲氨蝶呤耐受性好 ,副作用小
Objective To investigate the efficacy of methotrexate combined with steroid or non-steroidal anti-inflammatory for the treatment of juvenile rheumatoid arthritis. Methods Small doses of prednisone, naproxen, while treatment or improvement of symptoms after methotrexate 10 mg / m2 intravenous infusion once a week; in normal body temperature, systemic symptoms and joint swelling disappeared, the hormone Start reducing, reducing the withdrawal in 3 to 6 months; on hormone-dependent use to 1 year, while disabled naproxen, continued methotrexate 1 to 3 years. Results Of the 9 cases, 8 cases were stable during the treatment without recurrence, and 1 case recurred after leaving the hospital without persisting treatment. The existing 5 cases have been discontinued for 1 to 2 years, no recurrence, 2 cases of hormone reduction, 2 cases of methotrexate alone. All the patients were followed up in 9 cases. Blood routine, urine routine, erythrocyte sedimentation rate and liver function were reviewed once a month during the treatment. No abnormalities and normal growth and development were found. Conclusion The treatment of small doses, long interval, safe and effective, while children with methotrexate tolerance, side effects