邮件订阅 RSS

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

《中国儿童系统性红斑狼疮诊断与治疗指南》解读

王琳,  宋红梅

downloadPDF
文章导航 > 协和医学杂志  > 2022 >  13(3): 412-420
王琳, 宋红梅. 《中国儿童系统性红斑狼疮诊断与治疗指南》解读[J]. 协和医学杂志, 2022, 13(3): 412-420. doi: 10.12290/xhyxzz.2022-0018
引用本文: 王琳, 宋红梅. 《中国儿童系统性红斑狼疮诊断与治疗指南》解读[J]. 协和医学杂志, 2022, 13(3): 412-420. doi: 10.12290/xhyxzz.2022-0018
shu
WANG Lin, SONG Hongmei. Interpretation on Chinese Guidelines for the Diagnosis and Treatment of Childhood-onset Systemic Lupus Erythematosus[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(3): 412-420. doi: 10.12290/xhyxzz.2022-0018
Citation: WANG Lin, SONG Hongmei. Interpretation on Chinese Guidelines for the Diagnosis and Treatment of Childhood-onset Systemic Lupus Erythematosus[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(3): 412-420. doi: 10.12290/xhyxzz.2022-0018
shu

《中国儿童系统性红斑狼疮诊断与治疗指南》解读

doi: 10.12290/xhyxzz.2022-0018

  • 中国医学科学院北京协和医院儿科, 北京 100730

基金项目: 

国家重点研发计划 2021YFC2702004

详细信息
    通讯作者:

    宋红梅, E-mail: songhm1021@126.com

  • 中图分类号: R593.24;R593.2

Interpretation on Chinese Guidelines for the Diagnosis and Treatment of Childhood-onset Systemic Lupus Erythematosus

  • Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

Funds: 

National Key Research and Development Program of China 2021YFC2702004

More Information

    摘要
  • 摘要: 鉴于儿童系统性红斑狼疮的诊断和治疗较成人更具复杂性, 2021年中华医学会儿科学分会免疫学组联合指南方法学专家及《中华儿科杂志》编辑部制定了我国首部《中国儿童系统性红斑狼疮诊断与治疗指南》。该指南是对2011年我国《儿童系统性红斑狼疮诊疗建议》的延续, 依据循证实践, 结合中国具体国情, 指南回答了12个儿童系统性红斑狼疮诊断、评估、治疗和预后管理等方面的关键临床问题, 以期为各级医疗机构和参与儿童系统性红斑狼疮诊疗及管理的专业人员提供指导, 规范系统性红斑狼疮患儿的诊断、合理用药及长期管理。本研究对该指南的重点内容进行解读, 以期促进指南的临床应用。
    Abstract: The diagnosis and treatment of systemic lupus erythematosus(SLE) in children are more complicated than in adults. In 2021, the Subspecialty Group of Immunology of the Society of Pediatrics of Chinese Medical Association, together with Chinese GRADE Center, and the editorial board of Chinese Journal of Pediatrics, jointly formulated the first Chinese Guidelines for the Diagnosis and Treatment of Childhood-onset Systemic Lupus Erythematosus. The guideline is a continuation of Recommendations on the Diagnosis and Treatment of Pediatric Systemic Lupus Erythematosus issued in 2011. After 10 years of clinical practice, the diagnosis and treatment of children with SLE is still not standardized. Based on this guidance, combined with China's specific national conditions, the target population is children with SLE and their guardians. The guideline answers 12 key and important clinical questions and management, regarding the diagnosis, assessment, treatment and prognosis of SLE. The purpose of the guidelines is to provide guidance for involved professionals and to standardize the diagnosis, rational drug use and long-term management of children with SLE.
    作者贡献：王琳负责查阅文献资料、撰写论文；宋红梅负责指导及修订论文。
    利益冲突：所有作者均声明不存在利益冲突
    • HTML全文
    • 参考文献(53)
  • [1] Lisnevskaia L, Murphy G, Isenberg D. Systemic lupus erythematosus[J]. Lancet, 2014, 384: 1878-1888. doi:  10.1016/S0140-6736(14)60128-8
    [2] 中华医学会儿科学分会免疫学组, 《中华儿科杂志》编辑委员会. 儿童系统性红斑狼疮诊疗建议[J]. 中华儿科杂志, 2011, 49: 506-514. doi:  10.3760/cma.j.issn.0578-1310.2011.07.006
    [3] Aringer M, Costenbader K, Daikh D, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus[J]. Arthritis Rheumatol, 2019, 71: 1400-1412. doi:  10.1002/art.40930
    [4] Groot N, de Graeff N, Avcin T, et al. European evidence-based recommendations for diagnosis and treatment of childhood-onset systemic lupus erythematosus: the SHARE initiative[J]. Ann Rheum Dis, 2017, 76: 1788-1796. doi:  10.1136/annrheumdis-2016-210960
    [5] Groot N, de Graeff N, Marks SD, et al. European evidence-based recommendations for the diagnosis and treatment of childhood-onset lupus nephritis: the SHARE initiative[J]. Ann Rheum Dis, 2017, 76: 1965-1973. doi:  10.1136/annrheumdis-2017-211898
    [6] Wu CY, Li CF, Wu QJ, et al. Chinese Systemic Lupus Erythematosus Treatment and Research Group Registry IX: Clinical Features and Survival of Childhood-onset Systemic Lupus Erythematosus in China[J]. Chin Med J (Engl), 2017, 130: 1276-1282. doi:  10.4103/0366-6999.206346
    [7] World Health Organization. WHO Handbook for Guideline Development[M/OL ]. 2nd Edition. (2014-12-18)[2022-01-10]. https://www.who.int/publications/i/item/9789241548960.
    [8] 蒋朱明, 詹思延, 贾晓巍, 等. 制订/修订《临床诊疗指南》的基本方法及程序[J]. 中华医学杂志, 2016, 96: 250-253. doi:  10.3760/cma.j.issn.0376-2491.2016.04.004
    [9] Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care[J]. CMAJ, 2010, 182: E839-E842. doi:  10.1503/cmaj.090449
    [10] Chen YL, Yang KH, Marušic A, et al. A reporting tool for practice guidelines in health care: the RIGHT statement[J]. Ann Intern Med, 2017, 166: 128-132. doi:  10.7326/M16-1565
    [11] Levisky Y, Broide M, Kagan S, et al. Performance of 2019 EULAR/ACR classification criteria for systemic lupus erythematosus in a paediatric population-a multicentre study[J]. Rheumatology (Oxford), 2021, 60: 5142-5148. doi:  10.1093/rheumatology/keab140
    [12] Fonseca AR, Felix Rodrigues MC, Sztajnbok FR, et al. Comparison among ACR1997, SLICC and the new EULAR/ACR classification criteria in childhood-onset systemic lupus erythematosus[J]. Adv Rheumatol, 2019, 59: 20 doi:  10.1186/s42358-019-0062-z
    [13] 中华医学会儿科学分会肾脏学组. 狼疮性肾炎诊治循证指南(2016)[J]. 中华儿科杂志, 2018, 56 : 88-94. doi:  10.3760/cma.j.issn.0578-1310.2018.02.003
    [14] Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis[J]. Ann Rheum Dis, 2012, 71: 1771-1782. doi:  10.1136/annrheumdis-2012-201940
    [15] Hahn BH, McMahon MA, Wilkinson A, et al. American College of Rheumatology guidelines for screening, treat-ment, and management of lupus nephritis[J]. Arthritis Care Res (Hoboken), 2012, 64: 797-808. doi:  10.1002/acr.21664
    [16] Ma H, Dong J, Wang L, et al. Impact of follow-up visits on disease outcome in Chinese systemic lupus erythematosus[J]. Clin Rheumatol, 2018, 37: 101-105. doi:  10.1007/s10067-017-3781-8
    [17] Ruiz IG, Espinosa G, Frutos MA, et al. Diagnosis and treatment of lupus nephritis. Consensus document from the systemic auto-immune disease group (GEAS) of the Spanish Society of Internal Medicine (SEMI) and Spanish Society of Nephrology (S.E.N. )[J]. Nefrologia, 2012, 32: 1-35.
    [18] Gladman DD, Ibañez D, Ruiz I, et al. Recommendations for frequency of visits to monitor systemic lupus erythe-matosus in asymptomatic patients: data from an observational cohort study[J]. J Rheumatol, 2013, 40: 630-633. doi:  10.3899/jrheum.121094
    [19] Ibañez D, Gladman DD, Touma Z, et al. Optimal frequ-ency of visits for patients with systemic lupus erythematosus to measure disease activity over time[J]. J Rheumatol, 2011, 38: 60-63. doi:  10.3899/jrheum.100575
    [20] 冷晓梅, 曾小峰. 糖皮质激素在系统性红斑狼疮患者合理应用的专家共识[J]. 中华内科杂志, 2014, 53: 502-504. doi:  10.3760/cma.j.issn.0578-1426.2014.06.023
    [21] Gordon C, Amissah-Arthur MB, Gayed M, et al. The British Society for Rheumatology guideline for the manage-ment of systemic lupus erythematosus in adults[J]. Rheumatology (Oxford), 2018, 57: e1-e45. doi:  10.1093/rheumatology/kex286
    [22] 中华医学会儿科学分会儿童用药委员会. 糖皮质激素在儿童风湿病中应用专家共识(下)[J]. 中华儿科杂志, 2019, 57: 16-20. doi:  10.3760/cma.j.issn.0578-1310.2019.01.006
    [23] 中华医学会风湿病学分会, 国家皮肤与免疫疾病临床医学研究中心, 中国系统性红斑狼疮研究协作组. 2020中国系统性红斑狼疮诊疗指南[J]. 中华内科杂志, 2020, 59: 172-185. doi:  10.3760/cma.j.issn.0578-1426.2020.03.002
    [24] GlaxoSmithKline plc. GSK receives US approval of Benlysta for intravenous use in children with lupus aged five years and above[EB/OL ]. (2019-04-26)[2022-01-10]. https://www.gsk.com/en-gb/media/press-releases/gsk-receives-us-approval-of-benlysta-for-intravenous-use-in-children-with-lupus-aged-five-years-and-above/.
    [25] 国家药品监督管理局. 首个系统性红斑狼疮(SLE)儿童药物新适应证在中国获批[EB/OL]. (2020-12-07)[2022-01-10]. https://www.nmpa.gov.cn/zwfw/sdxx/sdxxyp/yppjfb/20201207163143123.html.
    [26] 国家药品监督管理局. 国家药监局批准注射用泰它西普上市[EB/OL ]. (2021-03-12)[2022-01-10]. https://www.nmpa.gov.cn/directory/web/nmpa/zhuanti/ypqxgg/gggzjzh/20210312165618199.html.
    [27] Trindade C, Carneiro M, Bonfa E, et al. An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus[J]. Pediatric Drugs, 2021, 23: 331-347. doi:  10.1007/s40272-021-00457-z
    [28] Mok CC, Cheung TT, Lo WH. Minimal mesangial lupus nephritis: a systematic review[J]. Scand J Rheumatol, 2010, 39: 181-189. doi:  10.3109/03009740903456300
    [29] Srivastava P, Abujam B, Misra R, et al. Outcome of lupus nephritis in childhood onset SLE in North and Central India: single-centre experience over 25 years[J]. Lupus, 2016, 25: 547-557. doi:  10.1177/0961203315619031
    [30] Smith E, Al-Abadi E, Armon K, et al. Outcomes following mycophenolate mofetil versus cyclophosphamide induction treatment for proliferative juvenile-onset lupus nephritis[J]. Lupus, 2019, 28: 613-620. doi:  10.1177/0961203319836712
    [31] Baskin E, Ozen S, Cakar N, et al. The use of low-dose cyclophosphamide followed by AZA/MMF treatment in childhood lupus nephritis[J]. Pediatr Nephrol, 2010, 25: 111-117. doi:  10.1007/s00467-009-1291-x
    [32] Tunnicliffe DJ, Palmer SC, Henderson L, et al. Immunosuppressive treatment for proliferative lupus nephritis[J]. Cochrane Database Syst Rev, 2018, 6: CD002922.
    [33] Mao Y, Yin L, Huang H, et al. Addition of cyclosporine/tacrolimus for pediatric relapsed lupus nephritis during mycophenolate mofetil maintenance therapy[J]. J Int Med Res, 2019, 47: 105-113. doi:  10.1177/0300060518796751
    [34] Pereira M, Muscal E, Eldin K, et al. Clinical presentation and outcomes of childhood-onset membranous lupus nephritis[J]. Pediatr Nephrol, 2017, 32: 2283-2291. doi:  10.1007/s00467-017-3743-z
    [35] Hladunewich MA, Troyanov S, Calafati J, et al. The natural history of the non-nephrotic membranous nephropathy patient[J]. Clin J Am Soc Nephrol, 2009, 4: 1417-1422. doi:  10.2215/CJN.01330209
    [36] Tang KT, Tseng CH, Hsieh TY, et al. Induction therapy for membranous lupus nephritis: a systematic review and network meta-analysis[J]. Int J Rheum Dis, 2018, 21: 1163-1172. doi:  10.1111/1756-185X.13321
    [37] Swan JT, Riche DM, Riche KD, et al. Systematic review and meta-analysis of immunosuppressant therapy clinical trials in membranous lupus nephritis[J]. J Investig Med, 2011, 59: 246-258. doi:  10.2310/JIM.0b013e318204c965
    [38] Govoni M, Hanly JG. The management of neuropsychiatric lupus in the 21st century: still so many unmet needs?[J]. Rheumatology, 2020, 59: 52-62. doi:  10.1093/rheumatology/keaa404
    [39] Lauvsnes MB, Omdal R. Systemic lupus erythematosus, the brain, and anti-NR2 antibodies[J]. J Neurol, 2012, 259: 622-629. doi:  10.1007/s00415-011-6232-5
    [40] Bertsias GK, Ioannidis JP, Aringer M, et al. EULAR recommendations for the management of systemic lupuserythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standingcommittee for clinical affairs[J]. Ann Rheum Dis, 2010, 69: 2074-2082. doi:  10.1136/ard.2010.130476
    [41] Magro-Checa C, Zirkzee EJ, Huizinga TW, et al. Management of neuropsychiatric systemiclupus erythematosus: current approaches and future perspectives[J]. Drugs, 2016, 76: 459-483. doi:  10.1007/s40265-015-0534-3
    [42] Narváez J, Ríos-Rodriguez V, de la Fuente D, et al. Rituximab therapy in refractory neuropsychiatric lupus: current clinical evidence[J]. Semin Arthritis Rheum, 2011, 41: 364-372. doi:  10.1016/j.semarthrit.2011.06.004
    [43] Manzi S, Sánchez-Guerrero J, Merrill JT, et al. Effects of belimumab, a B lymphocyte stimulator-specificinhibitor, on disease activity across multiple organ domains in patients with systemic lupus erythematosus: combined results from two phase Ⅲ trials[J]. Ann Rheum Dis, 2012, 71: 1833-1838. doi:  10.1136/annrheumdis-2011-200831
    [44] De Marchi G, Quartuccio L, Bond M, et al. Efficacy of belimumab for the long-term maintenance therapy of thrombocytopenia in systemic lupus erythematosus[J]. Clin Exp Rheumatol, 2017, 35: 1056.
    [45] Ji J, Wu Y, Meng Y, et al. JAK-STAT signaling mediates the senescence of bone marrow-mesenchymal stem cells from systemic lupus erythematosus patients[J]. Acta Biochim Biophys Sin (Shanghai), 2017, 49: 208-215. doi:  10.1093/abbs/gmw134
    [46] Mok CC. The Jakinibs in systemic lupus erythematosus: progress and prospects[J]. Expert Opin Investig Drugs, 2019, 28: 85-92. doi:  10.1080/13543784.2019.1551358
    [47] Littlejohn E, Marder W, Lewis E, et al. The ratio of erythrocyte sedimentation rate to C-reactive protein is useful in distinguishing infection from flare in systemic lupus erythematosus patients presenting with fever[J]. Lupus, 2018, 27: 1123-1129. doi:  10.1177/0961203318763732
    [48] Danza A, Ruiz-Irastorza G. Infection risk in systemic lupus erythematosus patients: susceptibility factors and preventive strategies[J]. Lupus, 2013, 22: 1286-1294. doi:  10.1177/0961203313493032
    [49] Gupta D, Zachariah A, Roppelt H, et al. Prophylactic antibiotic usage for Pneumocystis jirovecii pneumonia in patients with systemic lupus erythematosus on cyclophosphamide: a survey of US rheumatologists and the review of literature[J]. J Clin Rheumatol, 2008, 14: 267-272. doi:  10.1097/RHU.0b013e31817a7e30
    [50] Quaglia M, Merlotti G, De andrea M, et al. Viral Infec-tions and Systemic Lupus Erythematosus: New Players in an Old Story[J]. Viruses, 2021, 13: 277. doi:  10.3390/v13020277
    [51] Pringe A, Trail L, Ruperto N, et al. Macrophage activa-tion syndrome in juvenile systemic lupus erythematosus: an under-recognized complication?[J]. Lupus, 2007, 16: 587-592. doi:  10.1177/0961203307079078
    [52] Ravelli A, Minoia F, Davì S, et al. 2016 classification criteria for macrophage activation syndrome complicating systemic juvenile idiopathic arthritis: a European league against rheumatism/American college of rheumatology/paediatric rheumatology international trials organisation collabora-tive initiative[J]. Ann Rheum Dis, 2016, 75: 481-489.
    [53] Abdirakhmanova A, Sazonov V, Mukusheva Z, et al. Macrophage Activation Syndrome in Pediatric Systemic Lupus Erythematosus: A Systematic Review of the Diagnostic Aspects[J]. Front Med (Lausanne), 2021, 8: 681875.
    • 相关文章
    • 施引文献
  • 资源附件(0)
  • 加载中
WeChat 点击查看大图
计量
  • 文章访问数:  1647
  • HTML全文浏览量:  259
  • PDF下载量:  686
  • 被引次数: 0
出版历程
  • 收稿日期:  2022-01-10
  • 录用日期:  2022-02-28
  • 网络出版日期:  2022-03-16
  • 刊出日期:  2022-05-30

目录

    /

    返回文章
    返回
    友情链接: 国家卫生健康委员会 北京协和医院 中国医学科学院 学术不端检测系统 国际知识资源总库 中国知网 术语在线 中国全科医学
    地址：北京市东城区帅府园1号 北京协和医院老楼7号楼
    3层302室 《协和医学杂志》编辑部
    电话：010-69154261/4262
    E - mail：medj@pumch.cn
    mjpumch@126.com
    期刊网站版权所有：《协和医学杂志》编辑部
    京ICP备 11002662

    本系统由 北京仁和汇智信息技术有限公司 开发    百度统计

    x 关闭 永久关闭

    【温馨提醒】近日，《协和医学杂志》编辑部接到作者反映，有多名不法人员冒充期刊编辑发送见刊通知，鼓动作者添加微信，从而骗取版面费的行为。特提醒您，本刊与作者联系的方式均为邮件通知或电话，稿件进度通知邮箱为：mjpumch@126.com，编辑部电话为：010-69154261，请提高警惕，谨防上当受骗！如有任何疑问，请致电编辑部核实。谢谢！