Rheumatoid Arthritis

(Rheumatoid Arthritis,RA)0.320.36%355023

RA()B(EB-Ab)TEB gp100HLA-DR4 70-74AA

RARA3.6RA30%RAHLA-DR404010404040570-74----QRRAA/QKRAA

HLA-DR4IL-168TNFT-HLA-DR4TTCRThCD4+TTIL-234B B IgRFIg

MTBCKs(IL-1,2,3,4,6,8,TNF,IFN-PRF(IgG,IgM)ICsPGsLysosomeO2- IL-1IL-1PGsMMPsIL-1TNFGM-CSFIL-8TNFTGF

RA

3/198911/19903/199211/19931/19956/1996PIP

MCP

Wrist

C X

1h 3 14

5 RA* 14625

NSAIDsSAARDs

NSAIDs COX-1/COX-2COX-1COX-2TXA2PGI2PGE2PGsA2

SAARDs(methotrexate, MTX) MTXDNA(IL-2) MTX7.520mgRA68(35) (1)(2) ()(3)(4)

SAARDs(salicylazosulfapyridine, SASP)SASP5-(5-ASA)(SP) 1.0g/d2.0g/d3.0g/d

SAARDs(gold compound) TBRFESR, CRP (auranofin,)3mg

SAARDsD-(D-Penicillamine, DPA) 250mg/d13500mg/d750mg/d(1)(2)(3)(4)(5)

SAARDs(chloroquine,Hydrochloroquine) (1)A(2)IL- 1(3) 400mg/d(6mg/kg/d)250mg/d(4mg/kg/d)3(1)6(2)

SAARDs(azathioprine , Azp) DNATB 50150mg/d

SAARDs(cyclophosphamide, CTX) CTX(1)DNA(2)TBB(3)B 0.51g/m2CTX50100mg/d(1)(2)(3)(4)(5)(6)

SAARDs20mgtid1234

EtanerceptTNFP75IgGFcTNFTNFTNF199720%ACR75%14%50%AC40%5%1025mg/kgANA

InfliximbTNFTNFTNF20%ACR5060%20%50%2530%5%17%MTX48310mg/kg

AnakinraIL-1IL-1Anakinra 150mg qdRA43%20%ACRLarsen5%

2NSAIDs+Pred+MTX+SASPMTX+HCQMTX+T4MTX+AuAZA+MTX+SASP