介绍

From symptoms to diagnosis to treatments, here’s what you need to know about the progression of RA.

类风湿性关节炎（RA）是一种影响关节的慢性疾病。多于1.3 million Americanshave been diagnosed with RA. Of these individuals, more than 75 percent are women. It can occur at any age, but it’s most often diagnosed between the ages of 30 to 59.

RA是一种自身免疫性疾病，其与某些类型的关节炎等骨关节炎（OA）不同。通过RA，身体自身的免疫系统错误地攻击了衬里的组织（称为Symovium）。这导致炎症引起的疼痛，僵硬和肿胀。随着时间的推移，受影响的关节变得越来越多的功能失调。

如果未经处理过，RA可能导致永久性接头损坏。它可以影响任何关节，但手指，手和脚最常见的影响。

幸运的是，现代药物治疗极大地改善了RA人员能够带来健康和相对正常的生活的机会，并防止进步损害。

The symptoms of RA vary from person to person. Most people will experience swelling, pain, and stiffness in multiple joints, which will be similar on both sides of the body (symmetric). RA symptoms are usually worse in the morning, and stiffness may persist for hours after waking. As an autoimmune disease, RA symptoms may be marked by periods of flares followed by periods of remission or disease inactivity.

Possible Symptoms

  • 持续，清晨关节疼痛或僵硬
  • fatigue
  • muscle pain (myalgia)
  • 流感症状（包括低级发烧）
  • lumps under the skin (rheumatoid nodules)
  • 干眼睛或嘴巴

Because RA can progress rapidly, early diagnosis and treatment are important. Your doctor will review your symptoms and medical history, as well as perform a physical examination. It may take time to diagnose RA in its early stages as many of its symptoms mimic other conditions.

While there’s no single test for RA, your doctor and rheumatologist may perform one or multiple diagnostic tests.

As a progressive disease, RA is classified based on its stages or severity of symptoms and disability. Knowing the stage of your disease, as well as how fast the condition is progressing, can help your doctor determine the best treatment plan. Fortunately, due to modern medical advances, a person with RA is unlikely to reach stage IV if treatment is started early.

    阶段我（早）：

  • some joint swelling or pain during movement
  • some evidence of osteoporosis (around joints) based on X-ray scans
  • no destructive changes to joints
  • 没有身体限制
  • Stage II (Moderate):
    • some joint discomfort during movement
    • 骨质疏松症and slight bone or joint damage
    • 邻近的肌肉可能表现出萎缩的迹象
    • 结节或腱鞘炎可能存在
    • no joint deformities
    • 有限的流动性
  • Stage III (Severe):
    • 关节疼痛，延长刚度，弱点
    • 骨质疏松症and loss of cartilage and erosion of bones
    • muscle atrophy is extensive
    • nodules and tenosynovitis present
    • joint deformities present
    • unable to perform normal activities, including self-care or occupational activities
  • Stage IV (End-Stage):
    • jo包括阶段III中的一切
    • 纤维状或软骨病（关节保险丝）
    • 主要是或完全无法执行正常活动
    • 可能是床上的

    • 自从他们的引言一点十多年前，生物药物迅速成为一个 有效的 RA治疗的类型。

    Because they provide rapid symptomatic relief, steroids are sometimes also considered first-line therapies. Older疾病修饰的抗胃酸药物（DMARDS），如甲氨蝶呤，最多可能需要四周时间才能工作。另一方面，生物制剂往往会更快地降低炎症。在大多数情况下，如果单独的药物单独的药物不提供浮雕，则会将生物制剂添加到甲氨蝶呤中。然而，生物学也可以自行使用。

    What Are All the Treatment Options for RA?

    RA affects everyone differently, sotreatmentwill also vary from person to person. Starting treatment early can help ensure a better quality of life.

    DMARDS.

    疾病修饰的抗抗肠药物（DMARDS）仅通过处方提供。与其他治疗RA症状的其他药物不同，DMARD可能会减缓疾病的进展。他们还可以缓解疼痛和炎症，但可能需要几周甚至几个月才能生效。DMARDS包括：

    生物学

    生物学are the newest class of drugs for the treatment of moderate to severe RA. They work by selectively targeting certain components of the immune system directly involved in the RA inflammatory process. Similar to DMARDs, biologics can slow or even halt progression of the disease, especially when treatment begins relatively early. They may be prescribed alone, or in combination with another DMARD. While biologics have their own set of potential side effects, they tend to be better tolerated and may take effect more rapidly than other drugs. Biologics include:

    Nonsteroidal anti-inflammatory (NSAID) drugs

    This class of drugs includes over-the-counter medications and prescription COX-2 inhibitor drugs. NSAIDs provide symptomatic relief from pain and inflammation, but they don’t alter the progression of the disease. They may also pose some risk for heart and stroke issues.

    在柜台上的nsaids：

    • ibuprofen (Advil, Motrin IB, Nuprin)
    • Naproxen钠（Aleve）

    最常见的处方nsaids：

    Corticosteroids

    也称为类固醇，皮质类固醇是一方的处方药，可以减少疼痛和炎症。这些药物以一般方式抑制免疫系统，因此在服用时可能会更大。

    潜在的副作用包括：

    • increased blood sugar
    • 胃溃疡
    • 高血压
    • 骨质疏松症
    • cataracts
    • and others
    • 骨质疏松症

    Corticosteroids include:

    除了药物治疗外,某些生活方式的事实ors can also be beneficial in managing your RA. These factors include your diet, activity level, and other life choices.

    有一些人证据that eating a diet rich in natural antioxidants may help manage symptoms. This means eating a well-balanced diet centered on plant-based foods. Eating more fiber, and increasing your intake of fruits, vegetables, whole grains, and extra virgin olive oil, may also help reduce inflammation. Omega-3 fatty acids from cold-water fish may also help relieve inflammation. These types of fish include:

    • 三文鱼
    • 金枪鱼
    • 鳟鱼
    • mackerel

    研究还表明，锻炼也可能有助于ra症状。水健美操，散步，骑自行车和练习瑜伽可能是好选择。就其他生命选择而言，降低压力水平并获得足够的维生素D也可以有所帮助。戒烟是ra的主要危险因素，是另一个有用的推荐。

    过去，RA治疗在很大程度上包括提供症状缓解。但是，DMARDS和生物学的引入改变了RA的管理。今天被诊断出患有RA的人可能通过仔细监测和有针对性的治疗来拥有近常生的生活。

    Studies have found that early treatment may “改善长期结果” and that active and aggressive treatment “pays off, even in the long run” 。专家怀疑早期治疗with inflammation-reducing therapies may also reduce the incidence of cardiovascular disease among RA patients. Research 还显示,切换药物可能有帮助those who don’t respond to an initial therapy.

    但是，虽然早期治疗可以缓慢疾病进展，但一些治疗也可能引发不必要的感染。例如，因为生物学通过针对免疫系统的特定方面的特定方面，所以有潜在的发展风险机会主义感染如结核病和某些真菌感染。

    Despite this risk, biologics are still considered to be extremely beneficial to those with RA. Modern biologics have been shown to prevent joint damage and the associated surgeries and have greatly improved patients’ ability to lead near-normal, productive lives.