如何管理类风湿关节炎并发症

Doctors useX射线视图糜烂, where inflammation has "eaten away" at bone. "Clinically, that translates to a possible permanent loss of function ofcertain joints“拉里博士说，”所以我们的治疗原理是双重的。我们希望患者感觉更好，对疼痛和僵硬走开了，我们要防止关节损伤。好消息：按常规使用的疗法有效地管理疼痛和炎症，并且是疾病修饰的联合水平，防止损伤和残疾“。

Doctors typically like to start treatment early, but treatments may involve medications that降低或抑制免疫系统somehow, says Dr. Lally. "The immune system has been overactive, and then medications present us with a host of potential related side effects. Yes, these drugs can be life-changing in a good way, but side effects require appropriate use and close monitoring. The biggest concern is infection, so we take special care to try and prevent that."

As effective treatments for RA have progressed, the extent of complications has changed, Dr. Lally says, and in general, it's good news. "We don't really see a lot of neuropathy or nerve damage anymore. In addition, we don't see so much vasculitis or blood vessel inflammation. These both were part of a group of更严重的并发症that were more prominent before we had so many newer, effective therapies."

"Studieshave shown for a long time that there's ahigher risk for heart diseaseand stroke in patients with RA than in the general population," says Dr. Lally. That means RA treatment also focuses on reducing the risks of heart disease, which means controlling obesity, high cholesterol, high blood pressure, and diabetes. "Some conditions can worsen due to RA therapies, so it's important that patients be closely monitored on the right therapy for them."

Doctors must maintain a delicate balance between achieving remission and stopping more joint damage, while keeping side effects at bay. The majority of patients with RA take a disease-modifying antirheumatic drug or DMARD, which can includebiologicsthat do increase potential for infection in some people. Many RA patients also take nonsteroidal anti-inflammatory drugs or NSAIDs; glucocorticoids, a.k.a., steroids; or other analgesics such as acetaminophen.

拉里博士说，与RA的人是骨质疏松症的风险较高。该美国国立卫生研究院（NIH）引用研究确定增加骨量丢失和骨折的风险。在治疗中使用糖皮质激素药物也可诱发显著骨质流失的美国国立卫生研究院说。这是周期性的：疼痛和关节功能造成闲置的损失，提高骨质疏松症的风险。最后，研究表明，发生只是因为疾病的骨质流失。良好的营养，锻炼和健康的生活方式有助于减缓病情发展。

Patients with RA are at an increased risk for interstitial lung disease (ILD), which can be the result of the disease itself or from some therapies used to treat RA. There are many different subtypes of pulmonary involvement and ILD in RA. Collaboration between rheumatologists and pulmonologists is essential to make the right diagnosis and to formulate a treatment plan. In addition to immunosuppressive medications, ILD patients may also require oxygen therapy and pulmonary rehabilitation.

A study in the August 2017 edition of the journalRheumatology发现，生物药物，利妥昔单抗，可能是谁拥有RA相关性ILD人良好的治疗选择。患者组接受药物治疗关节炎。肺功能保持稳定或在长期随访期间利妥昔单抗使用后，大多数患者的改善。

这是众所周知的是关节炎引起关节发炎，以及关节炎患者可以发展在身体其他部位的炎症，拉里博士说。眼睛不免疫和可以开发的范围内干眼综合征，巩膜炎，巩膜外层炎和条件下，对周边溃疡性角膜炎，葡萄膜炎，白内障和青光眼甚至。看到HealthCentral's complete slideshow about RA and eye conditions.

Yourdiligent self-care, in coordination with your doctor, may help prevent some complications.

该Arthritis Foundationrecommends you consider an anti-inflammatory diet, balancing activity with rest, physical activity (exercise), heat and cold treatments, topical treatments, some natural and alternative therapies, supplements, and that you maintain a positive attitude and support system. Being proactive about your condition may benefit you in so many ways.