The Research Of Clinical Features Of Mycoplasma Pneumoniae Infection In Juvenile Idiopathic Arthritis(Non-systemic JIA)

Objective: To evaluate the the clinical features of mycoplasma pneumoniae infected in juvenile idiopathic arthritis(non-systemic JIA) in children and the influence of mycoplasma pneumoniae infection on juvenile idiopathic arthritis(non-systemic JIA) in children; Observe efficacy of drug intervention on the disease prognosis Method:1) According to the diagnostic criteria of JIA drafted by the International League Against Rheumatism and MP infection diagnosis standard drafted the respiratory group of pediatric branch of the Chinese medical association, collect 209 cases diagnosed as JIA(non-systemic JIA) in pediatric department of Renji Hospital affiliated to Shanghai Jiaotong university school of medicine, analyze the relationship of mycoplasma pneumoniae infection of JIA(non-systemic JIA) with different ages, genders, subtypes. By the method of retrospective cohort study, 209 patients diagnosed as juvenile idiopathic arthritis(non-systemic JIA) will be divided into two groups: with mycoplasma pneumoniae infection group and mycoplasma pneumonia non-infection group. 76 patients in the mycoplasma pneumoniae infection group, 133 patients in the mycoplasma pneumonia non-infection group. Compare the differences of disease activity at the disease onset, blood white cells and platelets, erythrocyte sedimentation, c-reactive protein, D-dimer, activity of natural killer cells, T cells subgroups, magnetic resonance imaging of the involved joints between the two groups. 2) 40 cases of JIA(non-systemic JIA with mycoplasma pneumoniae infection follow-up, divided into etanercept treatment group and etanercept with macrolides treatment group, 20 cases in each group. After treatment for 3 months follow-up, compare two groups of DAS28, ACR30, ACR70 and magnetic resonance imaging of involved joints. Results:1)The total positive rate of JIA(non-systemic JIA) with mycoplasma pneumoniae infection was 36.4%. The rate of MP infection in the preschool group is 22.2%, in school age group is 43%, in adolescent group is 30.8%; in male group 32.5%, in female group is 42.2%; 26.2% in ERA group,39.1% in polyarticular JIA group, 45.6% in oligoarticular JIA group. There is significant difference between different ages and joint subtypes, school age>preschool age> adolescent; oligoarticular JIA> polyarticular JIA >ERA. There is no significant difference between different genders. The proportion of patients in the high activity and CHAQ score in the mycoplasma pneumoniae infection group is significantly high than that in the mycoplasma pneumoniae non-infection group. There is no significant difference between the two groups in blood cells. The proportion of increased ESR/CRP ?D – dimer in mycoplasma pneumoniae infection group is obviously higher than that in mycoplasma pneumoniae non-infection group. Activity of natural killer cells ?CD4 and CD4/CD8 in mycoplasma pneumoniae infection group is obviously less than that in mycoplasma pneumoniae non-infection group, to the contrary, CD8 in mycoplasma pneumoniae infection group is obviously more than that in mycoplasma pneumoniae non-infection group. There is no significant difference about CD19 between the two groups. The proportion of which has one or more of images in MRI of joint in the mycoplasma pneumoniae infection group, including joint effusion, bone marrow edema and synovial hyperplasia, is higher than that in the other group. The proportion of which has all the images in MRI of joint in the mycoplasma pneumoniae infection group is higher than that in the other group. 2) The is no significant difference about DAS28 decline numbers and ACR30 improved numbers between the etanercept treatment group and etanercept with macrolides treatment group after three months treatment; The numbers with ACR70 improvement in macrolides with etanercept group are significantly more than that in the etanercept group. About the improvement of their magnetic resonance imaging of involved joints, the etanercept with macrolides treatment group is obviously higher than that of etanercept treatment group. Conclusion: A large proportion of children with juvenile idiopathic arthritis(non-systemic JIA) are infected with mycoplasma pneumoniae, the most susceptible age is school-age and the most susceptible joint type is Oligoarticular JIA. Mycoplasma pneumoniae infection aggravates the condition of children with juvenile idiopathic arthritis(non-systemic JIA). Removal of mycoplasma pneumoniae infection in a timely and effective manner contributes to the treatment of juvenile idiopathic arthritis(non-systemic JIA).