(单词翻译:单击)
Rheumatoid Arthritis
类风湿性关节炎
It is an autoimmune disease that causes inflammation in your joints.
类风湿性关节炎是一种会导致关节发炎的自身免疫性疾病。
This means that your immune system starts attacking your body's own tissues.
这意味着你的免疫系统开始攻击你身体自身的组织。
Rheumatoid arthritis causes inflammation in the joint lining.
类风湿性关节炎会导致关节内壁发炎。
This results in red, painful and swollen joints.
这会导致关节发红、疼痛和肿胀。
The redness is caused by the flow of blood increasing.
发红是由于血液流量增加引起的。
As a result, the inflammed joint may feel warmer than usual.
因此，发炎的关节可能会比平时感觉更热。
Inflammation is caused by extensive migration of neutrophiles, B-Lymphocytes, T-Lymphocytes, and certain cytokines like IL1, IL6, IL17, IL23, TNF-Alpha, etc. in the joints, leading a swollen painful joints.
炎症是由中性粒细胞、B淋巴细胞、T淋巴细胞和某些细胞因子如IL1、IL6、IL17、IL23、TNF-α等在关节内的广泛迁移引起的，同时会导致关节肿痛。
Common Symptoms
常见症状
Common symptoms of rheumatoid arthritis include joint pain and swelling, stiffness, inability to make a fist, tiredness, fatigue, myalgia.
类风湿性关节炎的常见症状包括关节疼痛、肿胀、僵硬、不能握拳、疲倦、疲劳、肌肉疼痛。
Less commonly: weight loss, inflammation in the eyes, dryness of eyes(sicca symptoms), scleritis, episcleritis, etc.
不常见的症状有：体重减轻、眼部发炎、眼睛干燥（干燥症状）、巩膜炎、巩膜外层炎等。
Rheumatoid nodules, (fleshy lumps below the elbows or in hands and feet).
类风湿性结节（手、脚、肘部以下的肉质肿块）。
Inflammation of other body parts, i.E. Lungs leading to interstitial lung disease.
身体其他部位的炎症，也就是肺部导致间质性肺病。
Rheumatoid arthritis varies from one person to another, but usually starts quite slowly.
类风湿性关节炎因人而异，但通常初期发展得很慢。
Usually, it starts in the small joints of the hand and feet. Later involving large joints as well.
通常始于手和脚的小关节。后来也牵涉到大关节。
You may also feel stiff when you wake up in the morning.
早上醒来时，你可能会感到僵硬。
If you have painful swollen joints and stiffness in the morning that lasts for longer than half an hour, you should see your rheumatologist.
如果你早上关节疼痛、肿胀和僵硬，持续时间超过半小时，你应该去看风湿科医生。
Research shows that the soon as you start treatment for rheumatoid arthritis, the more effective it's likely to be.
研究表明，越早开始治疗类风湿性关节炎，效果就可能越好。
So, early diagnosis, better the outcome.
所以，越早诊断，结果越好。
If not treated properly
如果治疗不当
If not treated properly or there's a delayed diagnosis, this can lead to irreversible joints damage which in long term can lead to disability.
如果治疗不当或诊断延误，可能会导致不可逆转的关节损伤，长期来看，可能会导致残疾。
Common Deformities: - Swan Neck Deformity- Button Hole Deformity- Z Deformity- Ulnar Deviations and many more.
常见畸形：鹅颈畸形，纽孔状畸形，Z字畸形，尺骨偏斜等等。
OUTLOOK
展望
Because rheumatoid arthritis can affect different people in different ways, we can't predict how the condition might develop for you.
由于类风湿性关节炎会以不同的方式影响不同的人，我们无法预测病情会如何发展。
- 75% of people will continue having some joint pain, swelling, and flare-ups.
75%的人将继续有一些关节疼痛、肿胀和突然发作。
- 20% will always have very mild rheumatoid arthritis.
20%的人患有非常轻微的类风湿性关节炎。
- 5% will develop severe disease with extensive disability.
5%的人会发展成严重的疾病，并伴有广泛的残疾。
Seek help from a rheumatologist.
向风湿病医生寻求帮助。
How is Rheumatoid Arthritis Diagnosed?
类风湿性关节炎是如何诊断的？
No single test can give a definite diagnosis of rheumatoid arthritis in the early stage of the condition.
在类风湿性关节炎的早期阶段，任何一项单一的检查都不能给出明确的诊断。
Doctors have to arrive at the diagnosis based on your symptoms, a physical examination and the result of x-rays and blood test.
医生必须根据你的症状、体检以及X光和血液检查结果做出诊断。
Tests which can help to make a diagnosis.
测试可以帮助诊断。
- ESR and CRP can be raised but not always.
红细胞沉降率和蛋白量会提高，但不总是如此。
- RF-IgM usually positive but always remember that negative results do not rule out rheumatoid arthritis.
类风湿因子通常呈阳性，但要记住，阴性结果不能排除类风湿性关节炎的可能。
- Anti CCP: usually positive but always remember that negative results do not rule out rheumatoid arthritis.
抗环瓜氨酸肽抗体通常是阳性的，但要记住，阴性结果不能排除类风湿性关节炎的可能。
Note: rheumatoid arthritis is a clinical diagnosis so always use the test to help to make your diagnosis.
注意：类风湿性关节炎是一种临床诊断，所以一定要使用测试来帮助你做出诊断。
The test can be positive in small number of healthy people as well.
这项检测在少数健康人中也可以呈阳性。
So use this test judiciously along with the clinical history.
因此，要灵活地结合临床病史使用这项检查。
Do not rely on the test without a typical clinical history.
不要依赖没有典型临床病史的测试。
X-rays of hands to look for erosions and joint damage.
手部X光检查是否有侵蚀和关节损伤。
But remember that they are usually normal in the first year of disease.
要记住，在患病的第一年，它们通常是正常的。
Treatment Options
治疗选择
Regular physiotherapy and foot wear are necessary.
定期理疗和穿合适的鞋是非常有必要的。
Four main groups of drugs are used to treat rheumatoid arthritis: - Painkillers, (Analgesics), - Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), - Disease Modifying Anti-Rheumatic Drugs (DMARDs): Conventional: methotrexate, leflunomide, sulfasalazine, HCQ;
用于治疗类风湿性关节炎的药物主要有四类：止痛药，镇痛药，非甾体抗炎药(NSAIDs)，抗风湿改善性药物，常规类如甲氨蝶呤、来氟米特、柳氮磺胺吡啶、羟氯喹；
Biologics: TNF-Alpha blockers, in other words, Etanercept, Adalimumab, etc. IL6 Inhibitors, in other words, Tocilizumab;
生物制剂类如TNF-α受体抑制剂，依那西普、阿达木单抗等。IL6受体抑制剂，托珠单抗；
B-Cell Blockers, in other words, Rituximab; IL17 Inhibitors, secukinumab；Inhibitors of Janus Kinase Pathways, in other words, Tofacitinib - Low Dose Steroids.
B细胞受体抑制剂，利妥昔单抗；IL17受体抑制剂，苏金单抗；两面激酶抑制剂，托法替尼，也是低剂量类固醇。
Remember, most people with rheumatoid arthritis need to take more than one drug.
记住，大多数风湿性关节炎患者需要服用不止一种药物。
This is because different drugs work in different ways.
因为不同的药物有不同的作用方式。
Patients taking any disease modifying antirheumatic drugs, (DMARDs), should have their baseline tests, including cell counts, liver function test, and renal function test every four weeks initially for three months followed by every one to three months, life-long.
服用任何抗风湿改善性药物的患者应该接受基线测试，包括细胞计数、肝功能测试和肾功能测试，最初为每四周测试一次，持续3个月，接下来一直保持每1至3个月测试一次。
Because DMARDs take some time to start working, you may also be given a steroid which can reduce the inflammation and ease your symptoms while the DMARDs are taking effect.
因为抗风湿改善性药物需要一些时间才能起作用，所以在药物生效期间，患者可能还需服用一种类固醇，可以减少炎症，缓解症状。
Regular follow up is the most important part of treatment.
定期随访是治疗中最重要的部分。
The safety and efficacy of drugs needs monitoring at regular intervals.
需要定期监测药物的安全性和有效性。
