译者：李变变校对：侯睿宏审核：张莉芸

Abstract：Polymyalgiarheumatica(PMR)isacommoninflammatoryconditionthatoftenaffectspeopleover

theageof50years.Characteristicsymptomsareshoulderandhipgirdlepainandprolongedmorningstiffness.

Markersofinflammationareoftenelevated.CliniciansareoftenfacedwiththechallengeofdistinguishingPMR

fromotherconditions,particularlyrheumatoidarthritisandspondyloarthropathythatcanmimicsymptomsof

PMRinolderpeople.Additionally,thereisanassociationbetweenPMRandgiantcellarteritis,acommonlarge-vesselvasculitiswhichalsoaffectspeopleovertheageof50years.Imagingofthelargevesselsinasymptomatic

patientswithPMRoftenrevealsfindingsofsubclinicalvasculitis. Presently,therearenoteststhatarespecific

forthediagnosisofPMRandcliniciansrelyonacombinationof

history,physicalexamination,laboratorytestsandimagingstudiestomakeadiagnosis.Arecentundertaking

bytheEuropeanLeagueAgainstRheumatism/AmericanCollegeofRheumatologyhasledtothepublication

ofprovisionalclassificationcriteriaofPMR.Ultrasonography,whichisbeingincreasinglyusedby

rheumatologists,cangreatlyaidinthediagnosisofPMRandoftenshowschangesofsynovitisandtenosynovitis. Treatmentconsistsoflowdosesofglucocorticoidswhichareassociatedwithmorbidity.Evaluationofnewer

biologictherapiestargetinginflammatorycytokinesisunderway.Despitetreatment,relapsesarecommon.

摘要：风湿性多肌痛(PMR)是一种常见的炎症性疾病,常常累及50岁以上的老人。典型症状为肩部、臀周的疼痛和晨僵。炎症指标通常升高。临床医生常常面临较大的难题是如何鉴别风湿性多肌痛和与其有相似症状的也同样发生在老年人的其它风湿疾病，尤其是类风湿关节炎和脊柱关节病。另外,PMR和巨细胞动脉炎具有相关性，而巨细胞动脉炎是一种普遍发生在大血管的炎症，也常累及50岁以上的老人。在无症状PMR的患者中，大血管的影像学检查可发现亚临床血管炎。目前,诊断PMR缺乏确切的检查手段。临床医生依据病史、体格检查,实验室检测和影像学资料来明确诊断。欧洲风湿病联盟/美国风湿病学会最近制定了PMR的临时分类标准。超声这一技术广泛地应用于风湿科，它能够有助于诊断风湿性多肌痛，并且能显示滑膜炎和腱鞘炎的变化。治疗上可以使用小剂量的糖皮质激素，并取决于疾病活动度。针对炎症细胞因子的新的生物治疗仍在研究中。尽管有明确的治疗方法,但复发是常见的。

引自：KermaniTA，WarringtonKJ. Advancesandchallengesinthediagnosisandtreatmentofpolymyalgiarheumatica. TherAdvMusculoskeletDis.Feb2014;6(1):8–19.

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