英夫利西单抗治疗儿童肠白塞病的疗效分析  

Analysis on the efficacy of infliximab in treatment of intestinal Beh et′s disease in children

作　　者：李超[1] 邓江红[1] 王江[1] 邝伟英[1] 张俊梅[1] 檀晓华[1] 李士朋[1] 李彩凤[1] LI Chao;DENG Jianghong;WANG Jiang;KUANG Weiying;ZHANG Junmei;TAN Xiaohua;LI Shipeng;LI Caifeng(Department of Rheumatology,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院风湿科,北京100045

出　　处：《中国临床新医学》2024年第9期967-971,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的分析英夫利西单抗治疗儿童肠白塞病的疗效。方法回顾性分析首都医科大学附属北京儿童医院风湿科2017年1月至2020年12月收治的10例肠白塞病患儿的临床资料,均接受英夫利西单抗治疗>3次。探讨肠白塞病患儿消化道及其他系统受累情况、激素及免疫抑制剂治疗情况、英夫利西单抗应用情况以及随访情况等。结果男性7例,女性3例,起病年龄为(8.18±3.66)岁,病程中位时间为3(1~72)个月。10例患儿均有消化道症状,其中腹泻6例、腹痛5例、血便3例、呕吐1例、腹胀1例,3例肠穿孔。消化道超声和内镜检查提示回盲部溃疡最常见。3例合并血管受累。英夫利西单抗的剂量3~5 mg/(kg·次)。英夫利西单抗治疗时间为(20.9±9.5)个月。10例患儿随访中位时间为17.5(14~54)个月。9例患儿予甲泼尼龙冲击治疗。泼尼松初始剂量为1.6~2.0 mg/(kg·d)。8例使用甲氨蝶呤,5例使用环孢素A,5例使用沙利度胺,1例使用吗替麦考酚酯。治疗后所有患儿均无临床症状,炎症指标及消化道超声无异常,病情稳定。6例停用英夫利西单抗。英夫利西单抗输注过程中无过敏反应及活动性感染。结论英夫利西单抗治疗对儿童肠白塞病是一种耐受性良好且有效的治疗方法。Objective To analyze the efficacy of infliximab in treatment of intestinal Beh et′s disease in children.Methods The clinical data of 10 pediatric patients with intestinal Beh et′s disease who were admitted to the Department of Rheumatology of Beijing Children′s Hospital,Capital Medical University from January 2017 to December 2020 were retrospectively analyzed.All the pediatric patients were treated with infliximab more than 3 times.The involvement of digestive tract and other systems in the pediatric patients with intestinal Beh et′s disease,the treatment of hormones and immunosuppressants,the application of infliximab and follow-up results were explored.Results Among the 10 pediatric patients,7 cases were male and 3 cases were female.The age of the pediatric patients with onset was(8.18±3.66)years,and the median duration of disease was 3(1-72)months.All the 10 pediatric patients had digestive symptoms,including diarrhea in 6 cases,abdominal pain in 5 cases,bloody stool in 3 cases,vomiting in 1 case,abdominal distension in 1 case,and intestinal perforation in 3 cases.Digestive tract ultrasound and endoscopy indicated that ileocecal ulcer was the most common.There were 3 cases with concomitant vascular involvement.The dose of infliximab was 3-5 mg/(kg·per time).The duration of infliximab treatment was(20.9±9.5)months.The median follow-up time of the 10 pediatric patients was 17.5(14-54)months.Nine pediatric patients received methylprednisolone pulse therapy.The initial dose of prednisone was 1.6-2.0 mg/(kg·d).Methotrexate was used in 8 cases,cyclosporine A in 5 cases,thalidomide in 5 cases,and mycophenolate mofetil in 1 case.After treatment,all the pediatric patients had no clinical symptoms,and their inflammatory indicators and gastrointestinal ultrasound were normal,and their condition was stable.Infliximab was discontinued in 6 cases.There were no allergic reactions or active infections during the infusion of infliximab.Conclusion Infliximab is a well-tolerated and effective treatment for children

关 键 词：儿童 肠白塞病 英夫利西单抗 

分 类 号：R725.4[医药卫生—儿科]