英夫利西单抗治疗儿童克罗恩病的临床分析

Efficacy of infliximab in the treatment of Crohn's disease in children

摘要:

目的 探讨英夫利西单抗(IFX)治疗儿童克罗恩病(CD)的临床疗效与安全性。方法 2011年1 月至2014 年12 月确诊为CD 的患儿13 例,在常规综合治疗基础上,加用IFX(5 mg/kg)治疗,回顾性分析所有患儿治疗前及治疗30 周后的临床表现、实验室指标及儿童克罗恩病活动指数(PCDAI)的变化,同时内镜下进行疗效评估。结果 所有患儿腹痛、腹泻、便血等临床症状在治疗后短期内迅速缓解并未见复发,治疗30 周后白细胞计数、红细胞沉降率、C 反应蛋白及PCDAI 较治疗前明显降低,血红蛋白较治疗前明显升高(P<0.05);2 例患儿复查内镜,1 例痊愈,1 例无效;所有患儿均未见药物不良反应发生。结论 IFX 治疗儿童CD 临床疗效显著,无明显的不良反应,可作为治疗儿童CD 的首选方案之一。

Abstract:

Objective To evaluate the efficacy and safety of infliximab in the treatment of Crohn's disease in children. Methods Thirteen children who were diagnosed with Crohn's disease and received routine comprehensive treatment and infliximab (5 mg/kg) between January 2011 and December 2014 were enrolled. The changes in their clinical manifestations, laboratory indices, and Pediatric Crohn's Disease Activity Index (PCDAI) after the 30-week treatment were analyzed retrospectively. Meanwhile, endoscopy was performed to evaluate therapeutic effects. Results The symptoms such as abdominal pain, diarrhea, and bloody stool were relieved soon after infliximab treatment, with no recurrence observed;after the 30-week treatment, the white blood cell count, erythrocyte sedimentation rate, C-reactive protein, and the PCDAI decreased, while the hemoglobin increased significantly compared with those before treatment (P<0.05). After infliximab treatment, two children underwent endoscopy. The endoscopy showed that one child was cured, and the other child failed to respond to the treatment. No adverse drug reactions were seen in all patients. Conclusions Infliximab treatment has significant clinical effects in children with Crohn's disease, with no obvious adverse reactions, and therefore, it can be applied as one of the preferred alternatives for treatment of Crohn's disease in children.