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中国循证儿科杂志

中国循证儿科杂志 ›› 2020, Vol. 15 ›› Issue (3): 224-228.

• 论著 • 上一篇    下一篇

炎症性肠病患儿维持治疗期延迟使用英夫利昔单抗3周 未改变疾病活动指数

周颖1，黄瑛1，罗优优2，陈洁2，耿岚岚3，龚四堂3，游洁玉4，房永利5，张晶5，李中跃6，王朝霞7，吴捷8，肖园9，许春娣9，方莹10，钟雪梅11，李小芹12，陈競芳13，李在玲14，徐樨巍15，郭红梅16，金玉16，商丽红17，谢晓丽17，梅红18，朱莉19   

  1. （以提供病例多少排序）1 复旦大学附属儿科医院上海，201102；2 浙江大学医学院附属儿童医院杭州，310003；3 广州市妇女儿童医疗中心广州，510623；4 湖南省儿童医院长沙，410007；5 首都医科大学附属北京儿童医院北京，100045；6 重庆医科大学附属儿童医院重庆，401122；7 深圳市儿童医院深圳，518038；8 中国医科大学附属盛京医院沈阳，110004；9 上海交通大学医学院附属瑞金医院上海，200025；10 西安交通大学附属儿童医院西安，710003；11 首都儿科研究所附属儿童医院北京，100020；12 河南省儿童医院郑州，450018；13 复旦大学附属儿科医院厦门分院厦门，361006；14 北京大学第三医院北京，100191；15 北京京都儿童医院北京，102208；16 南京医科大学附属儿童医院南京，210000；17 成都市妇女儿童中心医院成都，610073；18 华中科技大学同济医学院附属武汉儿童医院武汉，430015；19 贵州省妇幼保健院贵阳，550003
  • 收稿日期:2020-07-15 修回日期:2020-07-21 出版日期:2020-06-25 发布日期:2020-06-25
  • 通讯作者: 黄瑛

Postponing infliximab infusion for three weeks during maintenance therapy without changing the disease activity index among children with inflammatory bowel disease

ZHOU Ying1，HUANG Ying1, LUO You-you2, CHEN Jie2，GENG Lan-lan3，GONG Si-tang3，YOU Jie-yu4，FANG Yong-li5，ZHANG Jing5，LI Zhong-yue6，WANG Zhao-xia7，WU Jie8，XIAO Yuan9，XU Chun-di9，FANG Ying10，ZHONG Xue-mei11，LI Xiao-qin12，CHEN Jing-fang13，LI Zai-ling14，XU Xi-wei15，GUO Hong-mei16，JIN Yu16, SHANG Li-hong17，XIE Xiao-li17，MEI Hong18，ZHU Li19   

  1. 1 Children's Hospital of Fudan University,Shanghai 201102, China; 2 The Children's Hospital, Zhejiang University School of Medicine,Hangzhou 310003, China; 3 Guangzhou Women and Children's Medical Center,Guangzhou 510623, China; 4 Hunan Children's Hospital,Changsha 410007, China; 5 Beijing Children's Hospital, Capital Medical University,Beijing 100045, China; 6 Childen's Hospital of Chongqing Medical University,Chongqing 401122, China; 7 Shenzhen Children's Hospital,Shenzhen 518038, China; 8 Shengjing Hospital of China Medical University,Shenyang 110004, China; 9 Ruijin Hospital, Shanghai Jiao Tong University School of Medicine,Shanghai 200025, China; 10 Xi'an Children's Hospital, Xi'an 710003, China; 11 Children's Hospital, Capital Institute of Pediatrics,Beijing 100020, China; 12 He'nan Children's Hospital,Zhengzhou 450018, China; 13 Children's Hospital of Fudan University Xiamen Branch,Xiamen 361006, China; 14 Peking University Third Hospital,Beijing 100191, China; 15 Beijing Jing Du Children's Hospital,Beijing 102208, China; 16 Children's Hospital of Nanjing Medical University,Nanjing 210000, China; 17 Chengdu Women's & Children's Central Hospital,Chengdu 610073, China; 18 Wuhan Children's Hospital,Wuhan 430015, China; 19 Clinical Medical School of Maternal and Child Affiliated to Guizhou Medical University,Guiyang 550003, China
  • Received:2020-07-15 Revised:2020-07-21 Online:2020-06-25 Published:2020-06-25
  • Contact: HUANG Ying

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摘要： 目的：评估新型冠状病毒（SARS-CoV-2）流行期间，因为不可抗力因素导致延迟使用英夫利昔单抗（IFX）对炎症性肠病（IBD）患儿疾病活动指数的影响。方法：多中心横断面调查。纳入2020年1月20日至2020年3月20日（疫情中）国内19家医院使用IFX的IBD连续病例，疫情中较疫情前（2020年1月20日前）儿童克罗恩病疾病活动指数（PCDAI）或儿童溃疡性结肠炎疾病活动指数（PUCAI）评分疾病分期加重为病例组，未加重为对照组。考察年龄、性别、延期治疗时间、WBC、Hb、PLT和CRP对疾病分期加重的影响。结果：19家医院参加了本次调查，232例应该接受IFX治疗的IBD患儿中，67例（28.9%）因疫情因素未按时使用IFX。暂停使用2例，疫情中失访；延迟使用65例，其中9例疫情中失访。56例延迟使用IFX［（17.9±9.9）d］并采集到疫情前和中数据的IBD患儿进入本文分析。男27例，女29例，平均年龄（11.3±4.1）岁。病例组11例（诱导阶段3例，维持阶段8例），对照组45例（诱导阶段2例，维持阶段43例）。疫情中与疫情前相比，延迟使用IFX的患儿WBC、Hb、PLT、CRP和疾病活动指数差异均无统计学意义（P分别为0.44、0.60、0.80、0.34和0.33）。11例疾病分期加重，其中6例需要住院，无因为延迟治疗而需要外科手术或死亡的病例。结论：维持治疗阶段延迟3周使用IFX未改变IBD患儿疾病活动指数。

Abstract: Objective:To investigate the effect of delayed infliximab infusion on the disease activity index among children with inflammatory bowel disease during the SARS-CoV-2 epidemic. Methods:This is a multicenter cross-sectional study. Children from 19 hospitals in China who received infliximab infusion for inflammatory bowel disease between January 20th and March 20th were enrolled in the study. Patients whose disease stages were deteriorated according to PCDAI/PUCAI were categorized as case group. Others were in control group. The impact of age, sex, the average length of postpone infusion, WBC count, Hb level, PLT count and CRP level on disease stage were analyzed. Results:Among 232 patients who should receive scheduled infliximab infusion, 67 cases (28.9%) had their infusion delayed due to the epidemic including 2 patients of discontinuing the therapy and losing follow up and 65 patients of delaying the infusion with 9 lost cases. A total of 56 patients (27 males, 29 females, with average age of 11.3±4.1 years) were finally included in the study. The average length of infusion postponement was 17.9±9.9 days. There were 11 patients (3 with induction therapy and 8 with maintenance therapy) in case group and 45 patients (2 with induction therapy and 43 with maintenance therapy) in control group. WBC count, Hb level, PLT count, CRP level and disease activity index were not significantly changed in patients who delayed the infusion (P was 0.44，0.60，0.80，0.34 and 0.33, respectively) compared with that before the epidemic. Disease stages of 11 patients were deteriorated, 6 of which needed hospitalization. There was no case of surgery or death. Conclusion:Postponing infliximab infusion for three weeks during maintenance therapy did not change the disease activity index among children with inflammatory bowel disease.