Clinical Effect Of Infliximab On Pediatric Inflammatory Bowel Disease

Objective: Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory disease of intestine.Infliximab(IFX)is a human mouse chimeric monoclonal IgG1 antibody.It is a synthetic biological agent,which can reduce the inflammatory response and chronic intestinal injury by regulating the immune pattern of the body.The purpose of this study is to evaluate the efficacy and safety of IFX in the treatment of children with inflammatory bowel disease(PIBD).Methods: The clinical data of PIBD patients admitted to Shengjing Hospital Affiliated to China Medical University from July 2010 to December 2019 were analyzed retrospectively.The clinical data of the patients treated with IFX at week 0,14 and 30,including clinical symptoms,time of onset,laboratory examination,imaging,gastroenteroscopy and pathological examination,adverse reactions,etc.;at the same time,the clinical data of the patients treated with IFX and PIBD treated with hormone at week 4 were compared.Results: A total of 31 children with IBD were treated with IFX regularly,including 22 cases of Crohn's disease and 9 cases of ulcerative colitis,18 males and 13 females.During the 0,14 and 30 weeks of treatment,the clinical symptoms of diarrhea,bloody stool,abdominal pain,weight gain,PCDAI and PUCAI of children decreased significantly(P < 0.05).In the early stage of disease(the 4th week),the total clinical effective rate of UC group treated with IFX was 100%(9 / 9),and that of UC group treated with IFX was significantly higher than that of CD group treated with hormone(44.44%,4 / 9),the difference was statistically significant(P < 0.05);the total clinical effective rate of CD group treated with IFX was 95.45%(21 / 22),significantly higher than that of control group(60%,6 / 10),the difference was statistically significant(P < 0.05).The biochemical indexes WBC,PLT,Hb,ESR and CRP tended to normal values at the 14 th and 30 th week after IFX treatment.According to the statistics of adverse reactions,during the treatment with IFX,2 patients(6.45%)had pulmonary infection(improved after antibacterial treatment),1 patient(3.23%)had transfusion reaction(improved after symptomatic treatment,no impact on the continued application of IFX),no allergic reaction,no tuberculosis spread and other serious infections,no tumor related adverse reactions.Conclusions: 1.Infliximab can significantly reduce the clinical symptoms of PIBD children,reduce disease activity,promote physical development,restore normal biochemical indicators and imaging changes.2.IFX treatment of PIBD,the incidence of adverse reactions is low,no serious adverse reactions,the application of safety.3.Compared with glucocorticoid,IFX is more effective in the treatment of PIBD.