儿童溃疡性结肠炎的临床表现和治疗进展
Clinical Manifestations and Treatment Progress of Childhood Ulcerative Colitis
摘要: 儿童溃疡性结肠炎(UC)是一组原因不明的累及结肠黏膜和黏膜下层的连续性、倒灌性、非特异性的慢性肠道炎症性疾病，目前对其病因尚没有完全明确。所以，目前在诊断和治疗方面仍面临着巨大的挑战。近年来随着经济的发展儿童溃疡性结肠炎的发病率正在逐年上升，引起了众多儿科医师的广泛关注。本文对儿童溃疡性结肠炎(UC)的临床表现及治疗等方面进行综述。
Abstract: Childhood ulcerative colitis bowel disease (UC) is a group of continuous, retrograde, non-specific chronic intestinal inflammatory diseases involving the colonic mucosa and submucosa of unknown etiology. Therefore, there are still great challenges in diagnosis and treatment. In recent years, with the development of economy, the incidence of childhood ulcerative colitis is increasing year by year, which has attracted the attention of many pediatricians. This article reviews the clinical manifestations and treatment of childhood ulcerative colitis (UC).
文章引用：王馨怡, 卢雪萌. 儿童溃疡性结肠炎的临床表现和治疗进展[J]. 临床医学进展, 2024, 14(11): 87-93. https://doi.org/10.12677/acm.2024.14112850

参考文献

[1] 张玉洁, 梁洁, 吴开春. 炎症性肠病诊断与治疗的共识意见(2018年, 北京)溃疡性结肠炎部分解读[J]. 中华消化杂志, 2018, 38(5): 312-314.
[2] Kwon, Y., Kim, E.S., Choe, Y.H. and Kim, M.J. (2022) Increased Demand for Therapeutic Drugs in Pediatric Ulcerative Colitis Patients with Extraintestinal Manifestations. Frontiers in Pediatrics, 10, Article ID: 853019. [Google Scholar] [CrossRef] [PubMed]
[3] Wang, X., Zhang, Y., Xu, C., Jiang, L., Huang, Y., Du, H., et al. (2013) Inflammatory Bowel Disease in Chinese Children: A Multicenter Analysis over a Decade from Shanghai. Inflammatory Bowel Diseases, 19, 423-428. [Google Scholar] [CrossRef] [PubMed]
[4] 中华医学会儿科学分会消化学组, 中华医学会儿科学分会临床营养学组. 儿童炎症性肠病诊断和治疗专家共识[J]. 中华儿科杂志, 2019, 57(7): 501-507.
[5] Kugathasan, S., Judd, R.H., Hoffmann, R.G., Heikenen, J., Telega, G., Khan, F., et al. (2003) Epidemiologic and Clinical Characteristics of Children with Newly Diagnosed Inflammatory Bowel Disease in Wisconsin: A Statewide Population-Based Study. The Journal of Pediatrics, 143, 525-531. [Google Scholar] [CrossRef] [PubMed]
[6] Mirzayi, C., Renson, A. and Genomic Standards Consortium (2021) Reporting Guidelines for Human Microbiome Research: The STORMS Checklist. Nature Medicine, 27, 1885-1892.
[7] Mamula, P., Telega, G.W., Markowitz, J.E., Brown, K.A., Russo, P.A., Piccoli, D.A., et al. (2002) Inflammatory Bowel Disease in Children 5 Years of Age and Younger. The American Journal of Gastroenterology, 97, 2005-2010. [Google Scholar] [CrossRef] [PubMed]
[8] Rothfuss, K.S., Stange, E.F. and Herrlinger, K.R. (2006) Extraintestinal Manifestations and Complications in Inflammatory Bowel Diseases. World Journal of Gastroenterology, 12, Article No. 4819. [Google Scholar] [CrossRef] [PubMed]
[9] Hyams, J.S., Brimacombe, M., Haberman, Y., Walters, T., Gibson, G., Mo, A., et al. (2021) Clinical and Host Biological Factors Predict Colectomy Risk in Children Newly Diagnosed with Ulcerative Colitis. Inflammatory Bowel Diseases, 28, 151-160. [Google Scholar] [CrossRef] [PubMed]
[10] Oliveira, S.B. and Monteiro, I.M. (2017) Diagnosis and Management of Inflammatory Bowel Disease in Children. BMJ, 357, j2083. [Google Scholar] [CrossRef] [PubMed]
[11] Ford, A.C., Khan, K.J., Achkar, J. and Moayyedi, P. (2012) Efficacy of Oral vs. Topical, or Combined Oral and Topical 5-Aminosalicylates, in Ulcerative Colitis: Systematic Review and Meta-Analysis. American Journal of Gastroenterology, 107, 167-176. [Google Scholar] [CrossRef] [PubMed]
[12] Harbord, M., Eliakim, R., Bettenworth, D., Karmiris, K., Katsanos, K., Kopylov, U., et al. (2017) Third European Evidence-Based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 2: Current Management. Journal of Crohn’s and Colitis, 11, 769-784. [Google Scholar] [CrossRef] [PubMed]
[13] Zeisler, B., Lerer, T., Markowitz, J., Mack, D., Griffiths, A., Bousvaros, A., et al. (2013) Outcome Following Aminosalicylate Therapy in Children Newly Diagnosed as Having Ulcerative Colitis. Journal of Pediatric Gastroenterology and Nutrition, 56, 12-18. [Google Scholar] [CrossRef] [PubMed]
[14] Marteau, P. (2005) Combined Oral and Enema Treatment with Pentasa (Mesalazine) Is Superior to Oral Therapy Alone in Patients with Extensive Mild/Moderate Active Ulcerative Colitis: A Randomised, Double Blind, Placebo Controlled Study. Gut, 54, 960-965. [Google Scholar] [CrossRef] [PubMed]
[15] Raine, T., Bonovas, S., Burisch, J., Kucharzik, T., Adamina, M., Annese, V., et al. (2021) ECCO Guidelines on Therapeutics in Ulcerative Colitis: Medical Treatment. Journal of Crohn’s and Colitis, 16, 2-17. [Google Scholar] [CrossRef] [PubMed]
[16] Sandborn, W.J., Su, C., Sands, B.E., D’Haens, G.R., Vermeire, S., Schreiber, S., et al. (2017) Tofacitinib as Induction and Maintenance Therapy for Ulcerative Colitis. New England Journal of Medicine, 376, 1723-1736. [Google Scholar] [CrossRef] [PubMed]
[17] Lawrance, I.C., Baird, A., Lightower, D., Radford-Smith, G., Andrews, J.M. and Connor, S. (2017) Efficacy of Rectal Tacrolimus for Induction Therapy in Patients with Resistant Ulcerative Proctitis. Clinical Gastroenterology and Hepatology, 15, 1248-1255. [Google Scholar] [CrossRef] [PubMed]
[18] Lie, M.R.K.L., Kreijne, J.E., Dijkstra, G., Löwenberg, M., van Assche, G., West, R.L., et al. (2020) No Superiority of Tacrolimus Suppositories vs Beclomethasone Suppositories in a Randomized Trial of Patients with Refractory Ulcerative Proctitis. Clinical Gastroenterology and Hepatology, 18, 1777-1784.e2. [Google Scholar] [CrossRef] [PubMed]
[19] Iacomino, G., Rotondi Aufiero, V., Iannaccone, N., Melina, R., Giardullo, N., De Chiara, G., et al. (2020) IBD: Role of Intestinal Compartments in the Mucosal Immune Response. Immunobiology, 225, Article ID: 151849. [Google Scholar] [CrossRef] [PubMed]
[20] Turner, D., Ruemmele, F.M., Orlanski-Meyer, E., et al. (2018) Management of Paediatric Ulcerative Colitis, Part 1: Ambulatory Care—An Evidence-Based Guideline from European Crohn’s and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition. Journal of Pediatric Gastroenterology and Nutrition, 67, 257-291.
[21] Falaiye, T.O., Mitchell, K.R., Lu, Z., Saville, B.R., Horst, S.N., Moulton, D.E., et al. (2014) Outcomes Following Infliximab Therapy for Pediatric Patients Hospitalized with Refractory Colitis-Predominant IBD. Journal of Pediatric Gastroenterology and Nutrition, 58, 213-219. [Google Scholar] [CrossRef] [PubMed]
[22] Fasanmade, A.A., Adedokun, O.J., Olson, A., Strauss, R. and Davis, H.M. (2010) Serum Albumin Concentration: A Predictive Factor of Infliximab Pharmacokinetics and Clinical Response in Patients with Ulcerative Colitis. International Journal of Clinical Pharmacology and Therapeutics, 48, 297-308. [Google Scholar] [CrossRef] [PubMed]
[23] Scaldaferri, F., D’Ambrosio, D., Holleran, G., Poscia, A., Petito, V., Lopetuso, L., et al. (2017) Body Mass Index Influences Infliximab Post-Infusion Levels and Correlates with Prospective Loss of Response to the Drug in a Cohort of Inflammatory Bowel Disease Patients under Maintenance Therapy with Infliximab. PLOS ONE, 12, e0186575. [Google Scholar] [CrossRef] [PubMed]
[24] 官德秀, 吴捷, 张晶, 等. 英夫利西单克隆抗体治疗儿童溃疡性结肠炎的疗效及安全性评价[J]. 中国小儿急救医学, 2022, 29(9): 676-680.
[25] Kim, M.J., Kim, E., Kang, B. and Choe, Y.H. (2021) Infliximab Therapy for Children with Moderate to Severe Ulcerative Colitis: A Step-Up versus a Top-Down Strategy. Yonsei Medical Journal, 62, Article No. 608. [Google Scholar] [CrossRef] [PubMed]
[26] 王风范, 韩亚楠, 任晓侠, 等. 阿达木单克隆抗体在儿童炎症性肠病治疗中的应用初探[J]. 中华炎性肠病杂志, 2021, 5(3): 267-270.
[27] 程小韵, 李景南. 生物制剂和小分子药物在炎症性肠病中的应用现状[J]. 中华内科杂志, 2021, 60(4): 376-379.
[28] Walters, T.D., Faubion, W.A., Griffiths, A.M., Baldassano, R.N., Escher, J., Ruemmele, F.M., et al. (2017) Growth Improvement with Adalimumab Treatment in Children with Moderately to Severely Active Crohnʼs Disease. Inflammatory Bowel Diseases, 23, 967-975. [Google Scholar] [CrossRef] [PubMed]
[29] Faubion, W.A., Dubinsky, M., Ruemmele, F.M., Escher, J., Rosh, J., Hyams, J.S., et al. (2017) Long-Term Efficacy and Safety of Adalimumab in Pediatric Patients with Crohnʼs Disease. Inflammatory Bowel Diseases, 23, 453-460. [Google Scholar] [CrossRef] [PubMed]
[30] Croft, N.M., Faubion, W.A., Kugathasan, S., Kierkus, J., Ruemmele, F.M., Shimizu, T., et al. (2021) Efficacy and Safety of Adalimumab in Paediatric Patients with Moderate-to-Severe Ulcerative Colitis (ENVISION I): A Randomised, Controlled, Phase 3 Study. The Lancet Gastroenterology & Hepatology, 6, 616-627. [Google Scholar] [CrossRef] [PubMed]
[31] Breton, J., Kastl, A., Hoffmann, N., Rogers, R., Grossman, A.B., Mamula, P., et al. (2019) Efficacy of Combination Antibiotic Therapy for Refractory Pediatric Inflammatory Bowel Disease. Inflammatory Bowel Diseases, 25, 1586-1593. [Google Scholar] [CrossRef] [PubMed]
[32] 向建康, 张吉翔, 田山, 等. 抗生素在炎症性肠病辅助治疗中的研究进展[J]. 中华炎性肠病杂志, 2022, 6(3): 254-258.
[33] Cottone, M., Scimeca, D., Mocciaro, F., Civitavecchia, G., Perricone, G. and Orlando, A. (2008) Clinical Course of Ulcerative Colitis. Digestive and Liver Disease, 40, S247-S252. [Google Scholar] [CrossRef] [PubMed]
[34] Hahnloser, D., Pemberton, J.H., Wolff, B.G., Larson, D., Harrington, J., Farouk, R., et al. (2004) Pregnancy and Delivery before and after Ileal Pouch-Anal Anastomosis for Inflammatory Bowel Disease: Immediate and Long-Term Consequences and Outcomes. Diseases of the Colon & Rectum, 47, 1127-1135. [Google Scholar] [CrossRef] [PubMed]
[35] Kjaer, M.D., Laursen, S.B., Qvist, N., Kjeldsen, J. and Poornoroozy, P.H. (2014) Sexual Function and Body Image Are Similar after Laparoscopy‐Assisted and Open Ileal Pouch-Anal Anastomosis. World Journal of Surgery, 38, 2460-2465. [Google Scholar] [CrossRef] [PubMed]
[36] 周娟, 肖雄, 夏雨, 等. 炎症性肠病初诊患儿营养状况及影响因素分析[J]. 中国当代儿科杂志, 2023, 25(7): 745-750.
[37] Bischoff, S.C., et al. (2022) Guía ESPEN: Nutrición clínica en la enfermedad inflamatoria intestinal [ESPEN Guideline: Clinical Nutrition in Inflammatory Bowel Disease]. Nutricion Hospitalaria, 39, 678-703.
[38] Turner, D., Travis, S.P.L., Griffiths, A.M., Ruemmele, F.M., Levine, A., Benchimol, E.I., et al. (2011) Consensus for Managing Acute Severe Ulcerative Colitis in Children: A Systematic Review and Joint Statement from ECCO, ESPGHAN, and the Porto IBD Working Group of Espghan. American Journal of Gastroenterology, 106, 574-588. [Google Scholar] [CrossRef] [PubMed]
[39] Forbes, A., Escher, J., Hébuterne, X., Kłęk, S., Krznaric, Z., Schneider, S., et al. (2019) ESPEN Guideline: Clinical Nutrition in Inflammatory Bowel Disease. Clinical Nutrition, 36, 321-347.
[40] Jansson, S., Malham, M., Paerregaard, A., Jakobsen, C. and Wewer, V. (2020) Extraintestinal Manifestations Are Associated with Disease Severity in Pediatric Onset Inflammatory Bowel Disease. Journal of Pediatric Gastroenterology and Nutrition, 71, 40-45. [Google Scholar] [CrossRef] [PubMed]
[41] Greuter, T., Bertoldo, F., Rechner, R., Straumann, A., Biedermann, L., Zeitz, J., et al. (2017) Extraintestinal Manifestations of Pediatric Inflammatory Bowel Disease: Prevalence, Presentation, and Anti-TNF Treatment. Journal of Pediatric Gastroenterology and Nutrition, 65, 200-206. [Google Scholar] [CrossRef] [PubMed]

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