Page 132 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第45卷第4期
·568 · Journal of Nanjing Medical University（Natural Sciences） 2025年4月

·临床研究·

儿童克罗恩病的临床模式：一项单中心的3年随访研究

林凤莲 ，程卫霞 ，闫坤龙 ，刘志峰 ，郭红梅 1*
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南京医科大学附属儿童医院消化内科，江苏 南京 210008；盐城市第一人民医院儿科，江苏 盐城 224000
［摘 要］ 目的：探索儿童克罗恩病的临床模式及其影响因素。方法：回顾性分析2015年11月—2020年11月于南京医科大
学附属儿童医院消化科初诊为克罗恩病的59例患儿的基线资料，包括年龄、性别、临床表现、实验室检查、影像学检查、内窥镜
检查以及治疗方案等。采用Logistic回归模型分析儿童克罗恩临床模式的影响因素。结果：在59例患儿中，11例失访，48例完
成长程随访。随访期间，1例死亡，1例行肠部分切除手术，7例（14.6%）出现新的狭窄性疾病行为，29例（60.4%）出现复发。31例
（64.6%）随访期间肠道症状严重程度下降，定义为静止模式；症状严重程度增加、慢性持续症状和慢性复发症状分别有 2 例
（4.2%）、5例（10.4%）和10例（20.8%），定义为严重模式。回归模型分析显示，初诊时消瘦可能是患儿克罗恩病进展为严重模
式的风险因素（OR=4.009，95%CI：1.047~15.346，P=0.043）；严重模式患儿合并狭窄或穿孔比例明显高于静止模式患儿（41.2%
vs. 16.1%），但差异无统计学意义；初诊时治疗方案未对克罗恩的疾病模式产生显著影响。结论：初诊时消瘦可能是克罗恩病
进展为严重疾病模式的风险因素，因此，应对这些患儿给予更为积极的治疗和紧密随访。
［关键词］ 克罗恩病；儿童；临床模式；消瘦；随访
［中图分类号］ R725.7 ［文献标志码］ A ［文章编号］ 1007⁃4368（2025）04⁃568⁃06
doi：10.7655/NYDXBNSN240787

Clinical pattern of Crohn’s disease in children：a 3⁃year single⁃center follow⁃up study
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LIN Fenglian ，CHENG Weixia ，YAN Kunlong ，LIU Zhifeng ，GUO Hongmei 1*
1 Department of Gastroenterology，Children’s Hospital Affiliated to Nanjing Medical University，Nanjing 210008；
Department of Pediatrics，Yancheng First People’s Hospital，Yancheng 224000，China
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［Abstract］ Objective：To investigate the clinical pattern and influencing factors of pediatric Crohn’s disease. Methods：A
retrospective analysis was conducted on the baseline data of 59 children who were diagnosed with Crohn’s disease and admitted at the
Children’s Hospital Affiliated to Nanjing Medical University，from November 2015 to November 2020. Data collected included age，
sex，clinical symptoms，laboratory tests，imaging，endoscopic examinations，and treatment plans. Logistic regression models were used
to analyze the influencing factors of clinical patterns in pediatric Crohn’s disease. Results：Among the 59 children，11 were lost to
follow⁃up，and 48 completed long⁃term follow⁃up. During the follow⁃up，1 child died，1 underwent partial enterectomy，7（14.6%）
developed new stenotic disease behavior，and 29（60.4%）had recurrence. Among the 48 children，31（64.6%）reported a decrease in
the severity of intestinal symptoms，defined as the quiescent pattern，2（4.2%），5（10.4%），and 10（20.8%）had an increase in symptom
severity，chronic persistent symptoms，and chronic reccurrent symptoms，defined as the severe pattern. The regression analysis
indicated that wasting at the time of initial diagnosis could be a risk factor for the progression of Crohn’s disease to a severe pattern
（OR=4.009，95% CI：1.047- 15.346，P=0.043）. The percentage of children with combined stenosis or perforation was significantly
higher in the severe pattern than in the quiescent pattern（41.2% vs. 16.1%）. The initial treatment plan did not significantly affect the
disease pattern of Crohn’s disease. Conclusion：Wasting at the time of initial diagnosis may serve as a risk factor for the progression of
Crohn’s disease to a severe pattern，indicating the need for more aggressive treatment and close follow⁃up for these children.
［Key words］ Crohn’s disease；children；clinical pattern；wasting；follow⁃up
［J Nanjing Med Univ，2025，45（04）：568⁃573］

［基金项目］ 南京市科学技术委员会（ZKX20042）
通信作者（Corresponding author），E⁃mail：guohongmei2026@aliyun.com（ORCID：0000⁃0001⁃6538⁃4234）
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