Analysis of the clinical features of pediatric Crohn′s disease with anal fistula
10.3760/cma.j.cn101480-20210609-00044
- VernacularTitle:合并肛瘘的儿童克罗恩病临床特点分析
- Author:
Xueping MA
1
;
Kunlong YAN
1
;
Mei LI
1
;
Yu JIN
1
;
Hongmei GUO
1
Author Information
1. 南京医科大学附属儿童医院消化科，南京 210008
- Publication Type:Journal Article
- Keywords:
Crohn′s disease;
Anal fistula;
Child;
Infliximab;
Clinical features;
Clinical remission
- From:
Chinese Journal of Inflammatory Bowel Diseases
2022;06(2):127-132
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical features, treatment and prognosis in pediatric Crohn′s disease (CD) with anal fistula.Methods:A retrospective case-control study was conducted. Clinical data of 66 children with CD diagnosed at the Department of Gastroenterology of Children′s Hospital of Nanjing Medical University from September 1st, 2014 to August 31th, 2020. According to the presence of anal fistula or not before diagnosis, the children were divided into anal fistula group and non-anal fistula group. The clinical features at initial onset between the above two groups were analyzed statistically. According to the use of infliximab (IFX) or not, children with anal fistula were divided into IFX group and non-IFX group and the clinical remission of anal fistula in the two groups was analyzed statistically.Results:Thirty CD children combined with anal fistula before diagnosis were set as anal fistula group, including 20 children of complex anal fistula and 10 of simple anal fistula. Eleven children underwent anal fistula incision-seton drainage and 19 did not receive surgery. The left 36 children without anal fistula were set as non-anal fistula group. The male proportion of children with anal fistula was higher than that of the children without anal fistula, and the difference was statistically significant (86.7% vs. 58.3%, P = 0.011) . Among the 30 children with anal fistula, 20 were treated with IFX-induced remission and maintenance therapy, and were set as IFX group, 10 were treated with enteral nutrition-induced remission and azathioprine-induced maintenance therapy, and were set as non-IFX group. The clinical remission rate of anal fistula in IFX group was significantly higher than that in non-IFX group after the follow-up period of 6 to 12 months (95% vs. 30%, P = 0.0001) . Conclusion:The CD children with anal fistula is more common in male, and the clinical remission rate of anal fistula is higher after IFX treatment.
