目的 探索英夫利昔单抗诱导治疗儿童克罗恩病疗效的预测指标。方法 回顾性分析2018年1月1日至2023年7月31日消化科收治的确诊为克罗恩病且初次使用英夫利昔单抗治疗的患儿临床资料。比较英夫利昔单抗诱导治疗14周黏膜愈合和未愈合患儿治疗前的临床特征和实验室检查。结果 纳入53例克罗恩病患儿，男39例、女14例，中位确诊年龄12.0（11.0~13.0）岁。从发病至第1次使用英夫利昔单抗的中位时间为5.0（2.0~12.0）个月。53例患儿均为中、重度克罗恩病，其中合并肛瘘27例，肛瘘合并肠腔狭窄9例，肠腔狭窄8例，肠道广泛病变7例，生长迟缓2例。多因素logistic回归分析显示克罗恩病简单内镜评分（SES-CD）、C-反应蛋白（CRP）、降钙素原（PCT）可能与英夫利昔单抗诱导治疗内镜下黏膜未愈合结局相关（P<0.05）。基线SES-CD、CRP和PCT预测英夫利昔单抗诱导治疗内镜下黏膜未愈合的受试者工作特征（ROC）曲线下面积（AUC）分别为0.73、0.77和0.77；三项指标联合预测的灵敏度为0.96，特异度0.68，AUC为0.88。结论 对于英夫利昔单抗诱导治疗儿童克罗恩病的疗效，治疗前SES-CD、CRP和PCT三项指标联合的预测价值更高。

Objective To explore the predictive indexes for the efficacy of infliximab induction therapy in children with Crohn's disease. Methods The clinical data of children diagnosed with Crohn's disease and initially treated with infliximab in the Gastroenterology Department from January 1, 2018 to July 31, 2023 were retrospectively analyzed. The clinical features and laboratory tests before treatment were compared between children with mucosal healing and those without mucosal healing after 14 weeks of infliximab induction therapy. Results Fifty-three children with Crohn's disease (39 boys and 14 girls) were included, and the median age of diagnosis was 12.0 (11.0-13.0) years. The median duration from disease onset to the first infliximab treatment was 5.0(2.0-12.0) months. All the 53 patients had moderate to severe Crohn's disease, including 27 cases with anal fistula, 9 cases with anal fistula combined with intestinal stenosis, 8 cases with intestinal stenosis, 7 cases with extensive intestinal lesions, and 2 cases with growth retardation. Multivariate logistic regression analysis showed that simple endoscopic score for Crohn's disease (SES-CD), C-reactive protein (CRP) and procalcitonin (PCT) might be related to the outcome of mucosal non-healing under endoscopy after infliximab induction therapy (P<0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of baseline SES-CD, CRP and PCT for predicting mucosal non-healing under endoscopy after infliximab induction therapy was 0.73, 0.77 and 0.77, respectively. The sensitivity, specificity and AUC of combined prediction of the three indicators were 0.96, 0.68 and 0.88, respectively. Conclusions The combination of SES-CD, CRP and PCT before infliximab treatment is more accurate in predicting the efficacy of infliximab induction therapy in children with Crohn's disease.