Abstract: Objective　To summarize the dosing regimen of tocilizumab and to explore a feasible，practical and economical treatment for systemic juvenile idiopathic arthritis.Methods　A retrospective study was carried out based on the data of children with systemic juvenile idiopathic arthritis treated with tocilizumab from March 2014 to March 2020 in the Department of Kidney and Immunology，Childrens Hospital of Soochow University.The administration intervals，drug efficacy，hormone reduction，and adverse reactions of tocilizumab were collected for analysis and summary.Results　Among the 15 cases collected，the age of onset was（6.75±2.84），the average course of disease was（3.53±2.90）years and the course of tocilizumab treatment was（2.02±0.96）years.All 15 patients were treated with tocilizumab and gradually the interval of medication was extended from 2 weeks based on the condition of the disease.One of the patients had been discontinued tocilizumab after the interval was extended to 24 weeks，while the remaining 14 cases still used the drug and received examinations regularly in the clinic.Adverse reactions observed during the treatment included allergy，mild transaminase rise and gastrointestinal infection.Conclusion　The clinical symptoms of the children are improved significantly after the administration of tocilizumab. The interval of administration of tocilizumab should be prolonged gradually based on disease condition until the drug is stopped.In addition，MAS should be paid more attention to during the treatment of tocilizumab.

Key words: tocilizumab, systemic juvenile idiopathic arthritis, macrophage activation syndrome, efficacy

摘要： 目的　总结托珠单抗（TCZ）用于全身型幼年特发性关节炎（sJIA）的给药方案，探讨可行、实用、经济的sJIA治疗方法。方法　收集苏州大学附属儿童医院肾脏免疫科2014年3月至2020年3月使用TCZ治疗sJIA患儿的相关资料，从TCZ给药间隔、药物疗效、激素减停情况以及不良反应等方面进行分析和总结。结果　共收集15例患儿，起病年龄为（6.75±2.84）岁，平均病程为（3.53±2.90）年，TCZ治疗疗程为（2.02±0.96）年。15例患者均在加用TCZ治疗后根据病情由2周逐渐延长用药间隔时间。其中1例延长至24周后已停用TCZ，其余14例尚未停药，门诊定期复查。TCZ治疗期间出现的不良反应有：过敏、胃肠道感染、轻度转氨酶升高。结论　在加用TCZ后，患儿的临床症状出现明显缓解。TCZ的用药间隔时间需根据临床症状逐渐延长直至停药。TCZ治疗期间，需警惕巨噬细胞活化综合征（MAS）的发生。

关键词: 托珠单抗, 全身型幼年特发性关节炎, 巨噬细胞活化综合征, 疗效