中国实用儿科杂志

中国实用儿科杂志 ›› 2026, Vol. 41 ›› Issue (8): 654-657.DOI: 10.19538/j.ek2026080608

• 专题笔谈 • 上一篇    下一篇

肿瘤坏死因子抑制剂在儿童风湿免疫性疾病的应用

  

  1. 青岛大学附属医院儿童肾脏风湿免疫科，山东  青岛  266003
  • 出版日期:2026-08-06 发布日期:2026-09-17
  • 通讯作者: 张秋业,电子信箱:qyzh9816@163.com

Clinical application of tumor necrosis factor inhibitors in pediatric rheumatic and immune diseases

  1. Department of Pediatric Nephrology and Rheumatology，the Affiliated Hospital of Qingdao University，Qingdao  266003，China
  • Online:2026-08-06 Published:2026-09-17

摘要： 肿瘤坏死因子抑制剂（TNFi）是治疗儿童风湿免疫性疾病的重要生物制剂。肿瘤坏死因子（TNF）-α作为关键炎症细胞因子，在多种自身免疫性疾病中过度表达，TNFi 通过特异性阻断TNF-α的生物学活性发挥治疗作用。临床常用的TNFi 主要包括受体融合蛋白类（依那西普）和单克隆抗体类（英夫利西单抗、阿达木单抗等）。TNFi 在成人的获批适应证包括类风湿性关节炎、强直性脊柱炎等；在儿童的获批适应证主要包括多关节型幼年特发性关节炎，以及非感染性葡萄膜炎等。此外，TNFi 在腺苷脱氨酶2 缺陷病、白塞病等多种难治性风湿性疾病中也有较多用药经验。儿童应用TNFi 总体安全性良好，治疗前应筛查潜伏的结核和乙肝感染，并定期监测疗效和不良反应。

关键词: font-family:", font-size:17px, background-color:#FFFFFF, ">肿瘤坏死因子抑制剂, 风湿免疫性疾病, 儿童, 疾病治疗

Abstract: Tumor necrosis factor inhibitors（TNFi）are an important class of biological agents for the management of pediatric rheumatic and immune diseases.TNF-α is a key inflammatory cytokine overexpressed in various autoimmune conditions. TNFi play their therapeutic roles by specifically blocking the biological activity of TNF-α.Two main categories are used clinically：receptor fusion proteins（etanercept）and monoclonal antibodies（infliximab and adalimumab）.Approved adult indications of TNFi include rheumatoid arthritis and ankylosing spondylitis；approved pediatric indications include polyarticular juvenile idiopathic arthritis and non-infectious uveitis.In addition，TNFi have also shown clinical utility in refractory rheumatic diseases such as adenosine deaminase 2 deficiency and Behçet’s disease.The overall safety profile is favorable in children.Screening for latent tuberculosis and hepatitis B before treatment initiation，along with regular monitoring of efficacy and adverse events，is recommended. 

Key words: tumor necrosis factor inhibitors, rheumatic and immune diseases, child, treatment for diseases