~Teachingcenter的醫學筆記~

兒童克隆氏症活動性指標
PCDAI (Pediatric Crohn’s disease activity index)

分為三大項：病史、檢驗、檢察，須把這三大項的分數全部加總

最嚴重、最高分為100分
若總分<10分，代表疾病已緩解(remission)
若總分10~27.5分，代表輕微(mild Crohn’s disease)
若總分27.5~37.5分，代表中度(moderate Crohn’s disease)
若總分>37.5分，代表嚴重(severe Crohn’s disease)

※與成人使用的Crohn’s disease activity index, CDAI為不一樣的評估

History (Recall, 1 week) 病史(過去一周)

1. Abdominal Pain腹痛
   1. 0 = None (無)
   2. 5 = Mild: Brief, does not interfere with activities (輕微: 短暫，不影響活動)
   3. 10 = Moderate/ Severe: Daily, longer lasting, affects activities, nocturnal (中度/嚴重：每天，持續較長時間，影響活動，夜間痛)
2. Patient Functioning, General Well-Being 病人的功能、一般健康狀況
   1. 0 = No limitation of activities, well  (活動自主，狀況良好)
   2. 5 = Occasional difficulty in maintaining age-appropriate activities, below par (維持該年齡應有的活動偶爾會有困難，低於平均值)
   3. 10 = Frequent limitation of activity, very poor (活動經常受限，非常虛弱)
3. Stools (per day)糞便(每天)
   1. 0 = 0-1 liquid stools, no blood  (0-1次流質糞便，沒有血絲)
   2. 5 = Up to 2 semiformed with small blood, or 2-5 liquid  (最多2次的半成形及輕微血絲糞便，或是2-5次流質糞便)
   3. 10 = Gross bleeding, or ≥ 6 liquid, or nocturnal diarrhea (血便，或多於6次流質糞便，或夜間腹瀉)

Laboratory 檢驗值

1. HCT血比容
   1. < 10 years (Male and Female): (< 10 歲 (男/女))
      1. 0 = > 33%
      2. 2.5 = 28%-32%
      3. 5 = < 28%
   2. 11-14 years (Male): (11-14歲 (男))
      1. 0 = ≥ 35%
      2. 2.5 = 30%-34%
      3. 5 = < 30%
   3. 11-19 years (Female): (11-19歲 (女))
      1. 0 = ≥ 34%
      2. 2.5 = 29%-33%
      3. 5 = < 29%
   4. 15-19 years (Male): (15-19 歲 (男))
      1. 0 = ≥ 37%
      2. 2.5 = 32%-36%
      3. 5 = < 32%
2. ESR紅血球沈降速率
   1. 0 = < 20 mm/hr
   2. 2.5 = 20-50 mm/hr
   3. 5 = > 50 mm/hr
3. Albumin白蛋白
   1. 0 = ≥ 3.5 g/dL
   2. 5 = 3.1-3.4 g/dL
   3. 10 = ≤ 3.0 g/dL

Examination檢查

1. Weight體重
   1. 0 = Weight gain or voluntary weight stable/loss (體重增加，或刻意維持的體重/刻意減重)
   2. 5 = Involuntary weight stable, weight loss 1%-9% (非刻意維持的體重，體重降低1%-9%)
   3. 10 = Weight loss ≥ 10% (體重降低10%)
2. Height 身高
   1. Height at Diagnosis診斷時身高
      1. 0 = < 1 channel decrease (< 1 間距(channel)減少)
      2. 5 = ≥ 1, < 2 channel decrease (< 2間距(channel)減少)
      3. 10 = > 2 channel decrease  (>2間距(channel)減少)
   2. Height at Follow-Up 追蹤時身高
      1. 0 = Height velocity ≥ -1 SD (身高生長速度 ≥ -1 個標準差)
      2. 5 = Height velocity < -1 SD, > -2 SD (身高生長速度介於-1~ -2 個標準差)
      3. 10 = Height velocity ≤ -2 SD (身高生長速度≤ -2個標準差)
3. Abdomen腹部
   1. 0 = No tenderness, no mass (沒有壓痛、沒有腫塊)
   2. 5 = Tenderness or mass without tenderness (有壓痛，或有不痛的腫塊)
   3. 10 = Tenderness, involuntary guarding, definite mass (有壓痛，觸診時不自主的防衛，有明顯的腫塊)
4. Perirectal Disease直腸周邊的疾病
   1. 0 = None, asymptomatic tags (沒有，無症狀的贅瘤(表皮小肉球))
   2. 5 = 1-2 indolent fistula, scant drainage, no tenderness (1-2 個不痛的廔管，少量流出分泌物， 沒有壓痛)
   3. 10 = Active fistula, drainage, tenderness, or abscess (活動性廔管，有流出分泌物，有壓痛或是膿瘡)
5. Extraintestinal Manifestations腸道外症狀
   Fever ≥ 38.5°C for 3 days over past week, definite arthritis, uveitis, E. nodosum, P. gangrenosum (在過去一周發燒≥ 38.5°C至少3天、關節炎、虹膜炎、結節性紅斑(Erythema nodosum)、壞疽性膿皮症(pyoderma gangrenosum))
   1. 0 = None (無)
   2. 5 = 1 (有一個)
   3. 10 = ≥ 2 (有兩個以上症狀)