泼尼松龙与促皮质素治疗婴儿痉挛症的疗效与不良反应及对患儿脑电图的影响

doi:10.3969/j.issn.1006-6233.2019.06.008

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摘要目的: 探究泼尼松龙与促皮质素(ACTH)治疗婴儿痉挛症(IS)的疗效与不良反应及对患儿脑电图的影响。方法: 回顾性分析2010年3月至2017年5月我院儿科住院的90例IS患儿,根据治疗方法分为泼尼松龙组(应用大剂量泼尼松龙治疗,n=42)与ACTH组(应用ACTH治疗,n=48)。比较两组治疗疗效、脑电图改善情况及不良反应发生率。并展开为期1年的随访,记录两组复发率。结果: 泼尼松龙组治疗有效率为90.48%,ACTH组治疗有效率为95.83%,差异无统计学意义(χ²=1.033,P>0.05);泼尼松龙组脑电图改善有效率为95.83%,ACTH组脑电图改善有效率为97.92%,差异无统计学意义(χ²=0.499,P>0.05);泼尼松龙组不良反应发生率为33.33%,ACTH组不良反应发生率为37.50%,差异无统计学意义(χ²=0.170,P>0.05);泼尼松龙组复发率为7.14%;ACTH组复发率为4.17%,差异无统计学意义(χ²=0.378,P>0.05)。结论: 泼尼松龙与ACTH治疗IS疗效及不良反应相当,但泼尼松龙价格更低、操作简单,可在临床提倡以大剂量口服泼尼松龙替代ACTH治疗IS。

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	虎崇康
	江逊
	张薇

关键词 ：婴儿痉挛症, 泼尼松龙, 促皮质素, 脑电图

Abstract：Objective: To investigate the efficacy and adverse reactions of prednisolone and ACTH in the treatment of infantile spasm and effects on electroencephalogram. Methods: A retrospective analysis was made of 90 children with IS hospitalized in pediatrics department of our hospital from March 2010 to May 2017. They were divided into prednisolone group (treated with high dose prednisolone, n=42) and ACTH group (treated with ACTH, n=48) according to the treatment method. The curative effect, the improvement of EEG and the incidence of adverse reactions were compared between the two groups. One-year follow-up was performed and the recurrence rate was recorded. Results: The response rates of the prednisolone group and ACTH group were 90.48% and 95.83%, respectively (χ²=1.033, P>0.05). The effective rates of electroencephalogram improvement in prednisolone group and ACTH group were 95.83% and 97.92%, respectively (χ²=0.499, P>0.05). The incidence rates of adverse reactions in the prednisolone and ACTH group were 33.33% and 37.50. %, respectively (χ²=0.170, P>0.05). The recurrence rates of prednisolone group and ACTH group were 7.14% and 4.17%, respectively (χ²=0.378, P>0.05). Conclusion: The curative effect and adverse reactions of prednisolone and ACTH are equivalent in the treatment of IS. However, prednisolone is cheaper and simpler to operate. It can be used in clinical practice to replace ISTH with large-dose oral prednisolone.

Key words： Infantile spasm Prednisolone Adrenocorticotropic hormone Electroencephalogram

基金资助:陕西省卫生厅科研基金项目,(编号:2016D1180)

通讯作者: 张薇

引用本文:

虎崇康, 江逊, 张薇. 泼尼松龙与促皮质素治疗婴儿痉挛症的疗效与不良反应及对患儿脑电图的影响[J]. 河北医学, 2019, 25(6): 911-913.
HU Chongkang, JIANG Xun, ZHANG Wei. Efficacy and Adverse Reactions of Prednisolone and ACTH in the treatment of Infantile Spasm and Effects on Eectroencephalogram. HeBei Med, 2019, 25(6): 911-913.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.06.008 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I6/911