|
|
|
| Efficacy and Adverse Reactions of Prednisolone and ACTH in the treatment of Infantile Spasm and Effects on Eectroencephalogram |
| HU Chongkang, JIANG Xun, ZHANG Wei |
| Tangdu Hospital the Air Force Military Medical University, Shaanxi Xi'an 710038, China |
|
|
|
|
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.
|
|
|
|
|
|
[1] 吴涛,罗序峰,张胜,等.促肾上腺皮质激素治疗36例婴儿痉挛症的疗效分析[J].中国小儿急救医学,2014,21(7):436~439.
[2] 张延红,欧阳颖.促肾上腺皮质激素治疗婴儿痉挛症的现状[J].实用医院临床杂志,2017,14(2):123~125.
[3] Lux A L,Edwards S W,Hancock E,et al.The United Kingdom Infantile Spasms Study comparing vigabatrin with prednisolone or tetracosactide at 14 days:a multicentre,randomised controlled trial[J].Lancet,2004,364(9447):1773~1778.
[4] Hussain S A,Shinnar S,Kwong G,et al.Treatment of infantile spasms with very high dose prednisolone before high dose adrenocorticotropic hormone.[J].Epilepsia,2014,55(1):103~107.
[5] 陈辉,钟建民,易招师,等.泼尼松治疗婴儿痉挛症的免疫机制研究[J].中国当代儿科杂志,2017,19(10):1044~1050.
[6] O'Callaghan F J K,Edwards S W,Alber F D,et al.Safety and effectiveness of hormonal treatment versus hormonal treatment with vigabatrin for infantile spasms(ICISS):a randomised,multicentre,open-label trial[J].Lancet Neurology,2017,16(1):33~42.
[7] 陈辉,钟建民,易招师,等.泼尼松治疗婴儿痉挛症有效性及HPA轴机制分析[J].国际儿科学杂志,2017,44(10):701~706 |
|
|
|
2019, Vol. 25 
