期刊 促肾上腺皮质激素治疗婴儿痉挛症的疗效分析  被引量:4

Efficacy of adrenocorticotropic hormone in treatment of infantile spasms

作  者:钟金花[1] 廖建湘[1] 胡雁[1] 陈黎[1] 李冰[1] 黄铁栓[1] 路新国[1] 文家伦[1] 韩春锡[1] 

机构地区:[1]深圳市儿童医院癫痫中心

出  处:《第三军医大学学报》2012年第22期2257-2259,共3页Journal of Third Military Medical University

Efficacy of adrenocorticotropic hormone in treatment of infantile spasms

摘  要:目的分析婴儿痉挛症治疗中促肾上腺皮质素(adrenocorticotropic hormone,ACTH)作为首选和非首选治疗药物的疗效。方法回顾性分析1999-2010年在深圳市儿童医院确诊为婴儿痉挛症的住院患者50例,其中ACTH首选组19例,非首选组31例。比较近期(8周内)痉挛无发作率,药物选择次序对无发作率的影响。结果首选组取得近期无痉挛发作疗效14例,占74%,非首选组近期无发作疗效14例,45%。2组比较差异有统计学意义(χ2=3.889,P<0.05)。其中一种抗癫痫药物失败后用ACTH的15例,无发作8例(53%);2种抗癫痫药物联合治疗失败后用ACTH 10例,无发作4例(36%);3种抗癫痫药物联合治疗失败后用ACTH 5例,1例(20%)达到无发作效果。5种抗癫痫药物联合治疗失败后用ACTH 1例,也达到痉挛无发作效果。结论婴儿痉挛症治疗首选ACTH可以获得较高近期痉挛无发作率(74%),其抗癫痫药物失败后的患者,ACTH治疗获得无痉挛发作的机会较低(45%),但仍然值得尝试。

Objective To analyze the efficacy of adrenocorticotropic hormone(ACTH) as the first-line and non-first-line drug in treatment of infantile spasms.Methods The medical records of 50 patients with infantile spasms(19 patients taking ACTH as the first-line drug and 31 patients taking ACTH as the non-first-line drug) in the inpatient department of Shenzhen Children's Hospital from 1999 to 2010 were retrospectively analyzed.We compared the recent(within 8 weeks) spasm-free rate and the influence of the order of ACTH choice as the antiepileptic drug on the spasm-free rate of the patients.Results Fourteen patients were recently spasm-free in the 19 patients taking ACTH as the first-line drug(74%),and 14 patients were recently spasm-free in the 31 patients taking ACTH as the non-first-line drug(45%).The difference of the efficacy between the two groups was statistically significant(Chi-square=3.889,P0.05).Among the 31 patients,15 patients were treated with ACTH after the failure of one antiepileptic drug,and 8 patients were spasm-free(53%);10 patients were treated with ACTH after the failure of combining two antiepileptic drugs,and 4 patients were spasm-free(36%);5 patients were treated with ACTH after the failure of combining three antiepileptic drugs,and 1 patient(20%) was spasm-free;and 1 patient was treated with ACTH after the failure of combining five antiepileptic drugs,and were spasm-free.Conclusion The patients with infantile spasms who are treated with ACTH as first line drug can get a high spasm-free rate(74%).The patients who are treated with ACTH after the failure of other antiepileptic drugs have smaller chance to become spasm-free(53%).But ACTH therapy is still worth trying even if three antiepileptic drugs have failed.

关 键 词:婴儿痉挛症 促肾上腺皮质激素 抗癫痫药 一线治疗 非首选 无发作率 

infantile spasms  adrenocorticotropic hormone  antiepileptic drugs  first-line treatment  non-first-line treatment  spasm-free rate 

分 类 号:R742.1[医药卫生—神经病学与精神病学] R748[医药卫生—临床医学]

 

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