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大剂量甲泼尼龙冲击治疗婴儿痉挛症的临床分析 被引量:15

High-dose methylprednisolone effect on infantile spasms
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摘要 目的 探讨大剂量甲泼尼龙冲击治疗对婴儿痉挛的控制效果.方法 对郑州大学第三附属医院2002年11月至2012年11月收治的66例婴儿痉挛症采用静脉冲击甲泼尼龙20 mg/(kg.d)连续应用3~5 d,后改为口服强的松片1 ~2 mg/(kg·d),4~8周后减量停药,总疗程8~12周,对治疗的临床疗效进行回顾性研究.结果 (1)66例患儿中治疗有效者51例,总有效率77.2%,28例完全缓解,完全缓解率42.4%.(2)起病年龄对疗效无影响(P>0.05).(3)开始用甲泼尼龙治疗的年龄对疗效无影响(P>0.05).(4)病程对疗效的影响:病程在2个月以内者23例,有效率91.3%;大于2个月者43例,有效率69.7%,两组比较差异有统计学意义(x2=3.958,P<0.05).(5)病因对疗效的影响:症状性50例,有效率78.o%;隐源性16例,有效率75.0%;二组比较差异无统计学意义(x2 =0.008 7,P >0.05).(6)远期随访41例患儿,完全缓解14例(34.2%),有效29例(70.7%),复发3例(复发率10.3%).结论 应用甲泼尼龙治疗婴儿痉挛症的方案简单易行,近期控制效果肯定,不良反应少而轻;疗效与病程相关,病程越短,疗效越好;远期疗效可,复发率低,可以在临床上推荐应用. Objective To discuss high dose methylprednisolone therapy in infantile spasm. Methods Sixty-six children with infantile spasm of the Third Affiliated Hospital of Zhengzhou University from Nov 2002 to Nov 2012, adopted intravenous methylprednisolone with 20 mg/(kg-d) for 3 to 5 days continuously, then changed to oral prednisone with 1 -2 mg/(kg.d) ,4 - 8 weeks after drug withdrawal. The total course of 8 - 12 weeks of clinical curative effect was retrospectively studied. Results ( 1 ) Of 66 cases,51 cases were effective,total effective rate was 77. 2% ;28 cases achieved complete response, complete response rate was 42.4%. (2) The onset age had no influence on curative effect (P 〉0. 05). (3) The beginning ages of the patients to use methylprednisolone therapy had no effect on curative effect ( P 〉 0.05 ). (4) Course of cura- tive effect:23 cases within 2 months,the effective rate was 91.3% ,43 cases more than 2 months,the effec- tive rate was 69.7%. Difference of effective rate between the two groups had statistical significance ( x2 = 3. 958,P 〈0. 05). (5) Etiology of curative effect:50 cases of symptomatic,the effective rate was 78.0% ,16 cases of cryptogenic, the effective rate was 75.0% ;compared two groups, the effective rates had no statistical significance( X2 = 0. 008 7 ,P 〉 0. 05 ). (6) Long-term follow-up of 41 cases, 14 cases had complete remis- sion (34. 2% ) ,29 cases was effective(70. 7% ) ,3 cases had a recurrence (10. 3% ). Conclusion Applica- tion of methylprednisolone in the treatment for infantile spasm is simple,the recent control is effective,and it has a less adverse effect. The curative effect is related to the course, the shorter the duration, the better cura- tive effect;and the long-term effect is good, the recurrence rate is low, the method can be recommended in clinical application.
作者 杨庆华 贾天明 邹丽萍 张晓莉 Yang Qinghua,Jia Tianming,Zou Liping,Zhang Xiaoli. Third Affiliated Hospital of Zhengzhou University ,Zhengzhou 450052, China
出处 《中国小儿急救医学》 CAS 2014年第4期225-227,共3页 Chinese Pediatric Emergency Medicine
关键词 婴儿痉挛症 甲泼尼龙 抗癫痫药 治疗效果 Infant spasms Methylprednisolone Anfiepileptic drugs Treatment effect
作者简介 通信作者:贾天明,E—mail:790857077@qq.com
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