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大剂量甲泼尼龙冲击治疗婴儿痉挛症的疗效及安全性
孟慧琴1,褚新建2
0
(1. 河南省焦作市妇幼保健院,河南焦作 454000; 2. 河南省焦作市中心血站,河南焦作 454000)
摘要:
[摘要] 目的:评价大剂量甲泼尼龙冲击治疗婴儿痉挛症(IS)的疗效及安全性。 方法:选择2010年2月至2012年8月45例IS 患儿予以大剂量甲泼尼龙冲击治疗,疗程结束后分析不同病程、不同病因IS痉挛发作与脑电图的改善情况,并随访24个月观 察远期疗效,评价安全性。结果:IS病程≤2 个月的患儿痉挛发作有效率与脑电图有效率均高于病程>2个月的患儿(P<0.05); 症状性IS与隐源性IS的痉挛发作有效率与脑电图有效率比较差异均无统计学意义(P>0.05);远期随访痉挛发作有效率为 78.05%;治疗期间未见血糖异常、血压异常、电解质代谢紊乱、消化道出血等其他严重不良反应,远期随访未见药物依赖、股骨 头坏死病等情况。结论:大剂量甲泼尼龙冲击治疗IS尤其是短病程的IS有较好疗效,且不良反应轻微,具有临床推广与应用的 价值。
关键词:  甲泼尼龙  症状性婴儿痉挛症  隐源性婴儿痉挛症
DOI:doi:10.13407/j.cnki.jpp.1672-108X.2018.04.008
基金项目:
High Doses Methylprednisolone Implosive Therapy on Infantile Spasms
Meng Huiqin1, Chu Xinjian2
(1. Jiaozuo Maternal and Child Health Care Hospital, Henan Jiaozuo 454000, China; 2. The Central Blood Station of Jiaozuo, Henan Jiaozuo 454000, China)
Abstract:
[Abstract] Objective: To evaluate the effect and security of high doses methylprednisolone implosive therapy on infantile spasms (IS). Methods: Forty-five cases with IS were chosen to be given implosive therapy with high doses methylprednisolone form February 2010 to August 2012. At the end of the course, the improvement of convulsive seizure and electroencephalogram of different courses and pathogenies were analyzed. After 24 months follow-up, long-term curative effect were observed, and the security was evaluated. Results: Both the effective rate of convulsive seizure and electroencephalogram of IS course ≤2 months were significantly higher than those of IS course>2 months (P<0.05). Both the effective rate of convulsive seizure and electroencephalogram of symptomatic IS were not significantly different form those of cryptogenic IS ( P>0.05). The effective rate of convulsive seizure long-term follow-up was 78.05%.There were no serious adverse reaction as abnormal blood glucose and blood pressure, electrolyte disturbance and gastrointestinal bleeding, etc, and long-term follow-up no drug dependence, femoral head necrosis, etc. Conclusion: IS especially short course IS treat with high doses methylprednisolone implosive therapy can get a satisfactory curative effect relatively, and slight adverse reactions, whcih is a value to promote and apply in clinical.
Key words:  methylprednisolone  symptomatic infantile spasms  cryptogenic infantile spasms

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