婴儿痉挛症疗效分析

Analyses on Clinical Data of Infantile Spasms

回顾分析近12年来我院治疗婴儿痉挛症的临床情况。原发性30例,症状性270例。发病年龄7个月以内者251例占83.7％。首次脑电图以高峰节律失调及变异型居多,计109例(54.5％),亦有其他类型改变,正常脑电图只有39例(13％)。控制痉挛发作的治疗分两组,一为抗痫药加ACTH组,一为单一抗痫药组,经比较原发性组两种疗效无显著性差异(X^2-0.086,P>0.05);症状性组前者优于后者(X^2=7.03,P<0.01),总疗效无显著性差异(X^2=0.272,P>0.05)。治疗无效的部分病儿采用两种或三种抗痫药物联合治疗亦取得疗效。但智力障碍仍严重,原发组为30％,症状组为93％(X^2=91.45,P<0.01),原发组治疗后智力情况优于症状组,说明智力落后与症状组原有神经系统疾病有关。本文还讨论了ACTH的作用和副作用。

Three Hundred cases of infantile spasms (IS) enrolled in recent 12 years were reviewed, in which there were 30 idiopathic and 270 symptomatic patients. 251 of them (83- 7%) had the first onsets within 7 months of birth. Among 200 EEGs recorded prior to treatments 109 showed a high-voltage arrhythmia pattern, while 52 showed some other abnormal patterns. 39 normal. In a control experimental research, adrenocorticotropin ( ACTH ) co-administered with a single antiepileptic drug treatment showed a better inhibitory effect on seizures than an antiepilcptic drug alone did in symptomatic patients (X2= 7. 03,P>0. 01), but no difference of therapeutic effects was found in idiopathic patients (X2 = 0.086,P>0. 05). There was no difference between the total therapeutic results of the two groups (X2 = 0. 272, P>0. 05).30% of the idiopathic patients had hypophrenia contrast to 93% of the symptomatic group. It was suggested that hypophrenia was relevant to neurological protopathy. Actions and side effects of ACTH were also reviewed.