小剂量促皮质素治疗婴儿痉挛的临床疗效及随访分析

Clinical effect and follow-up analysis of low-dose adrenocorticotropic hormone for infantile spasms

目的探讨小剂量促皮质素(ACTH)治疗婴儿痉挛(IS)临床疗效及随访预后。方法收集2008年1月至2010年12月住院的IS患儿临床资料。采用回顾性资料分析方法分析初期疗效,随访远期发作、智力运动发育、脑电图了解其长期预后。采用logistic回归对影响预后的相关因素进行分析。结果远期发作预后与病因、病程及ACTH治疗效果相关(P<0.05),与发病年龄无关(P>0.05);智力运动发育预后与病因相关(P<0.05),与发病年龄、病程、ACTH治疗效果无关(P>0.05);脑电图随访至1年脑电图正常率51.9%,随访≥2年正常率66.7%。结论小剂量ACTH治疗婴儿痉挛初期疗效显著,其远期临床发作和智力运动预后隐源性者效果更佳。

Object To investigate the therapeutic efficacy and the follow-up prognosis of low-dose adrenocorticotropic hormone for infantile spasms.Methods The clinical data of IS patients in hospital from January 2008 to December 2010 were collected.Early effects were analyzed by the retrospective analytical method.In order to determine the long-term prognosis,we followed up the long-term seizures,the mental and motor development as well as the changes of EEG.At the same time,the related factors affecting prognosis were analyzed by logistic regression.Results Factors influencing long-term seizures were correlated with the etiologies,the course of the disease and the therapeutic effect of ACTH（P〈0.05）,but not correlated with the onset age（P〉0.05）.The mental and motor development was correlated with the etiologies（P〈0.05）,but not correlated with the onset age,the course of the disease and the therapeutic effect of ACTH（P〉0.05）.The normal rate of EEG was 51.9% followed-up for one year and 66.7% followed-up for more than two years.Conclusions Low-dose ACTH has an obviously early therapeutic efficacy and its long-term clinical seizure,mental and motor prognosis are better.