ACTH治疗婴儿痉挛症的不良事件

Adverse Events of Infantile Spasms Treated with ACTH

目的了解促肾上腺皮质激素(ACTH)治疗婴儿痉挛症(IS)的临床疗效及不良事件(AE)的发生概率,以指导临床合理安全用药。方法对53例新乡医学院第三附属医院儿科2012年6月至2015年2月进行ACTH治疗的婴儿痉挛症进行回顾性研究,分析性别、年龄、ACTH用药量和方式、AE累计器官和/或系统及实验室检查等。结果 53例患儿中,治疗效果完全控制64.15%(34/53),显效26.41%(14/53),有效7.54%(4/53),无效1.88%(1/53)。不良反应:体质量升高81.13%(43/53),低血钾60.38%(32/53),感染50.94%(27/53),烦躁不安45.28%(24/53),心率降低28.30%(15/53),转氨酶升高18.86%(10/53),血管炎9.43%(5/53),鹅口疮7.54%(4/53),嗜睡7.54%(4/53)。结论科学有效地进行ACTH治疗IS,应积极观察及处理不良事件,有利于顺利完成ACTH治疗的总疗程而达到良好的治疗目的。

Objective To understand the curative effect and the probability of adverse events（AE ）of infantile spasms（IS）treated with adrenocorticotropic hormone （ACTH）for guiding the clinical rational drug use. Methods A retrospective analysis was investigated in 53 cases treated with ACTH in the Third Affiliated Hospital of Xinxiang Medical College from Jun 2012 to Feb 2015 by analyzing the patient’s gender, age,drug dosage and mode,the involved organ and /or system of AE,and laboratory test results.Results In 53 cases,64.15%（34 /53）was completely relieved,26.41 %（14 /53）was markedly effective,7.54%（4 /53）was effective,and 1 .88% （1 /53 ）was no effect.AEs were included：weight increased 81 .13%（43 /53）,hypokalemia 60.38%（32 /53 ）,infection 50.94% （27 /53 ）,dysphoria 45.28% （24 /53 ）,the heart rate decreased 28.30%（15 /53）,transaminase rising 18.86%（10 /53 ）,vasculitis 9.43%（5 /53 ）, thrush 7.54% （4 /53 ）,the drowsiness 7.54% （4 /53 ）. Conclusion The AE of IS should be actively observed and effectively dealed with in treatment of IS with ACTH for the successful total course and good therapeutic purpose.