大剂量甲泼尼龙冲击治疗婴儿痉挛的疗效观察

Efficacy Observation of High Dose Methylprednisolone in the Pulse Treatment of Infantile Spasms

目的:观察大剂量甲泼尼龙冲击治疗婴儿痉挛的疗效及安全性。方法:婴儿痉挛症患儿70例随机分为常规剂量组和冲击治疗组各35例。常规剂量组给予醋酸泼尼松片口服治疗;冲击治疗组治疗前5d给予甲泼尼龙冲击治疗,其后治疗方案与对照组相同。两组疗程均为8周。观察两组患儿的脑电图转归情况,临床疗效和药品不良反应,及冲击治疗对不同病因和不同病程患儿的疗效。结果:冲击治疗组总有效率为94.29%,明显高于常规剂量组的71.43%(P<0.05)。两组的脑电图转归图结果比较,差异无统计学意义(P>0.05)。冲击治疗组的不良反应发生率略高,但与常规剂量组差异不明显(P>0.05)。冲击治疗对不同病因与不同病程患儿的疗效比较,差异无统计学意义(P>0.05)。结论:大剂量甲泼尼龙冲击治疗可以有效提高婴儿痉挛患儿的临床疗效,且对安全性无明显影响。

Totally 70 cases of infantile spasms were randomly divided into the conventional dose group and high dose group with 35 ones in each according to the random number table. High dose group was given methylprednisolone pulse therapy for the first 5 days, and then received the conventional dose treatment. The conventional dose group received prednisone tablets orally. The treatment course was 8 weeks. The ECG outcome, efficacy and incidence of adverse reactions were observed and compared between the groups, and the efficacy of pulse therapy for the patients with different causes and different course was also studied. Results： The total effective rate of high dose group was 94.29%, which was significantly higher than that of conventional dose group （71.43%）, and the difference was statistically significant （ P 〈 0.05）. The EEG outcome between the groups had not statistical significance （P 〉 0.05）. The incidence of adverse reactions in high dose group was wigher, while the difference was not significant （P 〉 0.05）. The efficacy of pulse therapy for different causes and different course had no statistically significant difference （ P 〉 0.05 ）. Conclusion： High dose methylpred- nisolone pulse therapy can effectively improve clinical efficacy for infantile spasms, which shows no effect on the safety of patients.