口服大剂量甲基泼尼松龙治疗婴儿痉挛症的疗效观察

Efficacy observation of high dose oral methylprednisolone in the treatment of infantile spasms

目的探讨口服大剂量甲基泼尼松龙治疗婴儿痉挛症（IS）的临床疗效和安全性。方法回顾性分析2016年1月至2017年4月华中科技大学同济医学院附属武汉儿童医院神经内科接受口服大剂量甲基泼尼松龙治疗的38例婴儿痉挛患儿临床资料。结果（1）38例患儿治疗2周时痉挛发作完全控制20例（52．6％）；疗程结束时痉挛发作完全控制16例（42．1％）。（2）38例均有典型或不典型高度失律，治疗2周时有25例（65．8％）高度失律消失；疗程结束时有30例（78．9％）高度失律消失。（3）不良反应主要有体重增加、库欣体征、食欲增加、易激惹、嗜睡、合并感染、电解质紊乱。停用药物后不良反应逐渐消失。（4）随访3～12个月，复发率低，发育商均有改善。结论口服大剂量甲基泼尼松龙治疗IS具有较好的疗效，且较安全，复发率低，可在临床上推广应用。

Objective To investigate the clinical efficacy and safety of oral high-dose methylpred- nisolone in the treatment of infantile spasms （IS）. Methods The clinical data of 38 children with infantile spasms were analyzed retrospectively who treated with oral administration of high-dose methylprednisone in Department of Neurology, Wuhan Children~ Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to April 2017. Results （1） Twenty patients （52. 6% ） of all the 38 patients were seizure-free after 2 weeks of treatment, and 16 cases （42. 1% ） were seizure-free at the end of treatment. （2） All the 38 cases were typical or atypical hyperarrhythmia. After treatment of 2 weeks, 25 cases （65.8%） of hyperarrhythmia disappeared; at the end of the treatment, 30 cases （78. 9% ） of hyperar-rhythmia disappeared. （3） Adverse effects mainly were weight gain, Cushing signs, increased appetite, irri- tability, drowsiness, co-infection, electrolyte disturbance. （4） Follow-up of 3 to 12 months, the recurrence rate was low and the development quotient had improved. Conclusions Oral high dose methylprednisolone in the treatment of IS is effective, safe and has a low recurrence rate. It can be recommended in clinicalal application.