甲泼尼龙不同疗程治疗儿童良性癫痫伴中央颞区棘波变异型的疗效分析

Therapeutic Effect of Different Treatments of Methylprednisolone on Children with Benign Epilepsy with Central Sacral Spine Variant

目的比较甲泼尼龙不同疗程治疗儿童良性癫痫伴中央颞区棘波(benigh childhood epilepsy with central-temporal spikes,BECT)变异型的疗效。方法回顾性分析2011年7月-2019年1月该院确诊的25例BECT变异型患儿甲泼尼龙不同疗程的治疗疗效,分为对照组和观察组。对照组甲泼尼龙治疗疗程为20 mg/(kg·d),每疗程用3 d,停4 d,停药期间口服醋酸泼尼松片20 mg/(kg·d),连续3个疗程。甲泼尼龙疗程结束后口服醋酸泼尼松序贯治疗,激素总疗程为6个月。观察组甲泼尼龙治疗疗程为20 mg/(kg·d)静点3 d,10 mg/(kg·d)静点3 d,5 mg/(kg·d)静点3 d,连续9 d。结束后口服醋酸泼尼松序贯治疗同对照组。分析不同疗程的疗效。结果采用Fisher确切概率法对视频脑电图(VEEG)疗效、发作疗效及复发率进行比较,对照组VEEG疗效有效率为86%,观察组有效率为82%,差异无统计学意义(P>0.05)。对照组发作疗效有效率为93%,观察组发作有效率为73%,两者在疗效上均差异无统计学意义(P>0.05)。治疗半年后观察组复发率36%,对照组复发率为45%,两组差异无统计学意义(P>0.05)。结论甲泼尼龙治疗BECT变异型疗效明显,不同治疗疗程之间无差异。观察组治疗可缩短住院时间,值得推广应用。

Objective To compare the efficacy of different treatments of methylprednisolone in children with benign epilepsy with centraltemporal spikes(BECT) variants. Methods A retrospective analysis of 25 patients with BECT variants diagnosed with methylprednisolone from July 2011 to January 2019 was divided into control group and observation group. In the control group, the course of methylprednisolone treatment was 20 mg/(kg·d), and each course of treatment was used for 3 days. The drug was stopped for 4 days.During the withdrawal, oral prednisone tablets were taken at 20 mg/(kg·d) for 3 consecutive courses. After the end of the methylprednisolone treatment, oral prednisone acetate was given. The total course of hormone treatment was 6 months. The treatment course of methylprednisolone in the observation group was 20 mg/(kg·d) for 3 days, 10 mg/(kg·d) for 3 days, and 5 mg/(kg·d) for 3 days for 9 days. After the end, oral prednisone acetate was sequentially treated with the control group. Analyze the efficacy of different courses of treatment. Results The efficacy, onset efficacy and recurrence rate of video electroencephalogram(VEEG) were compared by Fisher’s exact probability method. The effective rate of VEEG in the control group was 86%, and the effective rate in the observation group was 82%,there difference was not statistically significant(P>0.05). The effective rate of the control group was 93%, and the effective rate of the observation group was 73%. There was no statistically significant difference in the efficacy between the two groups(P>0.05). After half a year of treatment, the recurrence rate was 36% in the observation group and 45% in the control group. There was no statistically significant difference between the two groups(P>0.05). Conclusion The effect of methylprednisolone on BECT variants is obvious, and there is no difference between different treatment courses. The observation group treatment can shorten the hospital stay and is worthy of promotion and application.