不同泼尼松治疗方案联合托吡酯应用于婴儿痉挛症的疗效比较

Comparison of different prednisone treatment regimens combined with topiramate in infantile spasms

目的探讨不同泼尼松治疗方案联合托吡酯应用于婴儿痉挛症的疗效。方法选择2017年6月-2018年12月乌鲁木齐儿童医院小儿神经内科收治的婴儿痉挛症患儿92例,按照随机数字表法分为两组,各46例。两组均给予托吡酯治疗,对照组在此基础上行小剂量泼尼松治疗,观察组在托吡酯治疗基础上行大剂量泼尼松治疗。对比两组临床疗效、不良反应及复发率情况。结果观察组治疗2周后、疗程结束时高度失律总缓解率及痉挛发作总控制率均高于对照组,差异有统计学意义(P<0.05);观察组治疗期间不良反应发生率与对照组相比,差异无统计学意义(P>0.05);随访12个月,观察组疾病复发率低于对照组,差异有统计学意义(P<0.05)。结论大剂量泼尼松联合托吡酯治疗婴儿痉挛症可有效控制痉挛发作,缓解高度失律,降低疾病复发率。

Objective To investigate the efficacy of different prednisone treatment regimens combined with topiramate in infantile spasms. Methods A total of 92 children with infantile spasm from the Department of Pediatric Neurology in our hospital from June 2017 to December 2018 were enrolled. The patients were divided into two groups according to the random number table,46 cases each. Both groups were treated with topiramate. The control group received a small dose of prednisone on the basis of this treatment. The observation group received high-dose prednisone on the basis of topiramate treatment. The clinical efficacy,adverse reactions,and recurrence rate were compared between the two groups. Results The total remission rate and the total control rate of seizures were higher in the observation group than in the control group after 2 weeks of treatment,and the difference was statistically significant( P<0. 05). The incidence of adverse reactions during the treatment group was compared with the control group. There was no significant difference between the two groups( P >0. 05). The follow-up period of 12 months was lower than that of the control group( P<0. 05). Conclusion High-dose prednisone combined with topiramate in the treatment of infantile spasm can effectively control the seizures,relieve the high degree of disorder and reduce the recurrence rate of the disease,which is worth promoting.