不同剂量泼尼松联合托吡酯治疗婴儿痉挛症的效果比较

Therapeutic effects of different doses of prednisone combined with topiramate on infantile spasms

目的比较不同剂量泼尼松联合托吡酯治疗婴儿痉挛症的临床效果。方法抽取2019年2月至2022年2月开封市儿童医院收治的婴儿痉挛症患儿88例,采用随机数字表法将其分成对照组与研究组,每组44例。对照组给予托吡酯+小剂量泼尼松治疗方案,研究组给予口服托吡酯+大剂量泼尼松治疗方案。比较两组临床疗效、不良反应发生情况及痉挛发作复发情况。结果治疗14 d及治疗结束后,研究组脑电图总缓解率、痉挛发作总控制率高于对照组(P<0.05)。对照组不良反应发生率(52.27%,23/44)与研究组(56.82%,25/44)比较差异未见统计学意义(P>0.05)。随访6个月,研究组复发率(25.00%,11/44)低于对照组(75.00%,33/44),P<0.05。结论托吡酯联合大剂量泼尼松治疗婴儿痉挛症控制痉挛发作效果更佳,能降低婴儿痉挛症的复发率。

Objective To compare the clinical efficacy of different doses of prednisone combined with topiramate in the treatment of infantile spasms.Methods A total of 88 children with infantile spasms admitted to Kaifeng Children’s Hospital from February 2019 to February 2022 were selected,and they were divided into control group and study group by random number table method,with 44 cases in each group.The control group was treated with topiramate and low-dose prednisone,while the study group was treated with oral topiramate and high-dose prednisone.The clinical efficacy,incidence of adverse reactions,and recurrence of spasms were compared between the two groups.Results After 14 days of treatment and finishing treatment,the total remission rate of electroencephalogram and total control rate of spasms in the study group were higher than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the control group(52.27%,23/44)and the study group(56.82%,25/44),P>0.05.After 6 months of follow-up,the recurrence rate in the study group(25.00%,11/44)was lower than that in the control group(75.00%,33/44),P<0.05.Conclusions The combination of topiramate and high-dose prednisone has a better effect on controlling spasms in infants and reducing the recurrence rate of infantile spasms.