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长疗程生酮饮食对儿童发育性癫痫性脑病的疗效及认知功能的影响

Study on the clinical efficacy and cognitive function effects of long course ketogenic diet therapy on developmental epileptic encephalopathy in children
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摘要 目的研究长疗程生酮饮食(KD)添加治疗对发育性癫痫性脑病(DEE)患儿的临床疗效及认知功能的影响。方法选取2020年1月-2023年12月在山西省儿童医院神经内科进行KD添加治疗的DEE患儿;比较患儿治疗前与治疗12、24、36、48个月后的月平均癫痫发作频率、痫样放电指数、儿童神经心理发育量表评分等;分析长疗程KD对DEE患儿的疗效及其认知功能的影响。结果(1)添加KD 12、24、36、48个月后癫痫控制有效率分别为45.24、59.46、83.33、87.50%;脑电图好转率分别为38.10、56.76、76.67、83.33%(P<0.05),各时间点比较均有明显差异;(2)长疗程KD添加治疗后患儿认知功能明显改善,在大运动、精细动作、适应能力、言语、社交行为5个功能区的评分均得到提升,各时间点比较均有明显差异(P<0.05);(3)在治疗12个月后KD对不同类型综合征患儿的疗效均有明显差异(P<0.05),开始KD的不同年龄组患儿的疗效也均有明显差异(P<0.05)。结论长疗程KD对患儿癫痫发作控制效果显著,对DEE患儿的脑电图及认知功能均有明显的改善作用,且开始KD的年龄越小,治疗时间越长,其疗效越显著。 Objective The aim of this paper is to study the clinical efficacy and cognitive function effects of long course ketogenic diet(KD)addition therapy on children with developmental epileptic encephalopathy(DEE).Methods Children with DEE who underwent KD-addition therapy in the Department of Neurology of Shanxi Children's Hospital from January 2020 to December 2023 were selected.The mean monthly seizure frequency,epileptiform discharge index,and neuropsychological developmental scale score before and after treatment at 12,24,36,and 48 months were compared and the therapeutic efficacy of the long course of KD on children with DEE and its effect on cognitive function was analyzed.Results(1)After 12,24,36 and 48 months of KD addition,the effective rate of epilepsy control was 45.24%,59.46%,83.33%and 87.50%,respectively.And the rate of EEG improvement was 38.10%,56.76%,76.67%and 83.33%,respectively,with statistically significant differences between the different treatment times upon comparison.(2)The children's cognitive function improved significantly after the long course of KD-added treatment,and their scores in the five functional areas of gross motor,fine motor,adaptive,verbal,and social behavior were improved,with significant differences in comparison at all time points(P<0.05).(3)There was a significant difference in the efficacy of KD in children with different types of syndromes after 12 months of treatment(P<0.05),as well as in children of different age groups who started KD(P<0.05).Conclusion Long course of KD has significant effect on seizure control in children,and has significant improvement on EEG and cognitive function in children with DEE.Moreover,the younger the age at which KD is initiated and the longer the duration of treatment is,the more significant is its efficacy.
作者 纪惠茹 武运红 樊海珍 赵娇娇 郭瑾 Ji Huiru;Wu Yunhong;Fan Haizhen(Shanxi Medical University,Taiyuan 030000;不详)
出处 《卒中与神经疾病》 2024年第5期470-475,489,共7页 Stroke and Nervous Diseases
基金 中国抗癫痫协会癫痫科研基金-UCB基金项目(CJ-B-2021-19)。
关键词 发育性癫痫性脑病 生酮饮食 长期疗效 认知功能 Developmental epileptic encephalopathy Ketogenic diet Long-term efficacy Cognitive function
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