【摘要】 目的 观察低剂量锂盐用于脑性脑瘫合并认知障碍儿童的临床安全性及其认知功能改善效果。方法 选取2020-07—2023-12于郑州大学第三附属医院确诊并接受治疗的2.5～8岁脑瘫合并认知障碍患儿140例，采用随机数表法分为试验组和对照组各70例。试验组实施常规康复治疗联合低剂量碳酸锂口服方案[6 mg/（kg·次），2次/d]，对照组采取常规康复治疗联合同剂量碳酸钙口服干预，治疗周期均为3个月。治疗前后采用格里菲斯发育评估量表（GMDS）评估患儿认知功能，同时全程记录患儿临床症状及药物相关不良反应发生情况。结果 最终2组各60例患儿完成全部临床试验。试验组不良反应发生率8.57%(6/70)，对照组为2.85%(2/70),2组比较差异无统计学意义（P>0.05），且所有不良反应症状轻微，经停药及对症处理后均完全缓解。试验组患儿治疗后发育商（DQ）较治疗前显著提升，差异有统计学意义（P<0.05）；对照组患儿治疗前后DQ值比较差异无统计学意义（P>0.05）。亚组分析显示，试验组中粗大运动功能分级系统（GMFCS）Ⅰ～Ⅱ、Ⅲ级患儿及混合型脑瘫患儿治疗后DQ值均显著高于对照组，差异有统计学意义（P<0.05）；试验组GMFCSⅣ～Ⅴ级患儿治疗前后DQ值无明显变化（P>0.05）。结论低剂量锂盐在脑瘫合并认知障碍患儿中的临床应用具有良好的安全性，且能有效改善患儿认知功能，其中对GMFCS分级轻中度、临床分型为混合型的脑瘫合并认知障碍儿童的干预效果尤为显著。更多还原

【Abstract】 ObjectiveTo observe the clinical safety of low-dose lithium salt in children with cerebral palsy complicated by cognitive impairment and its effect on improving cognitive function.MethodsA total of140 children aged 2.5 to 8 years old with cerebral palsy and cognitive impairment who were diagnosed and treated at the Third Affiliated Hospital of Zhengzhou University from July 2020 to December 2023 were enrolled and randomly divided into experimental group and control group,with 70 cases in each group. The experimental group received conventional rehabilitation therapy combined with oral low-dose lithium carbonate(6 mg/（kg·dose）,twice daily),while the control group received conventional rehabilitation therapy combined with the same dose of oral calcium carbonate. The treatment course for both groups was 3 months. Cognitive function was evaluated by the Griffiths mental development scale before and after treatment,and clinical symptoms and drug-related adverse reactions were recorded throughout the study.ResultsFinally,60 children in each group completed the clinical trial. The incidence of adverse reactions was 8.57%(6/70)in the experimental group and 2.85%(2/70)in the control group,with no statistically significant difference between the two groups(P>0.05). All adverse reactions were mild and completely relieved after drug withdrawal and symptomatic treatment. The developmental quotient(DQ)of the experimental group was significantly increased after treatment(P<0.05),while there was no significant difference in DQ of the control group before and after treatment(P>0.05).Subgroup analysis showed that DQ values in children with gross motor function classification system(GMFCS)grade Ⅰ-Ⅱ,Ⅲ and mixed-type cerebral palsy in the experimental group were significantly higher than those in the control group after treatment(P<0.05),while DQ values in children with GMFCS grade Ⅳ-Ⅴ in the experimental group showed no significant change before and after treatment(P>0.05).ConclusionLow-dose lithium salt is safe in clinical application for children with cerebral palsy complicated by cognitive impairment and can effectively improve their cognitive function,especially for children with mild-to-moderate GMFCS grade and mixed-type cerebral palsy.更多还原