【作者】 韩金芬； 王家勤；

【Author】 Han Jinfen;Wang Jiaqin;Paediatrics of the Third Affiliated Hospital of Xinxiang Medical University;

【机构】 新乡医学院第三附属医院儿科；

【摘要】 目的探讨ACTH联合大剂量维生素B6辅助治疗婴儿痉挛症的疗效。方法收集新乡医学院第三附属医院2013年1月-2015年3月在儿科住院的53例婴儿痉挛症患儿,年龄为45天至5岁,给予ACTH,按1ug/Kg,1日1次泵入,每次泵入大于8小时,2周后有效,再用药2周,总疗程4周,或用ACTH,按1ug/Kg,1日1次泵入,每次泵入大于8小时,2周之后无效,加量至2ug/Kg,,最大量40ug/次,有效,总疗程4周,使用ACTH同时均应用大剂量维生素B630mg/Kg.d静滴;观察用药前后的患儿发作情况、脑电图改变、血常规,肝、肾功能及血电解质变化。结果 34例完全控制,11例显效,7例有效,1例无效,其中1例完全控制因合并肺部感染治疗14天终止治疗,1例完全控制因家属拒绝输液治疗9天终止治疗。全部病例一般情况和脑电图均有改善。治疗过程中8例病儿有低血钾,4例病儿低血钙等,高血糖1例,低血糖3例,高血压3例、合并代谢性酸中毒2例,血常规、肝、肾功能复查均未见异常变化。两组完全控制天数首发与非首发患儿比较P<0.05。首发患儿完全控制率67.86%,非首发患儿为62.5%,两组治疗完全控制率、总有效率相比差异无统计学意义。结论 ACTH联合大剂量维生素B6辅助治疗婴儿痉挛症无论是首发还是非首发均疗效肯定。更多还原

【Abstract】 Aims To observe the curative effect of adrenocorticotropic hormone(ACTH) combined with megavitamin for infantile spasms.Methods 53 infantile spasms of Paediatrics of the Third Affiliated Hospital of Xinxiang Medical University from March 2013 to March 2015 were collected.They are 0.125 to 5 years old.1ug/Kg ACTH were pumped with ltime every day for over 8 h every time.Two weeks later,the curative effect was evaluated.If it was effective,the treatment would be continued for another two weeks.That is to say the total treatment course is 4weeks.If it was noneffective,the dose of ACTH would be increased to 2ug/Kg.The total treatment course was 4 weeks and the maximum was 40ug/time.Additionally,30mg/Kg Vitamin B6 were used venously.Then the changes of children attack,electroencephalogram,routine blood test,functions of liver and kidney and electrolyte were detected.Results 34 infantile spasms were controlled totally.11 infantile spasms were excellent.7 infantile spasms were effective and lwere noneffective.The treatment of one of the 33 infantile spasms was terminated because of the pulmonary infection.The treatment of another patient was ended because of the refusion of the family.The symptoms and encephlogram of all the patients were improved.During the treatment course,there were 8 patients with hypopotassemia,4 with hypocalcemia,1 hyperglycaemia,3 hypoglycemia,3 hypertension and 2 metabolic acidosis.There were no abnormal changes for routine blood test and functions of liver and kidney.Compared with the noninitial treatment of children,the time of treatment for Initial treatment of children was shorter.There were no statistical difference between the two groups about the total controlled rates and the total effective rates.Conclusions There are good curative effect for infantile spasms with ACTH combined with megavitamin B6.更多还原