促肾上腺皮质激素治疗婴儿痉挛症近期疗效及远期预后及其影响因素的研究.pdfVIP

钟金花 遵义医学院硕士学位论文 药物失败后的患儿，ACTH 治疗获得无发作的机会较低(41.3%)，但仍然值得尝试； 2.视频脑电图监测是判断ACTH 治疗后近期疗效的重要指标，临床“无发作”情况不 能完全反映视频脑电图高峰节律紊乱消失情况；3.非首选 ACTH 近期疗效：起病年 龄6 月、初诊年龄6 月的患儿抗癫痫药失败后再用ACTH 效果更好；4.远期复发率 与是否首选ACTH 治疗无关；5.远期预后：起病年龄6 月、初诊年龄6 月、ACTH 近期及远期发作完全控制、病因为隐源性的患儿智力运动发育更好。 关键词：婴儿痉挛症；促肾上腺皮质激素；疗效；预后；一线治疗；无 发作率 3 万方数据 钟金花 遵义医学院硕士学位论文 Research on the recent and long-term outcome of ACTH therapy for infantile spasms and their influencing factors Abstract Objective:By analyzing the recent and long-term outcome of ACTH treatment of infantile spasms,we tried to provide evidence for improving the efficacy of the treatment of infantile spasms. Methods:This was a prospective,cohort study design in a single center.According to the diagnostic criteria,inclusion criteria,exclusion criteria,we established a database,collected cases,follow-up,analyzed the cases of patients with infantile spasms from 1999 to 2010 at Shenzhen Childrens Hospital,categorized patients as the ACTH first line and non-first line drug group.We compared the recent (within 8 weeks) spasm-free rate and the influence to it between two groups.Analyzed the correlation between ACTH recent effects and VEEG results;Analyzed the factors influencing ACTH recent effects in non-first line drug group, as well as long-term outcome and its related factors. Results:The final follow-up time was December,2013,we got 113 cases.1.33 cases were in ACTH first line drug group and 80 cases were in ACTH non-first line group.21 cases in