ACTH联合左乙拉西坦序贯治疗婴儿痉挛症例疗效观察.docxVIP

ACTH联合左乙拉西坦序贯治疗婴儿痉挛 症14例疗效观察 吴蕾彭镜刘沉涛尹飞 （中南大学湘雅医院儿科长沙410008） 【摘要】目的评价ACTH联合左乙拉西坦（LEV）序贯治疗对婴儿痉挛症（IS）的疗效和平安 性。方法对湘雅医院儿科2007年9月到2008年9月，应用ACTH联合LEV序贯治疗的IS患儿14 例，从治疗效果、不良事件、脑电图等几个方面进行开放性自身对照随访研究。结果ACTH 联合LEV序贯治疗14例，所有病例随访3-6个月以上，无失访病例。ACTH （25IU/d）治疗4周 后，有57. 1%（8/14例）完全控制,28.6有4/14例）显效,后3%（2/14例）有效。ACTH治疗 完成后予以LEV序贯治疗，其尚未完全控制的6例中，完全控制的2例，显效2例，有效1 例，无效1例，不良反响主要为嗜睡，情绪异常，食欲下降。3个月后脑电图复查3例为正常 婴儿脑电图，9例仅见少量棘波散发。6个月后复查5例正常，8例可见少量或偶发棘波散发。 结论ACTH联合LEV序贯治疗婴儿痉挛症能有效的控制发作、改善脑电，且具有良好的平安 性。 【关键词】ACTH；左乙拉西坦；婴儿痉挛症 Clinical Observation of ACTH combi nd with LEV as sequential therapy for infantile spasms about 14 cases. Wu lei, Peng Jing, Liu chen-tao, Yin fei （Department of Pediatrics, Xiang Ya Hospital of Central South University, Changsha 410008, Hunan Province, China ） Abstact: TO evaluate the efficacy and tolerability of ACTH combind with LEV as sequential therapy for infantile spasms （IS）. Method: In the open own-controled follow-up study from therapeutic efficacy, side effect and electroencephalogram, ACTH was combined with LEV as sequential therapy in 14 patients with IS from the Paediatrics of XiangYa Hospital during the year of 2007 to 2008. Result: After 4 weeks ACTH （25IU/d） therapy, eight patients were seizure free, after LEV therapy and followed up for 3-6 months, two patients were seizure free, three patients experienced at least 50% reduction in seizure frequency, and one patient had no improvement in seizure frequency. There were no relapses in the patients at 6 months after the cessation of seizures. The side effects mainly occurred in LEV, including drowsiness, psychiatric symptom and appetite decreased. After 3 months, the electroencephalographic pattern showed:3 patients for a well-organized background rhythm with no evidence of seizure activity, 9 patients for a few spikes and sharp waves to distribute, and after 6 months , 5 patients showed a well-organized background rhythm with no evidence of seizure activity. 8 patients had slight or adventitions spiks and sharp w