婴儿痉挛转型前发作持续时间与临床疗效分析

目的 探讨婴儿痉挛转型前发作持续时间与临床疗效的相关性。 方法 回顾分析63例婴儿痉挛转型前发作的临床及脑电图资料,随访治疗效果及预后。 结果 患儿男40例(63.5%),女23例(36.5%)。≤1岁起病50例(79.36%),>1岁起病13例(20.64%)。患儿痉挛转型间隔时间1个月14 d~23个月,平均8.06个月,中位数是6个月,转型间隔时间≤3个月10例(15.87%),>3个月53例(84.13%)。28例(44.44%)患儿存在潜在病因,35例(55.56%)未见明显病因。视频脑电图(VEEG)证实29例患儿(46.03%)是以最先出现强直发作作为转型点,34例(53.97%)患儿混合其他发作形式出现转型点。临床痉挛发作缓解与性别、转型间隔时间有关联,差异有统计学意义(P<0.05),而与患儿起病年龄及是否存在潜在病因无关联(P>0.05)。 结论 男孩痉挛缓解率差于女孩,痉挛转型前发作持续时间愈短,预后愈好。

An analysis of the duration and clinical efficacy of pre-transition infantile spasm

Objective To explore the correlation between duration of pre-transition infantile spasm and clinical efficacy. Methods The clinical and electroencephalogram data, follow-up results and prognosis of 63 infants with pre-transition spasm were retrospectively analyzed. Results There were 40 male(63.5%)and 23 female(36.5%)infants. The onset was ≤1 year in 50 patients(79.36%), and >1 year in 13 patients(20.64%). Duration of the transition was 14 days to 23 months, average 8.06 months, median 6 months. The interval of seizure transition was ≤3 months in 10 patients(15.87%), and >3 months in 53 patients(84.13%). Latent causes were found in 28 cases(44.44%)and no obvious causes were found in 35 cases(55.56%). VEEG confirmed that 29 cases(46.03%)had the first tonic episode as the transition point, and 34 cases(53.97%)had transition point mixed with other seizure types. Clinical spasm remission was related to gender and transition interval, and the differences were statistically significant(P<0.05), but not related to the age of onset and the presence of latent etiology(P>0.05). Conclusion The remission rate of spasm is worse in males than in females and those with shorter duration of spasm before transition have better prognosis.