中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2015年
7期
532-534
,共3页
生酮饮食%婴儿痉挛%疗效
生酮飲食%嬰兒痙攣%療效
생동음식%영인경련%료효
Ketogenic diet%Infantile spasms%Curative effect
目的 评估生酮饮食(KD)疗法在婴儿痉挛中的疗效、依从性及安全性,从而为婴儿痉挛的治疗提供有效依据.方法 对25例临床诊断为婴儿痉挛的患儿进行KD治疗.患儿均采用气相色谱-质谱法、高效液相色谱-串联质谱法除外代谢性疾病,行血常规、尿常规、粪常规、血脂、肝功能、心电图、脑电图、泌尿系统彩超等相关检查.患儿入院后均用过抗癫(癎)药后采用KD疗法,所有患儿不经过禁食直接启动KD.随访其疗效、依从性及不良反应.结果 KD维持治疗1个月、3个月、6个月者分别为25例(100％,25/25例),22例(88％,22/25例),10例(40％,10/25例).25例患儿中7例(28％,7/25例)癫(癎)发作完全控制,均在1个月内控制.达Ⅱ级、Ⅲ级疗效者分别为32％(8/25例)、12％(3/25例).KD治疗期间13例患儿出现轻重不一的消化系统症状,10例患儿出现无症状性低血糖症状,9例患儿出现睡眠增多症状,但经过对症治疗后,绝大多数患儿不良反应均可消退.仅4例患儿因不良反应大终止治疗.结论 KD对治疗婴儿痉挛效果肯定;KD虽有一些不良反应,但可以耐受;KD+抗癫(癎)药物联合治疗1～6个月尚未见严重器官功能障碍.
目的 評估生酮飲食(KD)療法在嬰兒痙攣中的療效、依從性及安全性,從而為嬰兒痙攣的治療提供有效依據.方法 對25例臨床診斷為嬰兒痙攣的患兒進行KD治療.患兒均採用氣相色譜-質譜法、高效液相色譜-串聯質譜法除外代謝性疾病,行血常規、尿常規、糞常規、血脂、肝功能、心電圖、腦電圖、泌尿繫統綵超等相關檢查.患兒入院後均用過抗癲(癎)藥後採用KD療法,所有患兒不經過禁食直接啟動KD.隨訪其療效、依從性及不良反應.結果 KD維持治療1箇月、3箇月、6箇月者分彆為25例(100％,25/25例),22例(88％,22/25例),10例(40％,10/25例).25例患兒中7例(28％,7/25例)癲(癎)髮作完全控製,均在1箇月內控製.達Ⅱ級、Ⅲ級療效者分彆為32％(8/25例)、12％(3/25例).KD治療期間13例患兒齣現輕重不一的消化繫統癥狀,10例患兒齣現無癥狀性低血糖癥狀,9例患兒齣現睡眠增多癥狀,但經過對癥治療後,絕大多數患兒不良反應均可消退.僅4例患兒因不良反應大終止治療.結論 KD對治療嬰兒痙攣效果肯定;KD雖有一些不良反應,但可以耐受;KD+抗癲(癎)藥物聯閤治療1～6箇月尚未見嚴重器官功能障礙.
목적 평고생동음식(KD)요법재영인경련중적료효、의종성급안전성,종이위영인경련적치료제공유효의거.방법 대25례림상진단위영인경련적환인진행KD치료.환인균채용기상색보-질보법、고효액상색보-천련질보법제외대사성질병,행혈상규、뇨상규、분상규、혈지、간공능、심전도、뇌전도、비뇨계통채초등상관검사.환인입원후균용과항전(간)약후채용KD요법,소유환인불경과금식직접계동KD.수방기료효、의종성급불량반응.결과 KD유지치료1개월、3개월、6개월자분별위25례(100％,25/25례),22례(88％,22/25례),10례(40％,10/25례).25례환인중7례(28％,7/25례)전(간)발작완전공제,균재1개월내공제.체Ⅱ급、Ⅲ급료효자분별위32％(8/25례)、12％(3/25례).KD치료기간13례환인출현경중불일적소화계통증상,10례환인출현무증상성저혈당증상,9례환인출현수면증다증상,단경과대증치료후,절대다수환인불량반응균가소퇴.부4례환인인불량반응대종지치료.결론 KD대치료영인경련효과긍정;KD수유일사불량반응,단가이내수;KD+항전(간)약물연합치료1～6개월상미견엄중기관공능장애.
Objective To assess the efficacy,compliance and safety of ketogenic diet (KD) for children with infantile spasms,thus to provide an effective basis for the treatment of infantile spasms.Methods Twenty-five patients with infantile spasms were treated with KD.The gas chromatography-mass spectrometry and high performance liquid chromatography-mass spectrometry (HPLC-MS/MS) were used,except for metabolic diseases,to detect the blood routine,urine,stool,blood Iipids,liver function,as well as electrocardiogram (ECG),electroencephalograph (EEG),ultrasound of the urinary system and other related checks of all patients.The KD antiepileptic drug therapy was given after all children were admitted to hospital,and KD started directly in all patients without fasting.The efficacy compliance and safety were followed up in this study.Results KD maintenance therapy for 1 month,3 mouths,6 months were given to 25 cases (100％,25/25 cases),to 22 cases (88％,22/25 cases),and to 10 cases (40％,10/25 cases),respectively.Among them 7 patients (28％,7/25 cases) were in complete control of seizures within 1 month.Up to Class Ⅱ,Ⅲ efficacy level accounted for 32％ (8/25 cases),12％ (3/25 cases),respectively.Thirteen cases of children had varying digestive symptoms,10 cases of them developed asymptomatic hypoglycemia,and 9 cases of children had sleep trouble during KD treatment,but after symptomatic treatment,children's adverse reactions almost subsided.Only 4 cases of children discontinued treatment due to adverse reactions.All children's seizures were fully controlled.Conclusions The effect of KD is sure in the treatment of infantile spasms.Although KD has some adverse reactions,but it can be tolerated;serious body organ dysfunction treated by KD + antiepileptic drugs combination therapy for 1 to 6 months is not found yet,so the therapy is worthy of promotion clinically.
