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目的探讨硫酸镁在婴儿痉挛症(IS)治疗中的作用及治疗前后脑电图变化与临床疗效的关系。方法将研究对象随机分为促肾上腺皮质激素(ACTH)治疗组(对照组)及硫酸镁辅助ACTH治疗组(硫酸镁组),对完成治疗方案的33例患儿临床疗效进行比较,对25例脑电图资料完整的患儿进行脑电图高峰失律消失率、正常率、棘波频率、部位进行比较,观察各因素与临床疗效的关系。结果 1.硫酸镁组治疗1周,临床发作次数减少优于对照组(P<0.05),治疗1周、2周、2个月、3个月完全缓解率(分别为23.5%、52.9%、76.5%和76.5%)均高于对照组,治疗1周、2周临床有效率(分别为66.7%、39.4%)均高于对照组。2.硫酸镁组治疗1周、2周和3周的脑电图高峰失律消失率(分别为7.7%、30.8%和38.5%)、正常化率(分别为7.7%、30.8%和30.8%)均较对照组高。3.二组治疗前棘波主要位于后头部,治疗后棘波显著部位向前头部及中央部扩展。结论 1.硫酸镁辅助ACTH治疗IS在1～3周短期及3个月长期治疗中均能提高临床完全缓解率。2.硫酸镁辅助ACTH治疗IS能提高短期脑电图正常化率、高峰失律消失率及临床确切疗效比率。
Objective To investigate the role of magnesium sulfate in the treatment of infantile spasms (IS) and the relationship between EEG changes and clinical outcomes before and after treatment. Methods The subjects were randomly divided into adrenocorticotropic hormone (ACTH) treatment group (control group) and magnesium sulfate-supplemented ACTH treatment group (magnesium sulfate group), the clinical efficacy of the 33 cases completed the treatment program were compared, 25 cases EEG children with complete information on the loss of peak EEG disappearance rate, normal rate, spike frequency, site comparison to observe the relationship between various factors and clinical efficacy. The results showed that: 1. The magnesium sulfate group was significantly better than the control group (P <0.05), and the complete remission rate was 23.5%, 52.9% at 1 week, 2 weeks, 2 months and 3 months after treatment, 76.5% and 76.5%, respectively) were higher than those in the control group. The clinical effective rates (66.7% and 39.4%, respectively) of 1 week and 2 weeks of treatment were higher than those of the control group. The disappearance rate of EEG peak loss (7.7%, 30.8% and 38.5%, respectively) at 1 week, 2 weeks and 3 weeks of treatment in magnesium sulfate group were normalized (7.7%, 30.8% and 30.8% ) Were higher than the control group. 3. The two groups of spikes before treatment are mainly located in the head, spike after treatment significant parts of the forward head and central part of the expansion. Magnesium sulfate-assisted ACTH treatment of IS in 1 to 3 weeks short-term and 3-month long-term treatment can improve the clinical complete response rate. Magnesium sulfate assisted ACTH treatment of IS can improve the normalization rate of short-term EEG, peak loss disappearance rate and the exact clinical efficacy rate.