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目的 探讨长效确杜先联合拉莫三嗪及维生素B6治疗婴儿痉挛的安全性。方法 在应用大剂量维生素B6[2 0~ 5 0mg/ (kg·d) ]基础上 ,加用小剂量人工合成的ACTH 长效确杜先 [0 0 10~ 0 0 15mg/ (kg·d) ]及拉莫三嗪治疗婴儿痉挛 2 5例。结果 长效确杜先疗程结束后 1个月 ,2 2例患儿 (88 0 % )的发作得到完全控制 ,长效确杜先用药至抽搐发作完全停止的平均时间为 (3 7± 2 0 )天 (1 5~ 6 0天 )。 2 5例患儿平均随访 (2 0 2± 14 1)个月 (6~ 30个月 ) ,9 1% (2 / 2 2 )患儿出现复发 ,无演变为其它类型发作者。 9例 (36 0 % )出现短暂的、不同程度的兴奋症状 ,7例(2 8 0 % )食量明显增加 ,无严重毒副作用发生。结论 长效确杜先联合拉莫三嗪及维生素B6治疗婴儿痉挛 ,能迅速有效地控制其痉挛发作 ,且复发率低 ,副作用小 ,是治疗婴儿痉挛更为安全有效的方法。
Objective To investigate the safety and efficacy of combination of lamotrigine and vitamin B6 in the treatment of infant spasticity. Methods The high dose of vitamin B6 [20 ~ 50 mg / (kg · d)] was used in combination with low dose of synthetic ACTH long-acting Du Xian [0 0 10 ~ 0 0 15mg / (kg · d) ] And lamotrigine treatment of infantile spasms 25 cases. Long-term results were confirmed at the end of treatment 1 month after the end of treatment, 22 cases of children (88%) were fully controlled seizures, long-term Du do medication to convulsive seizures completely stopped the average time (3 7 ± 20 ) Days (15 ~ 60 days). Twenty-five children were followed up for an average of (202 ± 141) months (6-30 months). Ninety-one percent (2/2 2) of the children showed recurrence without any change to other types of children. Nine patients (36 0%) experienced transient symptoms of varying degrees of excitement. Seven patients (280%) had significantly increased appetite without serious side effects. Conclusions Long-acting doxamine combined with lamotrigine and vitamin B6 in the treatment of infantile spasms can effectively and quickly control the onset of spasm. The relapse rate is low and the side effects are small. It is a safer and more effective method for the treatment of infantile spasms.