在标准治疗失败后,婴儿发作综合征对尼特拉泽帕姆的反应
Sunichaya Areekul1, Sirorat Suwannachote2, Rachata Boonkrongsak2
1Department of Pediatrics, Queen Sirikit National Institute of Child Health, Ministry of Public Health, Bangkok, Thailand.
Epilepsy & behavior : E&B
|April 17, 2025
概括
尼特拉泽帕姆有效地治疗了约31%未对标准疗法反应的儿童的婴儿发作综合征 (IESS). 早期用尼特拉泽治疗,特别是那些已知原因的人,可能会改善结果.
科学领域:
- 儿科神经学 儿科神经学
- 发病学 (Epileptology) 是一个专业的学科.
- 临床药理学 临床药理学
背景情况:
- 婴儿发作综合征 (IESS) 是一个治疗挑战,超过一半的患者对标准疗法没有反应.
- 尼特拉泽在管理IESS方面表现出与上腺皮质otrophic激素相当的疗效.
- 在耐火IESS病例中评估尼特拉泽的有效性和安全性至关重要.
研究的目的:
- 评估先前标准治疗失败的IESS儿童中尼特拉泽的响应率.
- 为了在这个儿科群体中识别与尼特拉泽治疗相关的不良影响.
- 为了确定影响治疗反应的因素,在接受尼特拉泽的IESS儿童.
主要方法:
- 采用了回顾性观察性研究设计,分析了2013年1月至2021年12月的数据.
- 参与者包括被诊断患有IESS的儿童,在标准治疗失败后接受了尼特拉泽.
- 响应被定义为在3个月的随访后,性的持续临床消失;病因被使用2017年ILAE标准分类.
主要成果:
- 在85名儿童中,26名 (30.5%) 对尼特拉泽有反应. 在23.5%的患者中,在12个月内观察到持续的缓解.
- 在61.2%的儿童中报告了不良反应,最常见的是过 (47.1%).
- 已知的病因 (OR 5.78) 增加了反应的可能性,而延长尼特拉泽帕姆治疗的时间 (OR 0.85) 降低了反应的几率.
结论:
- 尼特拉泽在约31%的IESS耐标准治疗的儿童中取得了反应.
- 早期启动尼特拉泽治疗似乎是有益的,特别是对于已知病因的患者.
- 尼特拉泽帕姆代表了耐火性IESS的可行的治疗选择,尽管需要仔细监测不良影响.
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