Partikian Arthur, Mitchell Wendy G
Pediatric Neurology Division, Women's and Children's Hospital, Keck School of Medicine, Los Angeles, California 90033, USA.
J Child Neurol. 2007 Dec;22(12):1360-6. doi: 10.1177/0883073807310988.
Few studies have focused on tolerability and adverse events associated with natural adrenocorticotropic hormone injections for treatment of infantile spasms. Using a retrospective chart review of 130 patients, the authors compare major adverse events, weight and blood pressure changes, and unplanned medication changes associated with adrenocorticotropic hormone (ACTH) injections versus other antiepileptic drugs. Children treated with adrenocorticotropic hormone injections experienced significant short-term weight gain and blood pressure elevations, which were readily reversible with weaning off the drug. Twenty-three percent of patients treated with adrenocorticotropic hormone (14 of 60) and 17% of patients treated with other antiepileptic drugs (11 of 65) experienced a major adverse event during treatment. Few patients overall required a change in medication due to intolerable side effects. Despite early changes in weight and blood pressure, short courses of high-dose natural adrenocorticotropic hormone are generally well tolerated with no increased major adverse events when compared to antiepileptic drugs in the treatment of infantile spasms.
很少有研究关注与天然促肾上腺皮质激素注射治疗婴儿痉挛相关的耐受性和不良事件。作者通过对130例患者的回顾性病历审查，比较了与促肾上腺皮质激素（ACTH）注射以及其他抗癫痫药物相关的主要不良事件、体重和血压变化，以及计划外的药物变更。接受促肾上腺皮质激素注射治疗的儿童出现了显著的短期体重增加和血压升高，在停药后这些情况很容易逆转。接受促肾上腺皮质激素治疗的患者中有23%（60例中的14例），接受其他抗癫痫药物治疗的患者中有17%（65例中的11例）在治疗期间发生了主要不良事件。总体而言，很少有患者因无法耐受的副作用而需要更换药物。尽管体重和血压早期有所变化，但与抗癫痫药物相比，在治疗婴儿痉挛时，短期高剂量天然促肾上腺皮质激素通常耐受性良好，且主要不良事件并未增加。
