Rua Galvão Bueno, Cruzeiro do Sul University, São Paulo, Brazil.
Department of Microbiology, Oral Microbiology Laboratory, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
Int J Paediatr Dent. 2019 Sep;29(5):635-641. doi: 10.1111/ipd.12488. Epub 2019 Mar 18.
Cerebral palsy (CP) individuals present with epilepsy, which requires the use of antiepileptic drug (AED).
Since an inflammatory response may contribute to epileptogenesis, the hypothesis tested was that constipation would be associated with gingivitis and the use of AED in children and adolescents (CA) with CP.
A comparative study was conducted with 101 CA aged 5-17 years (10.8 ± 4.9), classified as constipated (G1; n = 57) or not constipated (G2; n = 44). Clinical patterns, AED used, body mass index (BMI), fluid intake, toilet transfer, and gingival condition were evaluated. Student's t test, chi-squared test, and logistic regression analysis were performed (α = 0.05).
There were no differences between groups regarding gender (P = 0.531), age (P = 0.227), BMI (P = 0.437), and fluid intake (P = 0.346). G1, however, presented a higher percentage of quadriplegic individuals (P < 0.001), dependency for toilet transfer (P < 0.001), the presence of gingivitis (P = 0.020), and the use of AED polytherapy (P < 0.001) compared to G2. Constipation was associated with quadriplegic CA, using GABA as AED (P = 0.002).
Mucosal inflammation evidenced by constipation and gingivitis is associated with the most neurologically compromised CAs under the use of GABA AED.
脑瘫(CP)患者常伴有癫痫,需要使用抗癫痫药物(AED)。
由于炎症反应可能导致癫痫发作,因此本研究假设便秘与青少年 CP 患者的牙龈炎和 AED 使用有关。
对 101 名 5-17 岁(10.8±4.9 岁)的 CP 患儿进行了一项比较研究,将其分为便秘组(G1;n=57)和非便秘组(G2;n=44)。评估了临床模式、使用的 AED、体重指数(BMI)、液体摄入、厕所转移和牙龈状况。采用 Student's t 检验、卡方检验和逻辑回归分析(α=0.05)。
两组间在性别(P=0.531)、年龄(P=0.227)、BMI(P=0.437)和液体摄入(P=0.346)方面无差异。然而,G1 组四肢瘫痪患者比例较高(P<0.001),对厕所转移的依赖程度较高(P<0.001),牙龈炎的发生率较高(P=0.020),并且更常使用 AED 联合治疗(P<0.001)。与 G2 相比,便秘与四肢瘫痪的 CP 患儿和使用 GABA 作为 AED 相关(P=0.002)。
便秘和牙龈炎提示黏膜炎症与使用 GABA AED 的神经功能最受损的 CP 患儿有关。