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[泼尼松龙和促肾上腺皮质激素治疗婴儿痉挛症的效果:一项Meta分析]

[Effect of prednisolone and adrenocorticotropic hormone in the treatment of infantile spasms: a Meta analysis].

作者信息

Luo Ke-Ren, Tang Jun, Mu De-Zhi

机构信息

Department of Pediatrics, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2019 Jul;21(7):656-662. doi: 10.7499/j.issn.1008-8830.2019.07.008.

Abstract

OBJECTIVE

To compare the effect and safety of prednisolone and adrenocorticotropic hormone (ACTH) in the treatment of infantile spasms (IS).

METHODS

Cochrane Library, Embase, PubMed, China Biology Medicine Disc, CNKI, and Wanfang Data were searched for clinical studies on the comparison between prednisolone and ACTH in the treatment of IS. Literature screening, data extraction, and quality assessment were performed. Review Manager 5.3 was used for Meta analysis.

RESULTS

Five clinical studies were included according to the inclusion criteria and exclusion criteria. Meta analysis showed that there was no significant difference in the spasm remission rate, spasm remission time, complicating infection rate, and irritability rate between the prednisolone and ACTH treatment groups (P>0.05), but the disappearance rate of hypsarrhythmia in the electroencephalogram was higher in the ACTH treatment group than in the prednisolone treatment group (P<0.05).

CONCLUSIONS

The available evidence shows no difference in the clinical efficacy of prednisolone versus ACTH in the treatment of IS. However, ACTH is superior to prednisolone in stabilizing EEG. The two therapies have no difference in the incidence of adverse reactions such as infection and irritability.

摘要

目的

比较泼尼松龙与促肾上腺皮质激素(ACTH)治疗婴儿痉挛症(IS)的疗效及安全性。

方法

检索Cochrane图书馆、Embase、PubMed、中国生物医学文献数据库、中国知网和万方数据,查找关于泼尼松龙与ACTH治疗IS的比较的临床研究。进行文献筛选、数据提取和质量评估。使用Review Manager 5.3进行Meta分析。

结果

根据纳入标准和排除标准纳入5项临床研究。Meta分析显示,泼尼松龙治疗组与ACTH治疗组在痉挛缓解率、痉挛缓解时间、并发感染率和易激惹率方面无显著差异(P>0.05),但ACTH治疗组脑电图高峰失律消失率高于泼尼松龙治疗组(P<0.05)。

结论

现有证据表明,泼尼松龙与ACTH治疗IS的临床疗效无差异。然而,ACTH在稳定脑电图方面优于泼尼松龙。两种疗法在感染和易激惹等不良反应发生率方面无差异。

相似文献

本文引用的文献

1
Treatment of infantile spasms.婴儿痉挛症的治疗。
Epilepsia Open. 2018 Oct 23;3(Suppl Suppl 2):143-154. doi: 10.1002/epi4.12264. eCollection 2018 Dec.
2
High-Dose Prednisolone as a First-line Treatment for Infantile Spasms.大剂量泼尼松龙作为婴儿痉挛症的一线治疗方法。
Pediatr Neurol. 2018 Oct;87:3-4. doi: 10.1016/j.pediatrneurol.2018.08.011. Epub 2018 Aug 9.
4
Infantile Spasms-Have We Made Progress?婴儿痉挛症:我们有进展吗?
Curr Neurol Neurosci Rep. 2018 Apr 19;18(5):27. doi: 10.1007/s11910-018-0832-8.

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