@article {Grinspane1217作者={扎卡里·m·Grinspan和凯利·g·Knupp阿努普·d·帕特尔,艾丽莎Yozawitz和考特尼j . Wusthoff伊莱恩·c·Wirrell和伊格纳西奥·瓦伦西亚Nilika Singhal和道格拉斯·r·Nordli和约翰·r·Mytinger和温迪·g·米切尔和辛西娅·g·Keator Tobias Loddenkemper和肖恩·a·侯赛因Chellamani Harini和威廉·d·盖拉德伊万·s·费尔南德斯和杰森Coryell凯瑟琳·j·楚和安妮·t·伯格和蕾妮·a·Shellhaas}, title ={比较初始治疗婴儿痉挛症的有效性在当代美国队列},体积={97}={12},页面= {e1217——e1228} = {2021}, doi = {10.1212 / WNL。出版商0000000000012511}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={目的比较初始治疗婴儿痉挛症的有效性。首页方法全国婴儿痉挛症财团前瞻性随访最近诊断为婴儿痉挛症患儿在2岁到24个月23开始我们中心(2012 {\ textendash} 2018)。自由从60天治疗失败不需要第二次治疗婴儿痉挛症和没有临床痉挛治疗30天后开始。我们成功的治疗选择偏见倾向评分权重和中心点与广义估计方程相关性。自由从治疗失败率结果如下:促肾上腺皮质激素(ACTH) 88 190(46 \ %),口服类固醇42 95(44 \ %),氨己烯酸32 87(37 \ %),和非标准治疗4 51 (8 \ %)。从口服类固醇ACTH不是估计影响响应(观察44 \ %估计改变44 \ % %置信区间34 \ [95 \ % {\ textendash} 54 \ %])。从非标准疗法ACTH将改善反应8 \ %至39 \ % (17 \ % {\ textendash} 67 \ %),口服类固醇和变化将改善响应从8 \ %至38 \ % (15 \ % {\ textendash} 68 \ %)。有些大,但是没有统计上显著的估计的影响改变从氨己烯酸ACTH(29 \ %到42 \ % % {\ textendash} \[75 \ %]),从氨己烯酸口服类固醇(29 \ %到42 \ % [28 \ % {\ textendash} 57 \ %]),以及非标准疗法氨己烯酸(8 \ % 20 \ % 50 [6 \ % {\ textendash} \ %])。儿童接受氨己烯酸,那些复杂结节性硬化症(TSC)的反应比别人更多(62 \ % vs 29 \ %;p < 0.05)。讨论非标准治疗相比,ACTH和口服类固醇优越的初始治疗婴儿痉挛症。 The estimated effectiveness of vigabatrin is between that of ACTH/oral steroids and nonstandard therapy, although the sample was underpowered for statistical confidence. When used, vigabatrin worked best for TSC.Classification of Evidence This study provides Class III evidence that for children with new-onset infantile spasms, ACTH or oral steroids were superior to nonstandard therapies.ACTH=adrenocorticotropic hormone; ASM=antiseizure medication; CI=confidence interval; NISC=National Infantile Spasms Consortium; RCT=randomized controlled trial; TSC=tuberous sclerosis complex}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/97/12/e1217}, eprint = {//www.ez-admanager.com/content/97/12/e1217.full.pdf}, journal = {Neurology} }