TY -的T1 -比较初始治疗婴儿痉挛症的有效性在当代美国队列JF -神经学乔-神经病学SP - e1217 LP - e1228做- 10.1212 / WNL。首页0000000000012511六世- 97 - 12非盟-扎卡里·m·Grinspan盟凯利g . Knupp AU -阿努普·d·帕特尔盟艾丽莎g . Yozawitz AU -考特尼j . Wusthoff盟伊莱恩·c·Wirrell AU -伊格纳西奥·瓦伦西亚盟Nilika s Singhal AU -道格拉斯·r·Nordli AU -约翰·r·Mytinger盟温迪·g·米切尔AU -辛西娅·g·Keator盟Tobias Loddenkemper AU -肖恩·a·侯赛因盟Chellamani Harini盟——威廉•d•盖拉德盟-伊万·s·费尔南德斯AU -杰森Coryell AU -凯瑟琳·j·楚盟——安妮·t·伯格盟蕾妮·a·Shellhaas Y1 - 2021/09/21 UR - //www.ez-admanager.com/content/97/12/e1217.abstract N2 -客观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 - 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%), 95年口服类固醇42(44%)、氨己烯酸32 87(37%),和非标准治疗51例(8%)4。从口服类固醇ACTH不是估计影响响应(估计变化观察到44%到44%(95%置信区间34% - -54%))。从非标准疗法ACTH将改善响应从8%降至39%(17% - -67%),口服类固醇和变化将改善响应从8%到38% (15% - -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%至42%(15% - -75%)),从氨己烯酸口服类固醇(29%至42%(28% - -57%)),以及非标准疗法氨己烯酸(8%至20% (6% - -50%))。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 & lt; 0.05).Discussion Compared to nonstandard therapy, ACTH and oral steroids are superior for initial treatment of infantile spasms. 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 ER -