Objective To provide effective reference for clinical application of ketogenic diet ( KD) in the treatment of infantile spasm ( IS) by observing the curative effect and adverse reactions of KD as well as the factors that may affect the curative effect of KD. Methods Clinical data of 36 cases of IS accepting KD treatment in the Second Affiliated Hospital of Xi' an Jiaotong University from December 2011 to October 2015 were screened to compare the difference in KD effect among forecast factor groups and to evaluate the curative effect, retention rate and adverse reactions of KD. Results The retention rates of KD were 91. 7%, 88. 9% and 80. 6%, respectively after treatment for 1 month, 3 months and 6 months. The effective rate of KD for IS was 66. 7%. Because of poor control and even increasing seizures, cases terminating KD accounted for 57. 1%. The less types of AEDs administration before KD, the higher the efficiency of adding KD (χ2 =8. 309, P=0. 013<0. 05). Conclusion KD is efficient and safe as additional therapy for patients with IS. The efficacy of KD has a certain impact on retention rate of KD treatment. The types of antiepileptic drugs maybe predict the efficiency of KD.%目的 观察生酮饮食(KD)添加治疗婴儿痉挛(IS)的临床疗效、不良反应及可能影响KD疗效的因素,为临床上应用添加KD治疗IS提供有效参考依据.方法 筛选2011年12月至2015年10月在西安交通大学第二附属医院添加KD治疗的36例确诊为婴儿痉挛患儿的临床资料,比较KD疗效在各预测因素组内的差异,评估KD后的发作控制率、KD保留率及不良反应.结果 KD维持治疗1、3、6个月的保留率分别为91.7%、88.9%和80.6%.在6个月时KD控制婴儿痉挛的有效率为66.7%.因发作控制不佳甚至增加而中止KD者占57.1%.KD前使用抗癫痫药物(AEDs)的种类越少,添加KD的有效率越高(χ2=8.309,P=0.013<0.05).结论 KD作为对IS的添加治疗有效和安全;KD保留率主要的影响因素是疗效;KD治疗前的用药种类对其疗效可能有一定的预测价值.
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