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首页> 外文期刊>Epilepsia: Journal of the International League against Epilepsy >The impact of hypsarrhythmia on infantile spasms treatment response: Observational cohort study from the National Infantile Spasms Consortium
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The impact of hypsarrhythmia on infantile spasms treatment response: Observational cohort study from the National Infantile Spasms Consortium

机译:Hypsarrhalythmia对婴儿痉挛治疗响应的影响:国家婴儿痉挛联盟的观察队列研究

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Summary Objective The multicenter National Infantile Spasms Consortium prospective cohort was used to compare outcomes and phenotypic features of patients with infantile spasms with and without hypsarrhythmia. Methods Patients aged 2 months to 2 years were enrolled prospectively with new‐onset infantile spasms. Treatment choice and categorization of hypsarrhythmia were determined clinically at each site. Response to therapy was defined as resolution of clinical spasms (and hypsarrhythmia if present) without relapse 3 months after initiation. Results Eighty‐two percent of patients had hypsarrhythmia, but this was not associated with gender, mean age, preexisting developmental delay or epilepsy, etiology, or response to first‐line therapy. Infants with hypsarrhythmia were more likely to receive standard treatment (adrenocorticotropic hormone, prednisolone, or vigabatrin [odds ratio ( OR ) 2.6, 95% confidence interval ( CI ) 1.4–4.7] and preexisting epilepsy reduced the likelihood of standard treatment ( OR 3.2, 95% CI 1.9–5.4). Hypsarrhythmia was not a determinant of response to treatment. A logistic regression model demonstrated that later age of onset ( OR 1.09 per month, 95% CI 1.03–1.15) and absence of preexisting epilepsy ( OR 1.7, 95% CI 1.06–2.81) had a small impact on the likelihood of responding to the first‐line treatment. However, receiving standard first‐line treatment increased the likelihood of responding dramatically: vigabatrin ( OR 5.2 ,95% CI 2–13.7), prednisolone ( OR 8, 95% CI 3.1–20.6), and adrenocorticotropic hormone (ACTH; OR 10.2, 95% CI 4.1–25.8) . Significance First‐line treatment with standard therapy was by far the most important variable in determining likelihood of response to treatment of infantile spasms with or without hypsarrhythmia.
机译:发明内容本发明了多中心国家婴儿痉挛联盟潜在队列审美队队伍用于比较患有婴儿痉挛患者的结果和表型特征,没有低血肿。方法患者2个月至2年的患者预期,并进行了新的婴儿痉挛。在每个位点临床上临床诊断治疗和分类。对治疗的反应被定义为临床痉挛的分辨率(如果存在的低血淋淋性,如果存在,则会在发起后3个月复发。结果八十二次患者患有低血糖,但这与性别,平均年龄,预先存在的发育延迟或癫痫,病因或对初系治疗的反应无关。 Hypsarrhalythmia的婴儿更容易接受标准治疗(肾上腺皮质激素,泼尼松龙或vigabatrin [odab r比(或)2.6,95%置信区间(CI)1.4-4.7]和预先存在的癫痫减少了标准治疗的可能性(或3.2, 95%CI 1.9-5.4)。Hypsarrhalthmia不是对治疗反应的决定因素。逻辑回归模型表明,后期发病年龄(或每月1.09,95%CI 1.03-1.15)和缺乏预先存在的癫痫(或1.7, 95%CI 1.06-2.81)对响应第一线治疗的可能性略有影响。然而,接受标准的一线治疗增加了急性响应的可能性:Vigabatrin(或5.2,95%CI 2-13.7) ,泼尼松龙(或8,95%CI 3.1-20.6)和肾上腺激素激素(ACTH;或10.2,95%CI 4.1-25.8)。具有标准治疗的重要性第一线治疗是迄今为止确定可能性最重要的变量对我治疗的回应Nfantile痉挛有或没有低血肿的痉挛。

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