生酮饮食治疗31例儿童难治性癫痫的疗效观察  

Therapeutic effect of ketogenic diet on 31 children with refractory epilepsy

作　　者：王静 陆韦 黄云 幸黔鲁 徐忠祥 陈娅 梁涛 郝仁方 WANG Jing;LU Wei;HUANG Yun(Department of Prevention and Health Care,Affiliated Hospital of Zunyi Medical University, Zunyi (563000),Guizhou,China)

机构地区：[1]遵义医科大学附属医院预防保健科,贵州遵义563000 [2]遵义医科大学附属医院儿内科,贵州遵义563000 [3]遵义医科大学附属医院神经内科,贵州遵义563000

出　　处：《癫痫与神经电生理学杂志》2019年第1期21-25,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：国家自然科学基金资助项目(NO:81660227,81560224);贵州省科学技术基金(黔科合LH字[2016]7476号);贵州省卫计委科技基金资助项目(NO:gzwjkj2015-1-052).

摘　　要：目的:观察生酮饮食(ketogenic diet,KD)治疗小儿难治性癫痫的疗效和保留率。方法:选择2012年12月至2017年10月采用KD方案进行治疗的31例难治性癫痫患儿,记录启动KD前后患儿每日发作情况,随访其依从性、对KD的耐受性及不良反应等。观察不同因素(年龄、癫痫病因、发作类型、基本情况及抗癫痫药物使用等)对疗效的影响。结果:KD治疗3个月时有效率为64.5%(20/31),保留率为87.1%(27/31),其中发作减少≥90%有9例(29%);6个月时有效率为58.1%(18/31),保留率为7].0%(22/31),其中发作减少≥90%有12例(38.7%);12个月时有效率为48.4%(15/31),保留率为48.4%(15/31),其中发作减少≥90%有11例(32.3%)。结论:KD对小儿难治性癫痫疗效较好,且较为安全,使用成品的KD治疗有效率和保留率都更高,这有待更大样本的进一步论证和研究。Objective:To observe the efficacy and retention rate of ketogenic diet (KD)in the treatment of refractory epilepsy in children.Methods:Thirty-one children with refractory epilepsy from December 2012 to October 2017 were enrolled in this study.The daily onset,the compliance and adverse reactions were recorded and analyzed after treatment with KD.The different factors (age,epileptic etiology,type of attack,basic situation and antiepiIeptic drug use)were explored on the treatment outcome.Results:The effective rate was 64.5%(20/31)at 8 months after treatment with KD. The retention rate was 87.1%(27/31).Seizure frequency of 9 cases (29%)were reduced by ≥90%. The effective rate was 58.1%(18/31)at 6 months.The retention rate was 71.0%(22/31).Seizure frequency of 12 cases (38.7%)were reduced ≥90%.The effective rate was 48.4%(15/31) at 12 months.The retention rate was 48.4%(15/31).Seizure frequency of 11 cases (32.3%)were reduced by ≥90%.Conclusion:KD is better and safer for children with refractory epilepsy.The effective rate and retention rate of ketogenic diet are still needed further study.

关 键 词：生酮饮食(KD) 儿童 难治性癫痫 疗效 

分 类 号：R742.1[医药卫生—神经病学与精神病学]