生酮饮食对不同病因及发作形式儿童难治性癫痫疗效差异的临床观察  

Clinical observation on the efficacy of ketogenic diet in the treatment of refractory seizures in children with different causes and seizure forms

作　　者：刘微[1] 屈小金 官同珍[1] 梁檬[1] LIU Wei;QU Xiaojin;GUAN Tongzhen;LIANG Meng(Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院神内一科

出　　处：《中国中西医结合儿科学》2019年第5期432-434,共3页Chinese Pediatrics of Integrated Traditional and Western Medicine

摘　　要：目的 分析生酮饮食对不同病因及发作形式儿童难治性癫痫疗效差异。方法 选择2017年11月至2018年11月在本院接受生酮饮食治疗的难治性癫痫患儿50例作为观察对象,依据不同病因及发作形式进行分组。依据病因分为不明原因癫痫组和症状性癫痫组各25例。依据发作形式分为混合发作癫痫组20例和单一发作癫痫组30例;依据不同发作类型分为癫痫性痉挛发作组10例和非癫痫性痉挛发作组40例。患儿血酮2mmol/L时开始生酮饮食。同时给予枸缘酸钾药物,每日0.5g,复合维生素矿物质制剂每日6g。生酮饮食脂肪与蛋白以及碳水化合物比例为4∶1或3∶1。治疗时间超过3个月,观察治疗效果。结果 症状性癫痫组患儿治疗总有效率为80.0%(20/25),显著高于不明原因癫痫组48.0%(12/25),差异有统计学意义(P<0.05)。单一发作癫痫组和混合发作癫痫组总有效率比较差异无统计学意义(P>0.05)。癫痫性痉挛发作组总有效率为80.0%(8/10),显著高于非癫痫性痉挛发作组45.0%(18/40),差异有统计学意义(P<0.05)。结论 生酮饮食在难治性癫痫患儿治疗中具有较高应用价值,而本次研究进一步证实了,生酮饮食在不同发作形式癫痫患儿中并不存在明显差异,在原因上,症状性癫痫患儿的治疗效果更为理想,在发作类型上,癫痫性痉挛发作患儿的治疗效果更理想。Objective To analyze the difference in the effect of ketogenic diet in the treatment of refractory epilepsy in children with different causes and seizure forms. Methods From November 2017 to November 2018, 50 patients with refractory epilepsy were treated with ketone-producing diet in our hospital and they were selected as the observation subjects, and were grouped according to different causes and seizure forms. According to the etiology, there were 25 cases in the epilepsy group with unknown cause and 25 cases in the symptomatic epilepsy group. According to the seizure form, there were 20 cases in the mixed-seizure epilepsy group and 30 cases in the single-seizure epilepsy group. According to the different types of seizures, there were 10 cases in the epileptic spasm group and 40 in the nonepileptic spasm group. The ketogenic diet was started when the blood ketone was 2 mmol/L. At the same time, potassium bromate is administered, 0.5 g per day, and the compound vitamin mineral preparation was given at 6 g per day. The ratio of the fat in ketogenic diet to the protein and the carbohydrate was 4∶1 or 3∶1. The treatment time was more than 3 months, and the treatment effect was observed. Results The total effective rate of the patients in symptomatic epilepsy group was 80.0%(20/25), which was significantly higher than that of the epilepsy group with unknown cause(48.0%,12/25), and the difference was statistically significant( P <0.05). There was no significant difference in the total effective rate between the single-episode epilepsy group and the mixed-onset epilepsy group( P >0.05). The total effective rate of the epileptic spasm group was 80.0%(8/10), which was significantly higher than that of the non-epileptic spasm group(45.0%,18/40), and the difference was significant( P <0.05). Conclusion Ketogenic diet has high application value in the treatment children with refractory epilepsy. Here in this study it proved that the effect of ketogenic diet has no significant difference in epilepsy children with diffe

关 键 词：癫痫 生酮饮食 病因 发作形式 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]