Response to magnesium sulfate and adrenocorticotropic hormone combination therapy for infantile spasms with failed first-line treatments.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-03-09 eCollection Date: 2023-03-01 DOI:10.1002/ped4.12368

Qiuhong Wang, Wen He, Yangyang Wang, Liying Liu, Mengna Zhang, Xiaoyan Yang, Liping Zou

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引用次数: 0

Abstract

Importance: Infantile spasm (IS) is a kind of refractory epilepsy. The first-line treatments for IS are adrenocorticotropic hormone (ACTH), oral corticosteroids, and vigabatrin.

Objective: This study aimed to evaluate the efficacy of magnesium sulfate and ACTH (MgSO₄+ACTH) combination therapy in patients with IS who failed first-line treatments.

Methods: In this retrospective study, the clinical data of patients with IS who failed first-line treatments were collected in the Chinese PLA General Hospital. Patients received MgSO₄+ACTH combination therapy after first-line treatments failed. The course of treatments was 2 weeks. The therapeutic dose of ACTH and MgSO₄ was 2.5 U·kg^-1·d^-1 and 0.25 g·kg^-1·d^-1, respectively.

Results: A total of 229 patients with IS who failed the first-line treatments were collected. At the end of the MgSO₄+ACTH combination treatment, the seizure-free rate was 48.5% (111/229), and the resolution of hypsarrhythmia on electroencephalogram (EEG) was 72.1% (165/229). About 21.4% (49/229) of patients showed side effects, including infectious diseases, hypokalemia, and diarrhea.

Interpretation: For patients with IS who failed first-line treatments, in terms of the seizure-free rate and resolution of hypsarrhythmia on EEG, MgSO₄+ACTH combination therapy can be considered.

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对硫酸镁和促肾上腺皮质激素联合疗法治疗一线治疗失败的婴儿痉挛症的反应。

重要性：婴儿痉挛症（IS）是一种难治性癫痫。治疗婴儿痉挛症的一线疗法是促肾上腺皮质激素（ACTH）、口服皮质类固醇和维格巴曲林：本研究旨在评估硫酸镁和促肾上腺皮质激素（MgSO4+ACTH）联合疗法对一线治疗失败的 IS 患者的疗效：这项回顾性研究收集了中国人民解放军总医院一线治疗失败的IS患者的临床资料。患者在一线治疗失败后接受了 MgSO4+ACTH 联合治疗。疗程为两周。ACTH和MgSO4的治疗剂量分别为2.5 U-kg-1-d-1和0.25 g-kg-1-d-1：结果：共收集了229名一线治疗失败的IS患者。在 MgSO4+ACTH 联合治疗结束时，无癫痫发作率为 48.5%（111/229），脑电图（EEG）上的低节律性失常缓解率为 72.1%（165/229）。约21.4%（49/229）的患者出现副作用，包括感染性疾病、低钾血症和腹泻：解释：对于一线治疗失败的IS患者，从无发作率和脑电图低速性心律失常的缓解率来看，可以考虑采用MgSO4+ACTH联合疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.