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(1)
摘 要：目的 观察生酮饮食治疗不同病因及发作形式小儿难治性癫痫疗效的差异。方法 选取2012年8月～2017年3月我院使用生酮饮食治疗3个月以上的65例难治性癫痫患儿，根据病因随访坚持生酮饮食情况，记录生酮饮食期间患儿治疗3个月后癫痫发作情况。结果 31例症状性癫痫患儿中，有效16例(51.61%)，34例不明原因癫痫患儿中，有效25例(73.53%)，两者比较差异无统计学意义(P>0.05)。35例单一发作患儿中，有效23例(65.71%)，30例混合发作患儿中，有效18例(60.00%)，两者比较差异无统计学意义(P>0.05)。14例婴儿痉挛发作患儿中，有效12例(85.71%)，51例非痉挛发作患儿中，有效29例(56.86%)，两者比较差异有统计学意义(P<0.05)。结论 生酮饮食治疗不同病因难治性癫痫有效性不受病因影响，对婴儿痉挛效果更加显著。
关键词：生酮饮食；儿童；难治性癫痫；病因；婴儿痉挛
中图分类号：R742.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.027
, http://www.100md.com
文章编号：1006-1959(2018)08-0088-03
Clinical Observation of the Effect of Ketogenic Diet on the Efficacy of Children with Refractory Epilepsy Due to Different Causes and Attacks
XU Hai-quan
(Department of Neurology，Tianjin Children's Hospital，Tianjin 300074，China)
Abstract：Objective To observe the differences in the efficacy of ketogenic diet in the treatment of children with intractable epilepsy.Methods 65 children with intractable epilepsy who had been treated with ketogenic diet for more than three months in our hospital from August 2012 to March 2017 were selected.According to the etiology follow-up adherence to the ketogenic diet， record seizures after 3 months of treatment in children with ketogenic diet.Results Of the 31 children with symptomatic epilepsy，16(51.61%)were effective，and of the 34 children with unexplained epilepsy，25(73.53%)were effective.There was no significant difference between the two groups(P>0.05).Of the 35 children with single-onset epilepsy，23 (65.71%)were effective，and in 30 mixed seizures，18(60.00%) were effective.There was no significant difference between the two groups(P>0.05).Of the 14 infants with infantile spasm，12(85.71%) were effective，Of the 51 children with non-deaf seizures，29(56.86%)were effective，and there was a statistically significant difference between the two groups(P<0.05).Conclusion The effectiveness of ketogenic diet in treating different causes of refractory epilepsy is not affected by the etiology，and the effect on infantile spasm is more significant.
, 百拇医药
Key words：Ketogenic diet；Children；Intractable epilepsy；Etiology；Infantile spasm
癫痫(epilepsy)是常见的小儿神经系统疾病，约20%～30%的癫痫患儿将发展成难治性癫痫[1]。目前难治性癫痫普遍采用国际抗癫痫联盟2010年的定义：应用正确选择且能耐受的两种抗癫痫药物(单药或联合用药)，仍未能达到持续无发作者[2]。根据病因学分类，癫痫可分为原发性癫痫、不明原因癫痫和症状性癫痫。其发作形式可为单一发作形式或多种发作形式，婴儿痉挛是儿童最常见的癫痫综合征之一。生酮饮食是一种高脂肪、低碳水化合物、足够蛋白质的饮食方案，機体主要依靠脂肪代谢产生酮体来供应能量。生酮饮食已在多个国家应用于治疗儿童难治性癫痫，疗效确切。目前不同病因及发作形式对其有效性影响的报道尚不多见，本文对我科自2012年8月～2017年3月使用生酮饮食治疗3个月以上的65例难治性癫痫患儿的疗效差异进行了临床观察及分析，现报道如下。, http://www.100md.com(许海泉)
关键词：生酮饮食；儿童；难治性癫痫；病因；婴儿痉挛
中图分类号：R742.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.027
, http://www.100md.com
文章编号：1006-1959(2018)08-0088-03
Clinical Observation of the Effect of Ketogenic Diet on the Efficacy of Children with Refractory Epilepsy Due to Different Causes and Attacks
XU Hai-quan
(Department of Neurology，Tianjin Children's Hospital，Tianjin 300074，China)
Abstract：Objective To observe the differences in the efficacy of ketogenic diet in the treatment of children with intractable epilepsy.Methods 65 children with intractable epilepsy who had been treated with ketogenic diet for more than three months in our hospital from August 2012 to March 2017 were selected.According to the etiology follow-up adherence to the ketogenic diet， record seizures after 3 months of treatment in children with ketogenic diet.Results Of the 31 children with symptomatic epilepsy，16(51.61%)were effective，and of the 34 children with unexplained epilepsy，25(73.53%)were effective.There was no significant difference between the two groups(P>0.05).Of the 35 children with single-onset epilepsy，23 (65.71%)were effective，and in 30 mixed seizures，18(60.00%) were effective.There was no significant difference between the two groups(P>0.05).Of the 14 infants with infantile spasm，12(85.71%) were effective，Of the 51 children with non-deaf seizures，29(56.86%)were effective，and there was a statistically significant difference between the two groups(P<0.05).Conclusion The effectiveness of ketogenic diet in treating different causes of refractory epilepsy is not affected by the etiology，and the effect on infantile spasm is more significant.
, 百拇医药
Key words：Ketogenic diet；Children；Intractable epilepsy；Etiology；Infantile spasm
癫痫(epilepsy)是常见的小儿神经系统疾病，约20%～30%的癫痫患儿将发展成难治性癫痫[1]。目前难治性癫痫普遍采用国际抗癫痫联盟2010年的定义：应用正确选择且能耐受的两种抗癫痫药物(单药或联合用药)，仍未能达到持续无发作者[2]。根据病因学分类，癫痫可分为原发性癫痫、不明原因癫痫和症状性癫痫。其发作形式可为单一发作形式或多种发作形式，婴儿痉挛是儿童最常见的癫痫综合征之一。生酮饮食是一种高脂肪、低碳水化合物、足够蛋白质的饮食方案，機体主要依靠脂肪代谢产生酮体来供应能量。生酮饮食已在多个国家应用于治疗儿童难治性癫痫，疗效确切。目前不同病因及发作形式对其有效性影响的报道尚不多见，本文对我科自2012年8月～2017年3月使用生酮饮食治疗3个月以上的65例难治性癫痫患儿的疗效差异进行了临床观察及分析，现报道如下。, http://www.100md.com(许海泉)