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74例儿童难治性癫痫应用生酮饮食疗法效果分析_莫庭庭.pdf
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74 儿童 难治 癫痫 应用 饮食疗法 效果 分析 莫庭庭
7 中华医学会儿科学会急救学组.小儿危重病例评分法(草案)J.中华儿科杂志,1995,33(6):370-373.8 张慧芳,张雪,沙玉霞,等.血清及支气管肺泡灌洗液中 sTREM-1水平、APACHE评分及 SOFA 评分对重症肺炎患儿病情及预后评价J.中国当代儿科杂志,2020,22(6):626-631.9 吴仕燕,张华,吴文,等.血清 miR-21-3p 对脓毒症患儿并发急性肾损伤的预测价值J.中国当代儿科杂志,2020,22(3):269-273.10 FITZGERALD J C,ROSS M E,THOMAS N J,et al.Risk factors and inpatient outcomes associated with acute kidney injury at pediatric severe sepsis presentation J.Pediatr Nephrol,2018,33(10):1781-1790.11 李娟珍,王莹.PICU 中儿童脓毒症临床特点和预后相关因素分析J.临床儿科杂志,2017,35(10):762-768.12 段袁园,金丹群,许愿愿,等.PICU 脓毒症患儿并发急性肾损伤的危险因素及预后分析J.中华危重病急救医学,2019,31(8):1004-1007.13 向瑞,李振江.肝型脂肪酸结合蛋白在急性肾损伤中的研究进展J.医学综述,2019,25(14):2821-2825.14 康晓征,赵勇,乐磊,等.肝型脂肪酸结合蛋白对比白介素18 对肝硬化失代偿期急性肾损伤患者的诊断价J.安徽医科大学学报,2018,53(8):1289-1293.15 WANG L,XUE J,CHEN C,et al.Urinary liver-type fatty acidbinding protein predicts recovery from acute kidney injury J.Clin Nephrol,2015,84(5):255-261.16 YAMAMOTO T,NOIRI E,ONO Y,et al.Renal L-type fatty acid binding protein in acute ischemic injury J.J Am Soc Nephrol,2017,18(11):2894-902.17 唐荣,敖翔,钟永,等.尿 L-FABP 与尿 NGAL 联合应用在儿童心脏术后急性肾损伤早期诊断中的价值J.中国当代儿科杂志,2017,19(7):770-775.18 石耿利.尿肝型脂肪酸结合蛋白、尿中性粒细胞明胶酶相关脂质运载蛋白及尿肾损伤分子-1 检测对儿童急性肾损伤的诊断价值J.中国临床医生杂志,2017,45(9):48-50.19 XUE W,XIE Y Y,WANG Q,et al.Diagnostic performance of urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin for acute kidney injury in an obstructive nephropathy patient J.Nephrol(Carlton),2014,19(4):186-194.20 CHIRAG R,PARIK H,THIESSEN-PHILBROOK H,et al.Performance of kidney injury molecule-1 and liver fatty acid-binding protein and combined biomarkers of AKI after cardiac surgery J.Clin J Am Soc Nephrol,2016,8(6):1079-1088.21 HEMAT E E,RANIA N A,MONA W,et al.NLRP3 expression and urinary HSP72 in relation to biomarkers of inflammation and oxidative stress in diabetic nephropathy patien J.IUBMB Life,2017,69(8):623-630.22 MAO H,LI Z,ZHOU Y,et al.Hsp72 attenuates renal tubular cell apoptosis and interstitial fibrosis in obstructive nephropathy J.Am J Physiol Renal Physiol,2018,295(1):202-214.23 ORTEGA-TREJO J A,PREZ-VILLALVA R,BARRERA-CHIMAL J,et al.Heat shock protein 72(Hsp72)specific induction and temporal stability in urine samples as a reliable biomarker of acute kidney injury(AKI)J.Biomarkers,2015,21(6):1-7.24 MORALES-BUENROSTRO L E,SALAS-NOLASCO O I,BARRERA-CHIMAL J,et al.Hsp-72 is a novel biomarker to predict acute kidney injury in critically ill patients J.PLoS One,2014,9(10):e109407.(编辑:曾敏莉)(收稿日期:2021-10-21 修回日期:2021-12-15)doi:10.13407/ki.jpp.1672-108X.2023.07.011论著7 74 4 例例儿儿童童难难治治性性癫癫痫痫应应用用生生酮酮饮饮食食疗疗法法效效果果分分析析莫庭庭,贾珊珊,李霞,王治静,窦香君(西安市儿童医院,西安 710003)作者简介:莫庭庭(1991.09-),女,硕士,主治医师,主要从事儿童神经系统疾病研究,E-mail:760102191 。通信作者:窦香君(1987.06-),女(蒙古族),硕士,主治医师,主要从事儿童神经系统疾病研究,E-mail:douxiangjun 。摘要目的:探讨生酮饮食(KD)治疗儿童药物难治性癫痫的疗效及安全性。方法:收集 2013 年 6 月至 2020 年 2 月在西安市儿童医院神经内科接受 KD 治疗的 74 例癫痫患儿,评估 KD 治疗的临床疗效、保留率、终止原因及不良反应发生情况。结果:在纳入的 74 例患儿中,KD 治疗启动时平均年龄为 27.1 个月。KD 治疗在 3 个月末、6 个月末、12 个月末随访时,保留率分别为87.8%、63.5%、33.8%,有效率分别为 37.8%、29.7%、21.6%。KD 治疗对不同病因难治性癫痫患儿的疗效比较差异无统计学意义。KD 治疗不同癫痫病程组患儿中,病程2 年组(P0.05),病程0.05),KD 治疗不同癫痫病程组比较差异无统计学意义(P0.05)。KD 治疗不同疗程组难治性癫痫患儿中,疗程6 个月组有效率优于疗程3 个月组及 36 个月组(P0.05)。KD 疗程6 个月组无发作率优于疗程3 个月组及 36 个月组(P0.05),KD 疗程0.05)。大部分患儿不良反应轻微,多为胃肠功能紊乱如拒食、腹泻、呕吐、便秘等,仅 3 例因严重拒食、2 例因泌尿系结石而终止 KD 治疗。结论:KD 治疗儿童难治性癫痫是一项安全、有效的治疗措施。癫痫病程6 个月,可能有助于提高 KD 治疗儿童难治性癫痫的有效率。关键词生酮饮食;儿童;难治性癫痫;癫痫发作中图分类号R742.1 文献标识码A 文章编号1672-108X(2023)07-0040-0504儿科药学杂志 2023 年第 29 卷第 7 期 Journal of Pediatric Pharmacy 2023,Vol.29,No.7Efficacy of Ketogenic Diet in the Treatment of 74 Children with Refractory EpilepsyMo Tingting,Jia Shanshan,Li Xia,Wang Zhijing,Dou Xiangjun(Xian Childrens Hospital,Xian 710003,China)AbstractObjective:To probe into the efficacy and safety of ketogenic diet(KD)in the treatment of refractory epilepsy in children.Methods:A total of 74 children with epilepsy received KD treatment in the neurology department of Xian Childrens Hospital from Jun.2013 to Feb.2020 were collected.The clinical efficacy,retention rate,reason of termination and occurrence of adverse drug reactions of KD were evaluated.Results:Of the 74 children,the mean age at initiation of KD treatment was 27.1 months.At the end of 3 months,6 months and 12 months,the retention rate was respectively 87.8%,63.5%and 33.8%,and the effective rate was 37.8%,29.7%and 21.6%.There was no significant difference in the efficacy of KD in children with refractory epilepsy.Among the children with different epilepsy duration groups treated with KD,the efficiency of the group with duration 2 years(P0.05),and the difference between the efficiency of the group with duration 0.05),and the difference between the groups with different epilepsy duration treated with KD was not statistically significant(P0.05).In children with refractory epilepsy treated with KD in different treatment groups,the efficiency of the group with duration 6 months was better than that of the group with duration 3 months and the group with duration from 3 to 6 months(P0.05).The seizure-free rate was better in the KD duration 6 months group tha

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