摘要：目的 探讨拉莫三嗪(LTG)添加治疗婴儿痉挛症的疗效.方法 对2002年6月至2008年12月在我院诊治的76例婴儿痉挛症患儿的临床资料进行回顾性分析,采用自身前后对照的方法,所有患儿均给予促肾上腺皮质激素(ACTH)+丙戊酸钠(VPA)治疗3个月后进行疗效判断;根据发病情况在3个月后的不同时期对ACTH+VPA疗效不佳的33例患儿给予LTG添加治疗,观察LTG添加前、后疗效改变.结果 ACTH+VPA治疗3个月后显效率和总有效率分别为55.2%(42/76)、78.9%(60/76),LTG添加12个月后显效率和总有效率分别为77.6%(59/76)、89.5%(68/76);添加LTG前后疗效比较差异有统计学意义(P＜0.05).结论 拉莫三嗪添加治疗症状性或顽固性婴儿痉挛症疗效佳. Abstract： Objective To investigate the effect of adding lamotrigine to children with infantile spasms. Methods Seventy-six children diagnosed as infantile spasms in paediatric department of our hospital were enrolled into this retrospective and own control study from June 2004 to December 2008,all infantile spasms was given adrenocorticotrophin(ACTH) and valproate sodium(VPA),and estimated the response of this treatment after 3 months, lamotrigine was added to 33 infantile spasms which control unsatisfactory by ACTH and VPA in different periods of after 3 months on the base of former antiepileptic drugs to observe the different effect of after and before add-on therapy. Results The total effective rate and excellence rate were 55.2%(42/76) and 78.9%(60/76) after 3 months in ACTH and VPA treatment,but 77.6%(59/76) and 89.5%(68/76) after 12 months in add-on LTG treatment. The difference of seizure frequency of before and after in adding lamotrigine is statistical significant(P＜0.05). Conclusions LTG as add-on therapy can effectively reduce seizure frequency of the symptomatic or intractable infantile spasms controlled difficulty by other anti-epileptic drugs.

关键词：拉莫三嗪 添加治疗 婴儿痉挛症 treatment 疗效判断 

单位：郑州大学第一附属医院儿科 450052 河南省人民医院儿科