Analysis Of Factors Related To The Efficacy Of Adrenocorticotropic Hormone In The Treatment Of Infantile Spasms

Objective The clinical and EEG data before and after the treatment of children with infantile spasm（IS）were collected and analyzed to explore the related factors affecting the therapeutic efficacy of Adrenocorticotropic Hormone（ACTH）,so as to guide the clinical medication early and accurately and judge the prognosis.Method We collected 68 children with complete data on ACTH from October 1,2019to May 1,2021,which were divided into complete remission group（n=41）,effective group（n=9）,ineffective group（n=18）,and analyzed the clinical indicators and EEG indicators of the three groups.Results The present study included 68 children with IS,including 36 male and 32female children,with the mean age of onset（5.99±3.60）months old.After treatment,41 child patients achieved complete remission,9 child patients had effect,and 18children were ineffective,with a total efficiency of 73.53%.Statistical differences of disease course between complete remission,effective,ineffective,pre-treatment development,EEG typical high rhythm disorder,EEG discharge side（lateral/bilateral）（respectively:X~2=12.396,P=0.002;X~2=7.252,P=0.023;X~2=25.327,P=0.000;X~2=22.350,P=0.000）.Sex,age of onset,preferred ACTH,birth history is abnormal or not,EEG background,Is spindle present in EEG,The EEG discharge site（limited/wide）were not different between the three groups（respectively:X~2=1.836,P=0.471;X~2=3.350,P=0.185;X~2=4.832,P=0.100;X~2=1.761,P=0.485;X~2=1.301,P=0.559;X~2=2.026,P=0.413;X~2=5.032,P=0.072）.Logistic regression analysis showed a significant correlation between the disease course of the complete remission and ineffective groups,whether the EEG was typical of high rhythmic disorder,and the EEG discharge side（respectively:b=2.926,P=0.018;b=2.148,P=0.032;b=-3.069,P=0.009）.Correlation analysis is shown that the control of clinical symptoms after ACTH treatment was somewhat positively correlated to the EEG remission（r=0.571,P=0.000）.Conclusion 1)The shorter the course of the disease,the pretreatment EEG expression of children with typical high rhythm disorder and bilateral discharge showed good efficacy after ACTH treatment.2)Children with good clinical efficacy had relatively high EEG remission rates.