摘要目的 通过样本熵定量评估生酮饮食治疗婴儿痉挛症(IS)的临床疗效及脑电图的改变,了解临床疗效与脑电图之间的定量关系.方法 选择2010年4月至2013年12月在深圳市儿童医院神经内科门诊及病房诊断为难治性IS并启动生酮饮食的患儿,比较所有入组的经过生酮饮食治疗的IS患儿治疗前后脑电图样本熵的变化及治疗后临床无发作组和发作组的样本熵差异,探讨生酮饮食对其脑电图的影响及有关因素.结果 共入选35例患儿,治疗2个月以上,治疗后无发作10例,仍发作25例.35例患儿生酮饮食治疗前样本为0.377±0.246,治疗后为0.725±0.405,治疗前后比较差异有统计学意义(Z=-4.351,P=0.000).无发作组治疗前样本熵为0.342±0.277,治疗后为0.929±0.379,治疗前后比较差异有统计学意义(Z=-2.497,P=0.013);发作组治疗前样本熵为0.391±0.237,治疗后为0.643±0.393,治疗前后比较差异有统计学意义(Z=-3.371,P=0.001).发作组和无发作组经治疗智力和运动发育均有进步,改善率分别为56％(14/25例)和70％(7/10例),但差异无统计学意义(P =0.704).结论 无论发作控制与否,生酮饮食治疗可使脑电活动的复杂性增高,无发作组更明显;生酮饮食治疗后患者智力、运动发育均有进步.

abstractsObjective To evaluate clinical efficacy and electroencephalogram(EEG)changes quantitatively after the ketogenic diet (KD) by single sample entropy (SampEn) in the treatment of infantile spasms (IS),and to learn the quantitative relationship between the clinical efficacy and EEG.Methods Patients diagnosed as IS were enrolled and started KD in Shenzhen Children's Hospital from April 2010 to December 2013.The SampEn of EEG data in these patients before and after treatment with KD were analyzed.Patients were classified as seizure-free group and non-seizure-free group according to the therapeutic responsiveness to KD.The SampEn findings from two groups were compared to explore the effect of KD on EEG and its related factors.Results Among 35 patients,more than 2 months of treatment,10 cases were seizure free,25 cases still had seizures.SampEn was 0.377 ± 0.246 before treatment,and 0.725 ± 0.405 after treatment in all patients,there was significant difference (Z =-4.351,P =0.000).SampEn was 0.342 ± 0.277 before treatment,and 0.929 ± 0.379 after treatment in seizure free group,there was significant difference between 2 groups(Z =-3.371,P =0.001).While SampEn was 0.391 ± 0.237 before treatment,and 0.643 ± 0.393 after treatment in non-seizure free group,there was a significant difference between 2 groups(Z =-3.371,P =0.001).The mental and motor development was improved after KD with improvement rate were 56％ (14/25 cases) and 70％ (7/10 cases),respectively,but there was no statistical difference(P =0.704).Conclusions No matter seizures are controlled or not,KD can increase the complexity of electrical activity in the brain,which was more obvious in the seizure-free group.Intellectual and movement development can be improved in patients with KD.