Bentivoglio A R, Fasano A, Ialongo T, Soleti F, Lo Fermo S, Albanese A
Istituto di Neurologia, Università Cattolica del Sacro Cuore, Roma, Italia.
Eur J Neurol. 2009 Mar;16(3):392-8. doi: 10.1111/j.1468-1331.2008.02507.x.
To review the clinical characteristics and the long-term outcome of patients with hemifacial spasm (HFS) who received botulinum neurotoxin (BoNT) over the past 10 years.
A total of 108 patients received 665 treatments. Mean latency of clinical effect was 5.4 +/- 5.3 days for Botox and 4.9 +/- 4.6 days for Dysport (P > 0.05). Mean duration of clinical improvement was higher after the injection of Dysport than Botox: 105.9 +/- 54.2 and 85.4 +/- 41.6 days respectively (P < 0.01). The percentage of treatment failures was 6.5% for Botox and 4.6% for Dysport (P > 0.05). The doses of Botox significantly increased over time (beta = 0.35, P < 0. 001) whilst Dysport dose remained unchanged (beta = 0.16, n.s.). The duration of clinical benefit slightly increased with Botox (beta = 0.12; P < 0.01), but remained constant for Dysport. Side effects occurred in 17.4% of treatments: 16.7% of patients who had received Botox, and in 19.7% who had received Dysport (P > 0.05). The most common side effects were palpebral ptosis and lacrimation; ptosis and lagophtalmos was more common in Dysport treatments (P < 0.005).
Both brands are effective and safe in treating HFS; efficacy is long-lasting. The differences in outcome and side effects confirm that, albeit the active drug is the same, Botox and Dysport should be considered as two different drugs.
回顾过去10年接受肉毒杆菌神经毒素（BoNT）治疗的面肌痉挛（HFS）患者的临床特征及长期预后。
共108例患者接受了665次治疗。保妥适的临床起效平均潜伏期为5.4±5.3天，得保松为4.9±4.6天（P>0.05）。注射得保松后的临床改善平均持续时间高于保妥适：分别为105.9±54.2天和85.4±41.6天（P<0.01）。保妥适治疗失败率为6.5%，得保松为4.6%（P>0.05）。保妥适的剂量随时间显著增加（β=0.35，P<0.001），而得保松剂量保持不变（β=0.16，无统计学意义）。保妥适治疗的临床获益持续时间略有增加（β=0.12；P<0.01），但得保松保持不变。17.4%的治疗出现副作用：接受保妥适治疗的患者中有16.7%，接受得保松治疗的患者中有19.7%（P>0.05）。最常见的副作用是眼睑下垂和流泪；上睑下垂和兔眼在得保松治疗中更常见（P<0.005）。
两种品牌在治疗HFS方面均有效且安全；疗效持久。结果和副作用的差异证实，尽管活性药物相同，但保妥适和得保松应被视为两种不同的药物。
