A型肉毒毒素治疗单侧眼睑痉挛的疗效及其预后。

Efficacy of botulinum toxin A for treatment of unilateral spasms of the eyelid and its prognosis.

机构信息

Department of Otolaryngology, Changzheng Hospital, Second Military Medical University, Shanghai, China.

出版信息

Eur Rev Med Pharmacol Sci. 2013 Nov;17(21):2974-9.

PMID:24254570

Abstract

BACKGROUND

To this date, only a small number of studies have described the long-term use of BTX in Hemifacial spasm.

AIM

To assess the prognosis and long-term effectiveness of Botulinum toxin A (BTXA) in the treatment of unilateral spasms of the eyelid.

PATIENTS AND METHODS

From September 1998 to January 2006, 245 consecutive cases of unilateral spasms of the eyelid were included in this retrospective study. Among them, 143 patients (BTXA group) underwent BTXA injection treatment, and 102 patients did not receive any intervention (control group). BTXA injections were made subcutaneously around the eye with the dose of 2.5U other than the temporal canthus of 5U. Follow-up was performed for 1-7 years after the last injection.

RESULTS

In BTXA treatment group, the complete remission rate was 78.3% (112/143), recurrence rate was 21.7% (31/143) and the incidence of hemifacial spasm (HFS) was 18.9% (27/143); complete remission rate for patients with disease duration less than 3 months was 96.6% (86/89); for patients with a 3-6 months disease history, complete remission rate was 75.8% (25/33), and patients having the disease course exceeding 6 months had a complete remission rate of 4.8% (1/21). In the control group, the complete remission rate was 12.7% (13/102), and the prevalence of HFS was 71.6% (73/102); 16.7% (9/56) of patients with the disease duration less than 3 months were remitted, but the complete remission rate was 12.9% (4/31) for patients with a 3-6 months disease history. None was in remission when the disease history exceeded 6 months.

CONCLUSIONS

BTXA treatment can improve the complete remission rate and prevent further progression of unilateral spasms of the eyelid into HFS, especially in early stage.

摘要

背景

迄今为止，仅有少数研究描述了肉毒毒素 A（BTX）在面肌痉挛中的长期应用。

目的

评估肉毒毒素 A（BTXA）治疗单侧眼睑痉挛的预后和长期疗效。

患者和方法

1998 年 9 月至 2006 年 1 月，连续 245 例单侧眼睑痉挛患者纳入本回顾性研究。其中 143 例患者（BTXA 组）接受 BTXA 注射治疗，102 例患者未接受任何干预（对照组）。BTXA 注射在眼周皮下进行，除颞部外的 5U 剂量为 2.5U。末次注射后随访 1-7 年。

结果

在 BTXA 治疗组中，完全缓解率为 78.3%（112/143），复发率为 21.7%（31/143），半面痉挛（HFS）发生率为 18.9%（27/143）；病程小于 3 个月的患者完全缓解率为 96.6%（86/89）；病程 3-6 个月的患者完全缓解率为 75.8%（25/33），病程超过 6 个月的患者完全缓解率为 4.8%（1/21）。在对照组中，完全缓解率为 12.7%（13/102），HFS 发生率为 71.6%（73/102）；病程小于 3 个月的患者中有 16.7%（9/56）缓解，但病程 3-6 个月的患者完全缓解率为 12.9%（4/31）。病程超过 6 个月的患者无一例缓解。