纵向重复唾液腺注射肉毒毒素 A 的累积疗效：一项回顾性研究。

Cumulative Efficacy of Longitudinal Repeat Salivary Gland OnabotulinumtoxinA Injection: A Retrospective Study.

机构信息

From the Pediatric Physical Medicine and Rehabilitation, Children's Specialized Hospital, Clifton, New Jersey (HS); Burke Neurological Institute, White Plains, New York (KF); Brain-Mind Research Institute, Weill Cornell Medicine, New York, New York (KF); Blythedale Children's Hospital, Valhalla, New York (KF); Pediatric Physical Medicine and Rehabilitation, Columbia University Medical Center and Weill Cornell Medical College New York Presbyterian Hospital, New York, New York (JL, HK); and Physiatry, Blythedale Children's Hospital, Valhalla, New York (JL, HK).

出版信息

Am J Phys Med Rehabil. 2021 Aug 1;100(8):798-802. doi: 10.1097/PHM.0000000000001675.

DOI:10.1097/PHM.0000000000001675

PMID:33394592

Abstract

AIM

We hypothesized that repeat onabotulinumtoxinA (BTX-A) injections to salivary glands would have a cumulative effect on drooling, leading to prolonged efficacy duration.

METHODS

We retrospectively reviewed medical records and conducted a telephone survey of individuals treated with BTX-A to the salivary glands to investigate ongoing efficacy or adverse effects. Outcome measures were duration of decrease in drooling and adverse events. The main independent variable was the number of injections. We identified 52 consecutive individuals (26 females) with cerebral palsy with an average age of 9 yrs, 3 mos ± 5 yrs 2 mos, who had received BTX-A for sialorrhea.

RESULTS

Linear regression analysis showed that each additional injection resulted in the duration of efficacy being 0.68 mos longer (P < 0.001, R2 = 0.47). Age, sex, Gross Motor Function Classification System level, presence of tube feeding, presence of tracheostomy, gastroesophageal reflex, seizures, and concurrent intramuscular injections seizures were not significant contributors to the association between injection number and efficacy duration (F (6, 45) = 1.01, P = 0.431).

INTERPRETATION

There may be a cumulative effect of BTX-A injections to the salivary glands, resulting in longer periods of efficacy with consecutive injection.

摘要

目的

我们假设唾液腺重复使用肉毒毒素 A（BTX-A）注射会对流涎产生累积效应，从而延长疗效持续时间。

方法

我们回顾性地审查了病历，并对接受 BTX-A 治疗唾液腺的个人进行了电话调查，以调查持续的疗效或不良反应。结果测量为流涎减少的持续时间和不良反应。主要的独立变量是注射次数。我们确定了 52 名连续的脑瘫患者（26 名女性），平均年龄为 9 岁 3 个月±5 岁 2 个月，他们因流涎症接受了 BTX-A 治疗。

结果

线性回归分析表明，每次额外注射可使疗效持续时间延长 0.68 个月（P < 0.001，R2 = 0.47）。年龄、性别、粗大运动功能分类系统水平、管饲、气管切开、胃食管反流、癫痫发作和同时进行的肌肉内注射与疗效持续时间之间的关系中，年龄、性别、粗大运动功能分类系统水平、管饲、气管切开、胃食管反流、癫痫发作和同时进行的肌肉内注射均不是显著的影响因素（F（6，45）= 1.01，P = 0.431）。