赵　敏，孙　重



两种不同浓度的A型肉毒素注射治疗眼睑痉挛的观察对比

赵敏，孙重

Wuhan Aier Eye Hospital, Wuhan 430000, Hubei Province, China

Correspondence to:Zhong Sun. Wuhan Aier Eye Hospital, Wuhan 430000, Hubei Province, China. Sunzhongzhong@sina.com

Received：2016-04-26Accepted：2016-07-04

•AIM: To assess the efficacy and adverse reactions of two concentrations of diluted botulism toxin A (BTX-A) for blepharospasm.

•METHODS: Totally 220 patients (440 eyes) confirmedas blepharospasm in our department (from January 2013 to January 2015), were divided randomly into two groups: 110 in high concentration group and 110 in low concentration group. The two groups were given local injections with 25 U/mL or 40 U/mL concentration of botulism toxin type A to the upper and lower eyelids orbicular muscle, corrugator, reducing eyebrow muscle and procerus respectively. We observed dosage of two groups, the treatment effect, the duration of the effect and the incidence of adverse reactions.

•RESULTS: The high concentration group was given the BTX-A with 48.33±4.02U,the low concentration group was given the BTX-A with 28.51±3.42U,the differences were statistically significant(P<0.05). The differences of post-operative evaluation of curative effect, onset time and duration of the effect between the groups were not statistically significant (P>0.05). Sixteen cases had ptosis in different levels in the high concentration group, and 2 in the low concentration group, the differences were statistically significant (P<0.01). There were no serious complications such as intoxication, drug allergy in both groups. Ptosis relieved after using naphcon-A and disappeared in 2-3 wk.

•CONCLUSION: The efficacy of local injection with two concentrations of diluted botulinum toxin A for blepharospasm was positive. Considering the high incidence of ptosis in high concentration group, we recommended the 25U/mL botulism toxin A for blepharospasm.

Citation:Zhao M, Sun Z.Clinical efficacy of two concentrations of diluted botulism toxin A for blepharospasm.GuojiYankeZazhi(IntEyeSci) 2016;16(8):1587-1589

摘要

目的：观察两种不同浓度的A型肉毒素(BTX-A)治疗眼睑痉挛的疗效及不良反应。

方法：将220例440眼患者(2013-01/2015-01来我科确诊为眼睑痉挛患者)随机分为高浓度组110例和低浓度组110例，分别采用40U/mL和25U/mL浓度局部注射到上下眼睑轮匝肌、皱眉肌、降眉肌、降眉间肌。观察两组BTX-A的用量、治疗效果、维持时间及不良反应。

结果：高浓度组BTX-A的用量为48.33±4.02U,低浓度组BTX-A的用量为28.51±3.42U，差异有统计学意义(P<0.05)，而高浓度组与低浓度组术后疗效评估、起效时间和疗效持续时间无统计学意义(P>0.05),高浓度组出现不同程度上睑下垂16例，低浓度组出现2例，差异有统计学意义(P<0.01)。两组均未出现中毒和药物过敏症状，上睑下垂发生后通常在3～6wk内逐渐恢复，严重可以给予盐酸奈甲唑林点眼缓解。

结论：两种不同浓度的BTX-A局部注射治疗眼睑痉挛的疗效是肯定的，鉴于对上睑下垂并发症的评估，推荐使用低浓度注射。

关键词：A型肉毒素；眼睑痉挛；浓度；上睑下垂

引用：赵敏，孙重.两种不同浓度的A型肉毒素注射治疗眼睑痉挛的观察对比.国际眼科杂志2016;16(8):1587-1589

0引言

眼睑痉挛属于局限性肌张力障碍性疾病，目前病因不明确。A型肉毒素(BTX-A)注射在眼睑痉挛治疗中已经使用多年，疗效显著，但上睑下垂仍是这一治疗的重要并发症[1]，上睑下垂的出现可能与药物的浓度在眶隔周围的毒素弥散有关，为寻求较佳的BTX-A药物浓度应用于临床治疗眼睑痉挛，将2013-01/2015-01来我科确诊为眼睑痉挛患者220例采用不同的浓度注射，并将其效果进行对比观察，报告结果如下。

1对象和方法

1.1对象选取2013-01/2015-01来武汉爱尔眼科医院眼睑眼眶病科门诊就诊的220例440眼眼睑痉挛患者，注射前先行头部CT检查，排除颅内疾病及全身疾病，常规眼部检查，眼压、眼前节及眼底检查，排除因倒睫、炎症及其他疾病引起的继发性眼睑痉挛。……