【 文献重点摘要 】
 

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 re mission 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 dis ease duration less than 3 months were remit ted, 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 dis ease history exceeded 6 months.

CONCLUSIONS

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

Keywords: Efficacy , Botulinum toxin A, Unilateral spasms, Eyelid, Prognosis, Treatment.

背景

到目前为止，只有一小部分研究描述了BTX在面肌痉挛中的长期应用。

目的

评价A型肉毒毒素(BTXA)治疗单侧眼睑痉挛的预后和远期疗效。

患者和方法

从1998年9月到2006年1月，连续245例单侧眼睑痉挛患者纳入这项回顾性研究。其中143例(BTXA组)接受BTXA注射治疗，102例未接受任何干预(对照组)。除颞角皮下注射5U外，眼周皮下注射BTXA 2.5U。最后一次注射后随访1~7年。

结果

BTXA治疗组完全缓解率78.3%(112/143)，复发率21.7%(31/143)，面肌痉挛发生率18.9%(27/143)，病程<3个月者完全缓解率96.6%(86/89)；病史3~6个月者完全缓解率为75.8%(25/33)，病程超过6个月者完全缓解率为4.8%(1/21)。对照组完全缓解率为12.7%(13/102)，HFS患病率为71.6%(73/102)，病程<3个月者缓解率为16.7%(9/56)，病史3~6个月者完全缓解率为12.9%(4/31)。病史超过6个月时无一例缓解。

结论

BTXA治疗能提高单侧眼睑痉挛完全缓解率，防止单侧眼睑痉挛进一步发展为HFS，尤其是早期治疗效果更佳。

关键词

疗效，A型肉毒毒素，单侧痉挛，眼睑，预后，治疗。