单侧眼睑痉挛预后及其BTXA干预远期疗效.docVIP

单侧眼睑痉挛预后及其BTXA干预远期疗效 　作者：管进，林顺涨，范静平，孙爱华 【摘要】 目的 观察单侧眼睑痉挛（unilateral blepharospasm，UBS）的预后及其A型肉毒毒素（botulinum toxin A，BTXA）干预的远期疗效。方法 对1998年9月至2006年1月143例UBS接受BTXA局部注射治疗的病例和102例非治疗组UBS病例进行长期跟踪随访。治疗组所用BTXA的浓度为25 u/ml，除眼轮匝肌颞侧部位注射5 u外，其余部位均为2.5 u，末次注射后随访时间为3～7年。结果 UBS治疗组3年的治愈率为78.3%（112/143），复发率为21.7%（31/143）；发展为半面痉挛（hemifacial spasm，HFS）者18.9%（27/143）；病程3个月以内的恢复率为96.6%（86/89），3～6个月为75.8%（25/33），6个月以上为4.8%（1/21）。UBS非治疗组3年的恢复率12.7%（13/102），未愈87.3%（89/102）；发展为HFS者79.4%（81/102）。HFS的发生率治疗组较非治疗组低（Plt;0.01）。结论 部分UBS可发展为HFS，BTXA干预可治愈UBS，并可阻止其进一步发展为HFS。 【关键词】 单侧眼睑痉挛；A型肉毒毒素；干预治疗 ［Abstract］ Objective To observe the prognosis and the long-term therapeutic efficacy of botulinus toxin A （BTXA） in the interventional treatment for unilateral blepharospasm（UBS）.Methods This was a retrospective study involving 143 UBS patients who received local BTXA injection treatment between September 1998 and January 2006 （treatment group）.A total of 102 UBS patients who did not receive treatment （non-treatment group）. The concentration of BTXA used was 25 u/ml，and the dose injected at each site was 2.5 u,but the site of orbicularis muscle at the temple side was 5 u. Follow-up was performed for 1～7 years after the final injection.Results For the UBS treatment group，the three-year recovery rate was 78.3% （112/143），and recurrence rate was 21.7% （31/143），and the incidence of HFS was 18.9%（27/143）；recovery rate for those patients having the disease for less than 3 months was 96.6% （86/89）；for patients with a disease history between 3 and 6 months，recovery rate was 75.8% （25/33），and those patients having the disease for more than 6 months had a recovery rate of 4.8% （1/21）.For the non-treatment group，the spontaneous resolution rate was 12.7% （13/102）；the recovery rate was higher in the treatment group （Plt;0.01），and the incidence of HFS was 79.4%（81/104）.The incidence of HFS was lower in the treatment group than in the non-treatmen group（Plt;0.01）.Conclusion Some of the UBS can develop future progressio