摘要
目的:回顾性分析接受A型肉毒毒素(botulinum toxin type A,BTX-A)注射治疗的偏侧面肌痉挛患者的临床特征。方法:对单中心245例接受BTX-A注射治疗的偏侧面肌痉挛患者进行回顾性研究,分析人口统计学特征和临床特征,以及与Cohen痉挛强度分级和BTX-A注射疗效的关联。结果:245例偏侧面肌痉挛患者中,女性为159例(64.9%),就诊时平均年龄为54.2±10.3岁;男性为86例(35.1%),就诊时平均年龄为48.3±8.6岁。137例(55.9%)为左侧面肌痉挛,其中女性患者97例[占女性患者的61.8%(97/159)],男性患者40例[占男性患者的46.5%(40/86)]。根据Cohen痉挛强度分级,轻度痉挛患者51例(20.8%),中至重度痉挛患者194例(79.2%);与轻度痉挛患者相比,中至重度痉挛患者的年龄较大(P=0.021),病程较长(P=0.012)。偏侧面肌痉挛伴同侧耳鸣患者48例(19.6%),其中46例(95.8%)为中至重度偏侧面肌痉挛。轻度偏侧面肌痉挛患者的BTX-A平均注射剂量为35.5±5.2 U,平均疗效持续时间为145.5±36.1 d;中至重度偏侧面肌痉挛患者的BTX-A平均注射剂量为40.2±5.8 U,平均疗效持续时间为137.8±34.5 d。治疗后4周时随访,总有效率为96.3%,视觉模拟评分法(visual analog scale,VAS)治疗满意度平均为75%。结论:偏侧面肌痉挛女性患病率显著高于男性,并且左侧患病比例也高于男性;中至重度偏侧面肌痉挛患者占比较高,并且与同侧耳鸣症状相关;所有患者均对BTX-A注射治疗反应良好,且不良反应轻微,能够显著提升患者的工作和生活质量。
Objective:To retrospectively analyze the clinical characteristics of patients with hemifacial spasm who received botulinum toxin type A(BTX-A)injection.Methods:A retrospective study was conducted in 245 patients with hemifacial spasm who received BTX-A injection in a single center.The demographic and clinical characteristics were analyzed,and the correlations with Cohen’s scale and the efficacy of BTX-A injection was analyzed.Results:Among 245 patients with hemifacial spasm,159 patients(64.9%)were females with an average age of 54.2±10.3 years;86 patients(35.1%)were males,with an average age of 48.3±8.6 years.Left hemifacial spasm was seen in 137 patients(55.9%),including 97 females(61.8%of female patients,97/159)and 40 males(46.5%of male patients,40/86).According to Cohen’s scale,51(20.8%)had mild spasm,194(79.2%)had moderate-severe spasm;compared with mild spasm,patients with moderate-severe spasm had older age(P=0.021)and longer course of disease(P=0.012).The average injection dose of BTX-A in mild hemifacial spasm patients was 35.5±5.2 U,and the average duration of efficacy was 145.5±36.1 d;the average injection dose of BTX-A in patients with moderate-severe hemifacial spasm was 40.2±5.8 U,and the average duration of efficacy was 137.8±34.5 d.Four weeks after treatment,the total response rate was 96.3%,and the visual analog scale(VAS)score of treatment satisfaction was 75%.Conclusion:The prevalence of hemifacial spasm in females is significantly higher than that in males,and the proportion of left side involvement is also higher than that of males;patients with moderate-severe hemifacial spasm accounts for a high proportion,and is related to clicking sounds in the ipsilateral ear.All patients had good response to BTX-A injection with less adverse reactions,so as to significantly improve the quality of work and life.
作者
蒋仙国
JIANG Xianguo(Department of Neurology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)
出处
《神经病学与神经康复学杂志》
2020年第1期28-33,共6页
Journal of Neurology and Neurorehabilitation
作者简介
通信作者:蒋仙国,E-MAIL:jxg1977@163.com
