局部注射肉毒毒素A治疗干眼症疗效分析

Therapeutic effect of local injection of botulinum toxin A on dry eye disease

关键词:  局部注射  肉毒毒素A  干眼症  泪膜

Key words:  local injection  botulinum toxin A  dry eye disease  tear film

摘要:

目的　评价局部注射肉毒毒素A治疗干眼症的疗效。方法　收集2018年1—12月在淮安市第二人民医院就诊的双眼干眼症患者71例，依据随机数字表法分别在患者的两只眼下泪小点周围眼轮匝肌注射肉毒毒素A（观察组）或生理盐水（对照组），随访6个月，分别在注射前、注射后2周、4周、3个月和6个月比较两组患者泪膜破裂时间(break-up time，BUT)、基础泪液分泌试验(schirmer I test，SIt)、角膜荧光素(fluorescein，Fl)染色和中央泪河高度（tear meniscus height，TMH）。结果　治疗前两组患者BUT、SIt、Fl、TMH比较差异无统计学意义（P＞0.05）。注射后2周、4周，3个月，观察组TMH、BUT、SIt大于对照组，Fl小于对照组，差异均有统计学意义（P<0.05）。注射后6个月，观察组Fl小于对照组，差异有统计学意义（P<0.05）；TMH、BUT、SIt两组间比较差异无统计学意义（P＞0.05）。结论　局部注射肉毒毒素A治疗干眼症疗效肯定，但并非永久有效。

Abstract:

Objective　To evaluate the efficacy of local injection of botulinum toxin A in the treatment of dry eye disease. 　Methods　Totally 71 patients with dry eye disease (DED) were enrolled from January 2018 to December 2018. In this prospective study, patients were randomly assigned to Botulinum toxin A group (observation group) and saline group (control group). Before and at 2 weeks, 4 weeks, 3 months, and 6 months after injection, the tear meniscus height (TMH), break-up time (BUT), fluorescein (Fl) stain and schirmer I test (SIt) were assessed. 　Results　There were no significant differences between the two groups in the index of TMH, BUT, Fl and SIt before injection (t=0.808, P=0.422;t=0.894, P=0.374;Z=-1.265, P=0.206;t=-1, P=0.321, respectively). THM, BUT and SIt were higher, and Fl was better at 2 weeks, 4 weeks and 3 months in observation group. No significant differences were observed in THM, BUT and SIt at 6 months. But Fl was still lower in observation group at 6 months. 　Conclusions　Local injection of botulinum toxin A is effective in the treatment of DED, but the effect is not permanent.