选择性5羟色胺再吸收抑制剂协同局部肉毒素注射治疗原发性眼睑痉挛的疗效分析  

Selective serotonin 5 reuptake inhibitor add-on therapeatic effect on primary blepharospasm after botulinum toxin

作　　者：赤克美[1] 景筠[1] 张晓君[1] 

机构地区：[1]首都医科大学附属北京同仁医院神经内科,北京100730

出　　处：《中国眼耳鼻喉科杂志》2013年第4期233-235,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：北京市高层次卫生技术人才培养计划(2009-2-09);首都医学发展科研基金(2009-2064)

摘　　要：目的通过临床对照研究,评价选择性5羟色胺再吸收抑制剂(SSRI)对局部肉毒素注射治疗原发性眼睑痉挛的协同作用。方法对门诊收治的原发性眼睑痉挛患者39例,收集病史资料并进行Burke-FahnMarsden肌张力障碍评分(BFM)、汉米尔顿焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。将SAS评分和(或)SDS评分>50分的患者纳入SSRI协同治疗组(22例),接受肉毒素治疗并给予氟西汀抗焦虑、抑郁治疗。同期仅接受局部肉毒素注射治疗的患者为单纯注射组(17例)。随访6个月,将不同时间点2组患者的临床特征及疗效进行对照研究。结果协同治疗组与单纯注射组患者的平均年龄分别为(51.32±14.1)岁和(54.24±10.9)岁(P=0.485),女性分别占72.7%和64.7%(P=0.852);2组基线BFM评分,肉毒素注射后2周、1个月、3个月及6个月BFM评分协同治疗组与单纯注射组分别为(7.55±2.1)分和(7.88±2.3)分(P=0.657);(5.07±1.3)分和(5.24±1.3)分(P=0.701);(2.91±1.1)分和(2.79±0.8)分(P=0.714);(3.01±1.0)分和(4.03±0.9)分(P=0.03);(3.68±0.9)分和(7.59±2.0)分(P=0.01)。结论氟西汀加用治疗可以相对延长局部肉毒素注射治疗原发性眼睑痉挛的维持时间,改善患者的焦虑、抑郁状态,且无明显不良反应。Objective To evaluate the effects of Fluoxetine, a selective serotonin 5 reuptake inhibitor （SSRI）, as an add-on therapy on primary blepharospam after focal injection of botulinum toxin. Methods Thirty-nine patients with primary blepharospasm were collected and followed up. The Burke-Fahn-Marsden （BFM） scale was used to evaluate the dystonia of blepharospasm. Self-rating anxiety scale （SAS） and depression scale （SDS） were also used to evaluate the psychosocial characteristics of patients. Patients were treated with fluoxetine after botox injection if the SAS and/or SDS ≥50 （add-on group）, while the other were given botox injection alone （injection group）.Clinical characteristics and baseline BFM scales were compared between the two groups. The BFM scales were re-evaluated after 2 weeks, 1 month, 3 months and 6 months respectively, together with the SAS and SDS in add-on group. Results The mean age in add-on group and injection group was （51.32±14.1） years and （54.24±10.9） years respectively （P=0.485）, and female ratios of the two groups were 72.7% and 64.7% respectively （P=0.852）. The baseline, 2 weeks, 1 month, 3months and 6 months BFM scales in the two group were （7.55±2.1）,（7.88±2.3） （P=0.657）; 5.07±1.3,5.24±1.3 （P=0.701）;2.91±1.1,2.79±0.8 （P=0.714.）;3.01±1.0,4.03±0.9 （P=0.03）;3.68±0.9,7.59±2.0 （P=0.01） respectively. Conclusions Fluoxetine could prolong the action of botox injection without obvious side effects.

关 键 词：原发性眼睑痉挛 选择性5羟色胺再吸收抑制剂 肉毒素注射 焦虑抑郁症 

分 类 号：R746[医药卫生—神经病学与精神病学] R771.3[医药卫生—临床医学]