A型肉毒毒素对偏侧面肌痉挛和良性特发性眼睑痉挛患者焦虑/抑郁状态的影响  

The impact of botulinum toxin on the anxiety and depression in patients with hemifacial spasm and blepharospasm

作　　者：彭彬[1] 张申起[1] 董红娟[1] 罗瑛[1] 卢祖能[1] 

机构地区：[1]武汉大学人民医院神经内科,武汉430060

出　　处：《中国神经精神疾病杂志》2017年第10期603-607,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：中央高校基本科研业务费专项资金(编号:2042017kf0117);湖北省卫计委重点项目(编号:WJ2015MA007)

摘　　要：目的探讨偏侧面肌痉挛和良性特发性眼睑痉挛患者伴发焦虑/抑郁状态的情况,以及A型肉毒毒素局部注射治疗对患者焦虑/抑郁的影响。方法共纳入偏侧面肌痉挛(hemifacial spasm,HFS)患者90例和良性特发性眼睑痉挛(benign essential blepharospasm,BEB)患者90例,所有患者均进行BTX-A局部肌肉注射治疗,在注射前、注射后2个月采用焦虑自评量表(SAS)及抑郁自评量表(SDS)进行测评。比较HFS和BEB患者注射前后SAS和SDS分值的变化。结果(1)HFS患者治疗前SAS及SDS标准分的平均值分别为41.25±6.35、42.25±7.57,其中女性患者SAS评分比男性患者高(43.56±6.10、40.17±8.36,P=0.031),SDS评分比男性患者高(45.48±7.31、40.25±6.46,P=0.008),治疗后患者SAS及SDS评分分别为30.12±4.35(P=0.000)、30.58±4.89(P=0.000),与治疗前比具有统计学差异;(2)BEB患者治疗前SAS及SDS评分分别为58.90±10.61,58.78±9.89;其中女性患者SAS评分比男性患者高(60.89±9.11、56.45±8.75,P=0.017),SDS评分比男性高(60.12±8.35、57.90±7.93,P=0.011);治疗后SAS及SDS评分分别为38.17±3.67(P=0.000)、38.12±4.15(P=0.001),与治疗前比具有统计学差异。结论很多HFS和BEB患者伴发焦虑/抑郁状态,且女性较男性更明显,BTX-A治疗后可改善患者的焦虑/抑郁症状。Objective To explore anxiety and depression status in patients with hemifacial spasm （HFS） and benign essential blepharospasm （BEB）, and the change after botulinum toxin type A（BTX-A） therapy. Methods Ninety idiopathic HFS patients and 90 BEB patients. The anxiety and depression statud was evaluated by using SAS and SDS before and after the injection of BTX-A. Results Before treatment, the SAS and SDS standard scores of the HFS patients were 41.25±6.35and 42.25±7.57, respectively. The SAS scores were 40.17 ± 8.36 in the male and 43.56 ± 6.10in female（P=0.031 ）. The SDS scores were 40.25 ± 6.46 in the male and 45.48 ± 7.31 in the female（P=0.008）. After treatment, the SAS and SDS standard scores were 30.12 ± 4.35 （P=0.000）and 30.58 ± 4.89（P=0.000）respectively. There was significant difference inbetween before and after treatment. In BEB patients, before treatment, The SAS standard scores were 58.90±10.61, 58.78±9.89. The SAS of the male and female patients scored 56.45 ± 8.75, 60.89 ± 9.11 （P= 0.017）, The SDS of the male and female patients scored 57.90 ± 7.93, 60.12 ± 8.35 （P=0.011）respectively. After treatment, the SAS standard score were 38.17 ± 3.67 （P=0.000）, and the SDS standard score were 38.12 ± 4.15 （P=0.001 ）respectively. these two scores were significantly different between before and after treatment. Conclusion HFS and BEB patients, especially female patients are associated with anxiety and depression. BTX-A can improve the symptoms of anxiety and depression.

关 键 词：偏侧面肌痉挛 眼睑痉挛 焦虑 抑郁 A型肉毒毒素 

分 类 号：R745.12[医药卫生—神经病学与精神病学]