经结膜注射A型肉毒毒素治疗甲状腺相关眼病上睑退缩的临床研究  

The clinical research on the treatment of upper eyelid retraction related to thyroid-associated ophthalmopathy using subconjunctival botulinum toxin type A injections

作　　者：韩媛媛[1] 孙斌 罗燕[1] 张朝霞 闫春芳 王晶晶[3] 李宏[1] Han Yuanyuan;Sun Bin;Luo Yan;Zhang Zhaoxia;Yan Chunfang;Wang Jingjing;Li Hong(Department of Orbital Disease,Shanxi Eye Hospital,Taiyuan 030002,China;Central Laboratory,Shanxi Eye Hospital,Taiyuan 030002,China;Medical Department,Shanxi Eye Hospital,Taiyuan 030002,China)

机构地区：[1]山西省眼科医院眼眶病科,太原030002 [2]山西省眼科医院中心实验室,太原030002 [3]山西省眼科医院医务科,太原030002

出　　处：《中华眼外伤职业眼病杂志》2020年第12期938-941,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：山西省眼科医院科研基金(Q201802)。

摘　　要：目的评估经结膜注射A型肉毒毒素治疗甲状腺相关眼病上睑退缩的临床效果.方法回顾性研究.对山西省眼科医院2017年7月至2018年7月13例(17眼)甲状腺相关眼病上睑退缩行经结膜睑板上缘A型肉毒毒素(2.5~10 IU)注射,根据患者上睑下垂的程度不同,注射不同剂量的药物.随访观察3天~12周.结果在注射后2~3天94%(16/17)病例出现麻痹效果,注射后2周达高峰,12周药物失去作用,需要重复注射.9眼上睑退缩改善0~1.0 mm,5眼改善1.5~2.0 mm,2眼改善2.0~3.0 mm,1眼无明显改善.无上睑退缩加重者.暂时性的上睑下垂1眼.暂时性眼睑闭合不全2眼.结论结膜下注射A型肉毒毒素是一种有效的治疗甲状腺相关眼病上睑退缩的方法.Objective To evaluate the clinical efficacy of subconjunctival injection of botulinum toxin type A for treating upper eyelid retraction related to thyroid-associated ophthalmopathy.Methods This was a retrospective case study.A total of 17 eyes of 13 patients with upper eyelid retraction related to thyroid-associated ophthalmopathy from Jul.2017 to Jul.2018 in Shanxi Eye Hospital received botulinum toxin type A injection(2.5-10 IU).Based on the degree of ptosis,different doses of drugs were injected.The followed-up time were 3 days-12 weeks.Results The paralysis occurred in 94%(10/17)of the cases at 2-3 days after injection,and reached peak at 2 weeks after injection.The drug was ineffective at 12 weeks after injecton and repeated injection was required.The upper eyelid retraction was improved within 0-1.0 mm in 9 eyes,1.5-2.0 mm in 5 eyes,2.0-3.0 mm in 2 eyes,none-significant improvement in 1 eye.There was no aggravation of upper eyelid retraction.One patient developed a temporary ptosis with a duration of 2 weeks after injection,and the ptosis gradually recovered after 2 weeks.Two eyes had temporary lagophthalmus.Conclusion The subconjunctival injection of botulinum toxin type A is effective for upper eyelid retraction associated with thyroid-associated ophthalmopathy.

关 键 词：退缩 上睑 毒素 肉毒 A型 眼病 甲状腺相关性 

分 类 号：R581[医药卫生—内分泌] R777.1[医药卫生—内科学]