A型肉毒毒素治疗脑性瘫痪的剂量-反应关系的研究

目的 观察不同剂量A型肉毒毒素(BTX-A)治疗痉挛型脑性瘫痪(CP)的剂量-反应关系。方法用BTX-A对58例下肢痉挛型CP患儿局部肌肉注射,高剂量组32例,低剂量组26例。以MAS改良肌张力量表评定肌张力。分析治疗前后肌张力改善状况及副作用,进行统计学x2检验。结果 高剂量组中,肌张力改变显著、有效、无效病例分别为20、7、5例;低剂量组分别为7、13、6例。两组治疗前后肌张力改善情况,有显著性差异P<0.05。两组均副作用少、轻微,呈暂时性,无全身性副作用发生,两组比较无显著性差异P>0.05。结论 不同剂量BTX-A治疗CP的效果不同,一定范围内,高剂量组较低剂量组更有效。

A dose-reaction research on local intramuscular injection of botulinum toxin A in the treatment of cerebral palsy

Objective To study the dose-reaction of local botulinum toxin A(BTX-A) in the treatment of cerebral palsy. Methods Fifty eight patients (39 males, 19 females) with lower limb spasticity received local intramuscular injection. The patients ranged in age from 3.4 to 9 years. Thirty two cases received the higher dose and 26 cases received the lower dose. The muscle tone was assessed with the Modified Ashworth Scale. We observed the muscle tone during the treatment and the side-effects. The data were analyzed with x2 test. Results In higher dose, twenty cases had remarkable improvement in muscle tone after therapy, and 7 cases took effect and 5 cases did not take effect; in lower dose,seven cases had remarkable improvement, and 13 cases took effect and 6 cases did not take effect. The muscle tone had significant difference between two groups. The side effects were usually transient and mild, and no systemic adverse was observed. The side-effects had no significant difference between groups. Conclusions Local intramuscular injection of BTX-A is a relatively effective and safe treatment for lower extremity spastic cerebral palsy. A relatively higher dose may significantly improve motion ability than lower dose.