Arthritis Rheumatol:肉毒毒素用于硬皮病相关雷诺现象的疗效

2017-08-15 xiangting MedSci原创

激光多普勒成像流量数据不支持使用Btx-A来治疗所有硬皮病患者的RP。

这项研究旨在评估在继发于硬皮病的雷诺现象(RP)患者中,局部注射A型肉毒毒素(Btx-A)改善手部血流量的疗效。

在这项随机双盲安慰剂对照临床试验中,硬皮病相关RP患者随机一只手接受Btx-A(2.5 ml无菌盐水中50单位),另一只手接受无菌生理盐水(2.5 ml)。注射后第1和第4个月进行随访,包括手部激光多普勒成像,患者报告的结果和体检。使用成对t检验和总体平均广义模型与广义估计方程比较结果。

在40例入选患者中,25例有局部性硬皮病,15例有弥漫性硬皮病。从基线到1个月的随访中,与安慰剂治疗的手相比,Btx-A治疗手的平均血流量降低更多。该模型估计该差异具有统计学意义(平均差异-30.08通量单位[95%置信区间-56.19,-3.98],P相互作用= 0.024)。这种差异主要受长期RP和弥漫性硬皮病的影响。4个月随访血流变化组间没有显著差异。对于Btx-A治疗的手,临床评估(QuickDASH,McCabe Cold Sensitivity Score,视觉模拟量表上的疼痛和Raynaud's Condition Score)略有改善。

激光多普勒成像流量数据不支持使用Btx-A来治疗所有硬皮病患者的RP。次要临床结局提示有一些积极的作用,但其临床意义仍值得怀疑。Btx-A治疗RP的作用需要进一步的具有更均匀患者群体和独特临床情况的研究来证明。

原始出处:

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    2017-08-17 zhaojie88
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    2017-08-17 rgjl
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    2017-08-15 有备才能无患

    激光多普勒成像流量数据不支持使用Btx-A来治疗所有硬皮病患者的RP。次要临床结局提示有一些积极的作用,但其临床意义仍值得怀疑。Btx-A治疗RP的作用需要进一步的具有更均匀患者群体和独特临床情况的研究来证明。

    0

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