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在A型肉毒素注射后,过度活跃的肌肉结构和弹性的非侵入性分析:系统性审查和元分析
Marine Devis1, Frédéric Lecouvet2,3, Thierry Lejeune4,5
1Department of Health Sciences, Institute of Experimental and Clinical Research, Neuromusculoskeletal Lab (NMSK), Catholic University of Louvain, Brussels, Belgium - marine.devis@uclouvain.be.
概括
毒素A型 (BoNT-A) 注射在短期内暂时改善肌肉弹性. 然而,长期使用可能会减少肌肉体积,在神经疾病中需要谨慎重新注射时间.
科学领域:
- 神经学 神经学
- 生物医学工程 生物医学工程
- 康复医学 康复医学 康复医学
背景情况:
- 毒素A型 (BoNT-A) 是对性肌肉过度活动 (MO) 的首要治疗方法.
- 人们担心BoNT-A注射后肌肉结构和弹性的潜在不可逆转变.
- 这些变化可能会影响BoNT-A干预的长期有效性.
研究的目的:
- 系统地审查和综合有关肌肉弹性和肌肉结构变化的文献,在神经群体中注射BoNT-A后.
- 用诊断成像来定量评估BoNT-A对肌肉特性的影响.
主要方法:
- 从2021年10月到2023年4月,按照PRISMA指南进行了系统的文献搜索.
- 两个独立的审查员选了研究,提取了数据,并评估了方法质量.
- 一项元分析比较了BoNT-A注射前后的肌肉弹性和结构.
主要成果:
- 对19项研究的元分析显示,注射后4周肌肉弹性 (SMD=0.74) 短时间显著改善,通过超声波弹性学 (USE) 评估.
- 通过MRI/超声波,没有观察到肌肉厚度,角或回声强度的显著短期变化.
- 在注射后6个月,正常化肌肉体积 (SMD=-0.17) 略微但显著下降.
结论:
- 在短期内,BoNT-A注射可以暂时增强肌肉弹性.
- 方法的异质性使得关于肌肉结构变化的数据的合成变得复杂.
- 长期使用BoNT-A可能会降低正常化肌肉体积,建议仔细考虑重新注射时间,特别是在儿科脑患者中.
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