方法：将220例440眼患者(2013-01/2015-01来我科确诊为眼睑痉挛患者)随机分为高浓度组110例和低浓度组110例，分别采用40U/mL和25U/mL浓度局部注射到上下眼睑轮匝肌、皱眉肌、降眉肌、降眉间肌。观察两组BTX-A的用量、治疗效果、维持时间及不良反应。

结果：高浓度组BTX-A的用量为48.33±4.02U，低浓度组BTX-A的用量为28.51±3.42U，差异有统计学意义(P<0.05)，而高浓度组与低浓度组术后疗效评估、起效时间和疗效持续时间无统计学意义(P>0.05)，高浓度组出现不同程度上睑下垂16例，低浓度组出现2例，差异有统计学意义(P<0.01)。两组均未出现中毒和药物过敏症状，上睑下垂发生后通常在3～6wk内逐渐恢复，严重可以给予盐酸奈甲唑林点眼缓解。

结论：两种不同浓度的BTX-A局部注射治疗眼睑痉挛的疗效是肯定的，鉴于对上睑下垂并发症的评估，推荐使用低浓度注射。

METHODS: Totally 220 patients(440 eyes)confirmedas blepharospasm in our department(from January 2013 to January 2015), were divided randomly into two groups: 110 in high concentration group and 110 in low concentration group. The two groups were given local injections with 25 U/mL or 40 U/mL concentration of botulism toxin type A to the upper and lower eyelids orbicular muscle, corrugator, reducing eyebrow muscle and procerus respectively. We observed dosage of two groups, the treatment effect, the duration of the effect and the incidence of adverse reactions.

RESULTS: The high concentration group was given the BTX-A with 48.33±4.02U,the low concentration group was given the BTX-A with 28.51±3.42U,the differences were statistically significant(P<0.05). The differences of post-operative evaluation of curative effect, onset time and duration of the effect between the groups were not statistically significant(P >0.05). Sixteen cases had ptosis in different levels in the high concentration group, and 2 in the low concentration group, the differences were statistically significant(P<0.01). There were no serious complications such as intoxication, drug allergy in both groups. Ptosis relieved after using naphcon-A and disappeared in 2-3 wk.

CONCLUSION: The efficacy of local injection with two concentrations of diluted botulinum toxin A for blepharospasm was positive. Considering the high incidence of ptosis in high concentration group, we recommended the 25U/mL botulism toxin A for blepharospasm.