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目的观察人咬肌内注射A型肉毒毒素后咬肌纤维的组织形态学改变。方法自2011年4月至2015年10月,收集60例双侧下颌骨肥大伴咬肌肥大患者的左侧和右侧咬肌标本,共120份。将60份未注射A型肉毒毒素的咬肌标本作为对照组,60份已注射A型肉毒毒素的咬肌标本作为实验组。两组标本均行石蜡切片和HE染色,光镜下观察两组咬肌纤维的基本结构,测量其横截而面积,并进行统计学分析。结果光学显微镜观察,未发现两组咬肌纤维的基本结构发生改变,两组咬肌纤维横截面而积的差异具有统计学意义(P<0.05)。咬肌纤维横截面面积在第12周时减小程度最大,之后减小趋势放缓,第24周时,与第12周时的面积基本一致。结论 A型肉毒毒素能诱导人咬肌萎缩,在注射后第12周时萎缩程度最大,之后无明显变化。
Objective To observe the histomorphological changes of masseter muscle fibers after intramuscular injection of botulinum toxin type A in masseter. Methods From April 2011 to October 2015, a total of 120 left and right masseter muscle specimens from 60 patients with bilateral mandibular hypertrophy and masseter hypertrophy were collected. Sixty specimens of masseter muscle without botulinum toxin type A were used as the control group, and 60 specimens of botulinum toxin type A botulinum toxin were used as the experimental group. Two groups of specimens were paraffin sections and HE staining, observed under light microscope, the basic structure of the two groups of masseter muscle, measuring the cross-sectional area, and statistical analysis. Results The optical microscopy showed no change in the basic structure of the masseter muscle fibers between the two groups. The difference in the cross-section of the masseter muscle fibers between the two groups was statistically significant (P <0.05). The cross-sectional area of the masseter muscle fibers decreased the most at the 12th week, and then decreased. At the 24th week, the area of the masseter muscle fibers was basically the same as that at the 12th week. Conclusion Botulinum toxin type A can induce the masseter muscle atrophy in human, and it has the largest atrophy in the 12th week after injection, with no significant change afterwards.