环喷托酯单独用药和环喷托酯-复方托吡卡胺联合用药的睫状肌麻痹效果比较

doi:10.3760/cma.j.cn115909-20200110-00007

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摘要目的：比较6～12岁儿童单独使用1%环喷托酯和1%环喷托酯-复方托吡卡胺联合用药的睫状肌麻痹效果。方法：前瞻性随机对照研究。2018年7─9月在北京市海淀区妇幼保健院进行睫状肌麻痹验光的6～12岁屈光不正儿童98例（98眼），根据随机数字表法随机分为单独用药组和联合用药组。单独用药组给予1%环喷托酯点眼3次；联合用药组给予1%环喷托酯点眼3次和复方托吡卡胺点眼2次。分别于点眼前，第1次点眼后30、45、75 min测量等效球镜度（SE）和瞳孔直径。使用独立样本t检验比较2组基线数据。采用重复测量资料的方差分析对不同给药方法在不同时间SE和瞳孔直径的影响进行分析。使用Pearson相关性分析睫状肌麻痹程度与瞳孔散大程度之间的关系。结果：2组SE值均在点眼后30 min内向正值方向发展，45 min达到最佳效果，45～75 min基本保持平稳，不同时间点睫状肌麻痹作用差异有统计学意义（F=57.06，P<0.001）。不同给药方式对睫状肌麻痹效果影响差异无统计学意义。随时间延长，不同给药方式睫状肌麻痹效果差异无统计学意义。点眼后2组瞳孔直径均随时间延长而增大，时间因素引起瞳孔直径变化差异有统计学意义（F=502.87，P<0.001）。联合用药组瞳孔直径大于单独用药组（F=30.63，P<0.001），随时间延长，联合用药组瞳孔直径均大于单独用药组，差异有统计学意义（F=13.53，P<0.001）。2组点眼后75 min SE改变值与瞳孔直径增加值之间均无相关性。结论：在我国6～12岁儿童中，1%环喷托酯-复方托吡卡胺联合用药在睫状肌麻痹效果、起效时间以及持续时间方面均未优于1%环喷托酯单独用药，而联合用药后瞳孔散大的不良反应明显大于单独用药。

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关键词 ： , 睫状肌麻痹, 环喷托酯, 联合用药

Abstract： Objective: To study cycloplegia using 1% cyclopentolate alone and 1% cyclopentolate combined with a tropicamide compound in children aged 6-12 years. Methods: In this prospective randomized controlled study, 98 children aged 6-12 years with ametropia were randomly divided into two groups: One group was given 1% cyclopentolate 3 times, the other group was given 1% cyclopentolate 3 times and a tropicamide compound 2 times. The spherical equivalent and pupil diameter were measured before and 30 min, 45 min and 75 min after the first eyedrop. The baseline data of the 2 groups were compared by an independent-samples t test. ANOVA of repeated measures was used to analyze the influence of the different methods on the sphericity equivalent (SE) and pupil diameter at different times. The correlation between the degree of cycloplegia and mydriasis was analyzed by Pearson correlation analysis. Results: The negative sphericity of the two groups decreased rapidly within 30 minutes after the first drop, the best effect was achieved in 45 minutes, and remained stable from 45 minutes to 75 minutes. The cycloplegia between different time points were statistically different (F=57.06, P<0.001) but there was no significant difference between the 2 methods. As time progressed, the difference in cycloplegia between the 2 methods was not significant. The pupil diameter of the 2 groups increased with the progression of time and was statistically significant (F=502.87, P<0.001). The pupil diameter of the group with the compound was larger than that of the single group (F=30.63, P<0.001), and as time progressed, the difference was also statistically significant (F=13.53, P<0.001). There was no correlation between the decrease in the negative SE and the increase in pupil diameter in the 2 groups. Conclusions: In children aged 6-12 years, the cycloplegia effect, onset time and duration of 1% cyclopentolate combined with a tropicamide compound are not better than that of 1% cyclopentolate alone, but mydriasis with the compound is significantly greater than 1% cyclopentolate alone.

Key words： cycloplegia cyclopentolate combination

收稿日期: 2020-01-10

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通讯作者: 王立华（ORCID：0000-0002-3920-5826），Email：yanni6868@163.com

引用本文:

王立华陈巍浦佳宁冯晶晶. 环喷托酯单独用药和环喷托酯-复方托吡卡胺联合用药的睫状肌麻痹效果比较[J]. 中华眼视光学与视觉科学杂志, 2020, 22(11): 847-851. Lihua Wang, Wei Chen, Jianing Pu, Jingjing Feng. Comparative Study on Cycloplegia with Cyclopentolate Alone and Cyclopentolate Combined with a Tropicamide Compound. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(11): 847-851. DOI: 10.3760/cma.j.cn115909-20200110-00007

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20200110-00007 或 https://www.cjoovs.com/CN/Y2020/V22/I11/847

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