0.01%阿托品对青少年近视调节参数的影响

doi:10.3760/cma.j.issn.1674-845X.2019.12.011

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摘要

：观察0.01%阿托品对青少年近视调节参数的影响。方法：前瞻性非随机对照研究。选取2015年 4月至2018年6月于聊城市第二人民医院眼科就诊的轻中度近视患者61例（122眼），年龄13～16 （14.4±0.9）岁，根据监护人意愿分为2组：阿托品组30例（60眼），滴用0.01%阿托品滴眼液1次；对照组31例（62眼），滴用玻璃酸钠滴眼液1次。阿托品组在用药前及用药后2、4、6 h行近视力、调节幅度和调节灵敏度检查。对照组在用药前及用药后2、6 h行近视力、调节幅度和调节灵敏度检查。采用重复测量方差分析、t检验对数据进行统计学分析。结果：点眼药前后，2组间近视力差异无统计学意义（F=0.209，P=0.650），各时间点近视力比较差异无统计学意义（F=0.292，P=0.594），组别与时间无交互作用（F=0.097，P=0.756）。阿托品组用药后2 h调节幅度低于对照组（t=-13.09， P<0.001），2 组间用药后6 h调节幅度差异无统计学意义（t=-0.26，P=0.797）；阿托品组用药后 2 h调节幅度[（10.09±0.69）D]较用药前[（12.58±0.88）D]下降（P<0.001），用药后4 h调节幅度（10.98±0.77）D较用药后2 h升高（P<0.001），用药后6 h调节幅度（12.45±0.77）D和用药前相比，差异无统计学意义（P=0.911）。阿托品组用药后2、6 h的调节灵敏度与对照组比较，差异均无统计学意义；阿托品组各时间点调节灵敏度比较差异无统计学意义（F=0.09，P=0.965）。结论：0.01%阿托品滴眼液滴眼部1次后，调节幅度下降，但剩余的调节力足够，不影响近视力和调节灵敏度。

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关键词 ：阿托品, 青少年, 近视, 调节

Abstract：

To study the effect of 0.01% atropine on accommodation in myopic teenages. Methods: A prospective non-randomized controlled study was conducted. Sixty-one children (122 eyes) with low to moderate myopia were selected at the Second People's Hospital of Liaocheng from April 2015 to June 2018. Patients (aged 13-16 years old (average age, 14.4±0.9 years) were divided into an atropine group (30 patients, 60 eyes) and a control group (31 patients, 62 eyes) according to the wishes of the guardians. Sodium hyaluronateeye drops were used once in the control group and the atropine group was treated once with 0.01% atropine eye drops. In the atropine group, near vision, accommodative amplitude and accommodative facility were measured at 2 h, 4 h and 6 h after atropine treatment, and the same parameters were measured in the control group at 2 h and 6 h after treatment with sodium hyaluronate eye drops. The data were analyzed by repeated measures analysis of variance and a t-test. Results: The difference in near vision between the two groups and at the same time-points were not statistically significant (F=0.209, P=0.650; F=0.292, P=0.594) and there was no interaction between group and time (F=0.097, P=0.756). The accommodative amplitude of the atropine group was lower than that of the control group at 2 h after treatment and the difference was statistically significant (t=-13.09, P<0.001). The difference at 6 h after the atropine treatment was not statistically significant compared with sodium hyaluronate treatment (t=-0.26, P=0.797). In the atropine group, the accommodative amplitude at 2 h after treatment (10.09±0.69 D) was significantly lower than the baseline value (12.58±0.88 D) (P<0.001). At 4 h after treatment, the accommodative amplitude (10.98±0.77 D) was higher than that 2 h after treatment (P<0.001), and the difference between the baseline value (12.45±0.77 D) and 6 h after treatment was not statistically significant (P=0.911). The difference in accommodative facility between the two groups was not statistically significant at 2 h and 6 h after treatment. The accommodative facility at different time points in the atropine group was not statistically significant (F=0.09, P=0.965). Conclusions: After a single treatment with 0.01% atropine eye drops, the amplitude of accommodation decreases, but sufficient residual accommodation is retained without affecting near vision or accommodative facility

Key words： atropine childhood myopia accommodation

收稿日期: 2019-04-17

通讯作者: 刘真（ORCID：0000-0002-2065-5675），Email：lz2890966@126.com

引用本文:

刘真王甲李广林. 0.01%阿托品对青少年近视调节参数的影响[J]. 中华眼视光学与视觉科学杂志, 2019, 21(12): 942-946. Zhen Liu, Jia Wang, Guanglin Li. Effect of 0.01% Atropine on Accommodation in Myopic teenages. Chinese Journal of Optometry Ophthalmology and Visual science, 2019, 21(12): 942-946. DOI: 10.3760/cma.j.issn.1674-845X.2019.12.011

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https://www.cjoovs.com/CN/ 10.3760/cma.j.issn.1674-845X.2019.12.011 或 https://www.cjoovs.com/CN/Y2019/V21/I12/942

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