0.1g·L^(-1)阿托品滴眼液对瞳孔直径和调节的影响  

Effects of 0.1 g·L^(-1) atropine on pupil size and accommodation

作　　者：贺美男 祝颖[1] 王希莲[2] 李颖[1] 林伟平[1] 厉娜[1] 魏瑞华[1] 

机构地区：[1]天津医科大学眼科医院,天津市300000 [2]天津市北辰医院,天津市300400

出　　处：《眼科新进展》2016年第10期932-935,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81100646);天津市科委自然科学基金资助(编号:11JCYBJC26000);天津市北辰区科技发展计划项目(编号:BC2014-10)~~

摘　　要：目的评估0.1 g·L^(-1)阿托品滴眼液对瞳孔直径和调节的影响,以及不同溶剂对阿托品药理作用的影响。方法本研究对23名(46眼)受试者采用队列研究,根据0.1g·L^(-1)阿托品配制溶剂不同,将受试者随机分为生理盐水组和玻璃酸钠组,每组各23眼。试验前对所有受试者进行电脑验光、调节幅度、近视力、瞳孔直径以及瞳孔对光反射的测量,阿托品点眼后不同时间依次进行瞳孔直径的测量,当瞳孔散至最大时,我们将再次进行电脑验光、剩余调节力、近视力、瞳孔直径及瞳孔对光反射检查,并进行问卷调查。结果生理盐水组用药前瞳孔直径为(5.15±0.22)mm,调节幅度为(10.09±0.35)D,瞳孔充分散大后,瞳孔直径为(6.52±0.21)mm,剩余调节力为(8.79±0.36)D,差异均具有统计学意义(均为P<0.001);玻璃酸钠组用药前瞳孔直径为(5.04±0.22)mm,调节幅度为(10.17±0.46)D,瞳孔充分散大后,瞳孔直径为(6.86±0.21)mm,剩余调节力为(8.83±0.39)D,差异均具有统计学意义(均为P<0.001)。两组0.1 g·L^(-1)阿托品滴眼液点眼后,近视力均轻度下降,但差异均无统计学意义(均为P>0.05)。问卷调查结果显示,0.1 g·L^(-1)阿托品点眼后会出现轻微不适,但不影响近距离工作。结论 0.1 g·L^(-1)阿托品会造成瞳孔散大,但保留了功能性调节,不会引起明显的不适症状,对近距离工作和生活学习无明显影响;溶剂的类型不会影响阿托品的药理作用。Objeetive To evaluate the effects of 0. 1 g ~ L-~ atropine on pupil size and accommodation and different solvent on the pharmacological function of atro- pine. Methods The 45 eyes of 23 subjects were enrolled in this study. According to the 0.1 g L-1 atropine mixed solvent, they were randomly divided into normal saline （NS） group and sodium hyaluronate （SH） group, each group of 23 eyes. The measure- ments of autorefractor, accommodation amplitude, near vision, pupil size and pupil re- flex were performed before the treatment. And the pupil size was measured at l0 mi- nutes ,20 minutes,30 minutes, 45 minutes, 50 minutes, 90 minutes, 120 minutes, 180 mi- nutes,240 minutes,300 minutes and 360 minutes after atropine treatment. When the pu- pil was fully dilated, these measurements were done again and then a questionnaire was made. Results In the NS group, compared with baseline, the pupil size was signifi- cantly enlarged from （5.15 ±0.22） nml to （6.52 ±0.21 ） mm（P 〈 0. 001 ）, and the ac- commodation amplitude were significantly decreased from （ 10.09± 0.35 ） D to （ 8.79 ± 0.36） D（P 〈 0.001 ）. In the SH group, the pupil size was （5.04 ± 0.22 ） mm, and the ac- commodation amplitude was （ 10.17 ± 0.45） D at the baseline value; When the pupil was fully dilated,the pupil size reaches （5.85 ±0.21 ） mm,the accommodation ampli- tude kept （8.83 ± 0.39）D, there were significant differences compared with baseline （all P 〈 0.001 ）. In both groups, the near vision were reduced, but no significantly difference was found （ all P 〉 0.05 ）. Based on the questionnaire, mild discomfort symptoms were noticed after 0.1 g L-1 atropine treatment, but there was no effect on the near work. Conelusion 0.1 g L-1 atropine make pupil dilation but keeps the function of ac- commodation,and does not produce significantly clinical symptoms. And the types of solvent has no influence on the pharmacological function of atropine.

关 键 词：阿托品 瞳孔直径 调节幅度 近视力 

分 类 号：R777[医药卫生—眼科]