2种屈光矫正方式对青少年近视患者反应性AC/A率影响的对比  

Comparison of response AC/A ratio with two refractive correction methods for myopia teenagers

作　　者：杨扬[1] 王莉[1] 刘文兰[1] 闫瑾[1] 

机构地区：[1]西安医学院眼视光教研室,西安710021

出　　处：《重庆医科大学学报》2018年第2期255-259,共5页Journal of Chongqing Medical University

基　　金：陕西省教育厅2017年专项科学研究资助项目(编号:17JK0662);西安医学院青年科研基金资助项目(编号:2015QN08);西安医学院大学生创新基金项目(编号:2016DXS1-31);西安医学院大学生开放科研实验资助项目(编号:2016DXS2-12)

摘　　要：目的:观察并比较佩戴角膜塑形镜和佩戴框架眼镜后反应性调节性集合与调节的比值(accommodative convergence/accommodation ratio,AC/A ratio)的变化情况。方法:前瞻性试验对照研究。选择2015年3至5月在西安市第一医院就诊的120例10~16岁中低度青少年近视患者,根据检查结果和患者意愿将其分为角膜塑形镜组和框架眼镜组各60例,比较2组患者在戴镜前和戴镜后1、3、6、12个月的反应性AC/A率,并对每种矫正方式下不同屈光度的AC/A率进行分层分析。组间数据比较和组内不同屈光度的分层比较采用重复测量设计的方差分析,组内各时间点的两两比较采用SNK-q检验,组间各时间点的两两比较采用两独立样本t检验,并进行Bonferroni校正。结果:共113例患者完成该研究;角膜塑形镜组和框架眼镜组在戴镜前和戴镜后1、3、6、12个月的AC/A率分别为(4.52±0.58)、(3.40±0.46)、(3.48±0.42)、(3.54±0.42)、(3.63±0.44)D,(4.54±0.64)、(4.46±0.65)、(3.88±0.64)、(4.11±0.61)、(4.48±0.64)D;矫正方式对AC/A率的影响有统计学差异(F=43.737,P=0.000),近视程度对角膜塑形镜组AC/A率的影响没有统计学差异(F=3.468,P=0.068),但框架眼镜组的AC/A率会随着近视程度的增加明显增加(F=5.211,P=0.026);2组戴镜后的AC/A率相对于戴镜前均明显下降(F=94.037,F=168.559,F=26.661,均P=0.000),组别与测量时间的交互作用对AC/A率的影响也有统计学差异(F=36.226,P=0.000),但近视程度与测量时间的交互作用对AC/A率的影响均没有统计学差异(F=0.814,P=0.502,F=0.288,P=0.814);经Bonferroni校正后,角膜塑形镜组戴镜前的AC/A率与框架眼镜组相比无统计学差异(t=-0.140,P=0.889),但戴镜后1、3、6、12个月的AC/A率均小于框架眼镜组,差异有统计学意义(t=-9.898,t=-3.859,t=-5.748,t=-8.093,均P=0.000);角膜塑形镜组戴镜后1、3、6、12个月的AC/A率均明显小于戴镜前,但戴镜后各时间点间均无统计学差异;框架眼�Objective：To observe and compare the response accommodative convergence/accommodation（AC/A） ratio of myopic teenagers with orthokeratology and frame glasses. Methods：This was a prospective case-control study. One hundred and twentyjuvenile myopia aged 10-16 years were divided into orthokeratology group and frame glasses group according to the test results and wishes of patients,with 60 cases in each group.The AC/A ratios before and after correction of all the cases in the two groups will be followed up and compared after one,three,six and twelve months. AC/A ratios were also analyzed in stratification with different diopters in each correction. Data were analyzed using ANOVA for repeated measuring,SNK-q test,two independent t-test. Results：A total of 113 cases completed the study. The AC/A ratios before and after correction in orthokeratology group and frame glasses group were respectively（4.52±0.58）,（3.40±0.46）,（3.48±0.42）,（3.54±0.42）,（3.63±0.44）D,（4.54±0.64）,（4.46±0.65）,（3.88±0.64）,（4.11±0.61）,（4.48±0.64）D. There was significant difference in AC/A rate between two refractive correction methods（F = 43.737,all P =0.000）. The degree of myopia had no significant effect on AC/A rate in orthokeratology group,but significant effect in frame glasses group. The effects of measurement time on AC/A ratio of each group were significant（F=94.037,F=168.559,F=26.661,P=0.000）. The interaction between the group and the measurement time also had significant effects（F=36.226,P=0.000）. But the interaction between degree of myopia and measurement time had no significant effects（F=0.814,P=0.502,F=0.288,P=0.814）. The AC/A ratio in orthokeratology group after correction were less than frame glasses group respectively（t=-9.898,t=-3.859,t=-5.748,t=-8.093,all P=0.000）,but no significant difference was observed between two groups before correction（t=-0.140,P=0.889）.Conclusion：Frame glasses and orthokeratology can both reduce the AC/A ratio,but the effect

关 键 词：青少年 近视 角膜塑形镜 框架眼镜 调节性集合与调节的比值 

分 类 号：R778.1[医药卫生—眼科]