0.01%阿托品滴眼液对青少年近视患者眼部生物学参数的影响  

Effects of 0.01%atropine on ocular biometrics in myopic adolescents

作　　者：崔璨[1] 符爱存[1] 魏丽 赵兵新 于世傲 张俊杰 吕勇[1] 王卫群[1] 李秀娟[1] Cui Can;Fu Aicun;Wei Li;Zhao Bingxin;Yu Shiao;Zhang Junjie;Lyu Yong;Wang Weiqun;Li Xiujuan(Department of Ophthalmology,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Henan Eye Hospital,Henan Eye Institute,Zhengzhou 450003,China)

机构地区：[1]郑州大学第一附属医院眼科,郑州450000 [2]河南省立眼科医院河南省眼科研究所,郑州450003

出　　处：《中华实验眼科杂志》2023年第4期330-337,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：河南省卫计委医学科技攻关项目(201602073);河南省科技厅重点研发与推广专项项目(201801591);河南省教育厅高等学校重点科研项目(19A320066);河南省卫生计生科技英才海外研修工程项目(2018038)。

摘　　要：目的观察质量分数0.01%阿托品滴眼液对青少年近视患者眼部生物学参数的影响。方法采用前瞻性队列研究,收集2016年6月至2017年6月就诊于郑州大学第一附属医院并按时完成1年随访的青少年近视患者219例,按照受试者及监护人意愿分为2个组,其中0.01%阿托品+框架眼镜组119例均配戴全矫单焦框架眼镜,且每晚睡前双眼点用0.01%阿托品滴眼液;单纯框架眼镜组100例仅配戴全矫单焦框架眼镜。采用IOL Master测量眼轴长度(AL)、角膜屈光力和前房深度;依据Bennett-Rabbetts公式计算晶状体屈光力;采用非接触式眼压计测量眼压;睫状肌麻痹验光获得近视等效球镜度(SE);总散光和角膜散光由矢量分解计算获得。均选取右眼数据进行分析,比较2个组眼部生物学参数的变化规律,采用多重线性回归分析评估近视患者SE变化量的影响因素。结果治疗后12个月,0.01%阿托品+框架眼镜组SE变化量和AL增加量分别为(-0.47±0.45)D和(0.37±0.22)mm,小于单纯框架眼镜组的(-0.70±0.60)D和(0.46±0.35)mm,差异均有统计学意义(t=5.523、9.651,均P<0.001)。2个组治疗前后不同时间点SE和AL总体比较,差异均有统计学意义(SE:F组别=1.556,P=0.015;F时间=12.538,P=0.002;AL:F组别=3.425,P=0.021;F时间=18.235,P=0.008),其中治疗后4、8和12个月,2个组SE和AL均较各自治疗前增加,差异均有统计学意义(均P<0.001)。治疗后8个月和12个月,0.01%阿托品+框架眼镜组SE和AL均小于单纯框架眼镜组,差异均有统计学意义(均P<0.001)。治疗后8个月和12个月,2个组总散光和前房深度均较治疗前增加,晶状体屈光力均较治疗前减小,差异均有统计学意义(均P<0.05)。2个组治疗前后不同时间点角膜散光、角膜屈光力、眼压总体比较差异均无统计学意义(均P>0.05)。多重线性回归模型中,Δ近视SE=-0.012-2.685×ΔAL-1.002×Δ角膜屈光力-0.656×Δ晶状体屈光力+0.477×Δ总散光+0.363×Δ前房深度-0Objective To observe the effects of 0.01%atropine eye drops on ocular biometrics in myopic adolescents.Methods A prospective cohort study was conducted.Two hundred and nineteen myopic adolescents who visited the First Affiliated Hospital of Zhengzhou University from June 2016 to June 2017 and completed the 1-year follow-up on time were enrolled.The 219 adolescents were divided into a 0.01%atropine+single-vision spectacles(SV)group(119 cases)wearing single-vision spectacles with one drop of atropine eye drop applied to both eyes once nightly,and a simple SV group(100 cases)wearing SV only.Axial length(AL),corneal power and anterior chamber depth were measured with the IOLMaster.Lens power was calculated using the Bennett-Rabbetts formula.Intraocular pressure was measured by non-contact tonometry.Spherical equivalent(SE)was examined by cycloplegic autorefraction.Total astigmatism and corneal astigmatism were calculated by vector decomposition.The right eye data were analyzed to compare the ocular biometrics changes between the two groups,and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of First Affiliated Hospital of Zhengzhou University(No.2016-35).Written informed consent was obtained from guardians before any medical examination.Results The SE change and AL elongation 12 months after treatment in 0.01%atropine+SV group were(-0.47±0.45)D and(0.37±0.22)mm,respectively,which were significantly lower than(-0.70±0.60)D and(0.46±0.35)mm in simple SV group(t=5.523,9.651;both at P<0.001).There were significant differences in SE and AL between before and after treatment in both groups(SE:F group=1.556,P=0.015;F time=12.538,P=0.002;AL:F group=3.425,P=0.021;F time=18.235,P=0.008).The SE and AL at 4,8 and 12 months after treatment were all increased in comparison with before treatment in both groups,showing statistically significant differences(all at P<0.001).The SE and AL at 8 a

关 键 词：阿托品 近视 青少年 疗效 生物学参数 

分 类 号：R778.11[医药卫生—眼科]