低浓度阿托品控制青少年近视临床疗效的Meta分析  

Meta-analysis of the clinical efficacy of low-concentrations atropine in controlling adolescent myopia

作　　者：姜志东 程连 张勇[2] 梁镭 阮金婷 黄燕飞 李亮亮 Jiang Zhidong;Cheng Lian;Zhang Yong;Liang Lei;Ruan Jinting;Huang Yanfei;Li Liangliang(Department of Ophthalmology,Nanlang Branch,Zhongshan City People's Hospital,Zhongshan 528400,Guangdong Province,China;Ningxia Medical University,Yinchuan 750004,Ningxia Hui Autonomous Region,China;Dapeng New District Medical Health Group,Shenzhen 528051,Guangdong Province,China;Department of Optometry,the General Hospital of Foshan Aier Eye Hospital,Foshan 528000,Guangdong Province,China)

机构地区：[1]中国广东省中山市人民医院南朗分院眼科,528400 [2]宁夏医科大学,中国宁夏回族自治区银川市750004 [3]中国广东省深圳市大鹏新区医疗健康集团,528051 [4]佛山爱尔眼科医院总院视光科,中国广东省佛山市528000

出　　处：《国际眼科杂志》2024年第11期1784-1794,共11页International Eye Science

基　　金：佛山市卫生健康局医学科研项目(No.20230334)。

摘　　要：目的:系统评价低浓度阿托品滴眼液控制青少年近视的疗效和安全性。方法:计算机检索Wanfang Data、CNKI、VIP、PubMed、Cochrane Library及Embase数据库,检索2010-01/2024-03有关低浓度阿托品滴眼液控制青少年近视的临床研究。由2名研究者独立筛选试验,提取资料,行偏倚风险及质量评价,采用Review Manager5.4软件进行Meta分析。结果:共纳入17篇文献,共计近视青少年3764例3952眼。Meta分析结果显示,与对照组相比,低浓度阿托品能有效减缓眼轴增长[MD=-0.15,95%CI(-0.20,-0.10),P<0.00001],显著控制等效球镜度变化[MD=0.39,95%CI(0.29,0.48),P<0.00001],对瞳孔直径[MD=0.80,95%CI(0.33,1.28),P=0.0010]和调节幅度[MD=-2.54,95%CI(-4.49,-0.60),P=0.01]具有明显影响。结论:低浓度阿托品对青少年近视眼轴长度、等效球镜度的控制有良好效果,能显著影响瞳孔直径和调节幅度,能有效延缓近视进展。AIM:To systematically evaluate the efficacy and safety of low-concentrations atropine eye drops in controlling adolescent myopia.METHODS:A computer search was conducted on Wanfang Data,CNKI,VIP,PubMed,Cochrane Library,and Embase databases from January 2010 to March 2024 on clinical studies on low-concentration atropine eye drops for controlling adolescent myopia.Two researchers independently screened trials,extracted data,evaluated risk of bias and quality,and used Review Manager5.4 software to perform Meta-analysis.RESULTS:A total of 17 articles,involving 3764 cases and 3952 eyes,were included.The Meta-analysis showed that compared with the control group,low concentrations of atropine could effectively slow down the growth of axial length[MD=-0.15,95%CI(-0.20,-0.10),P<0.00001],significantly controlled the changes in spherical equivalent[MD=0.39,95%CI(0.29,0.48),P<0.00001],and had a significant effect on pupil diameter[MD=0.80,95%CI(0.33,1.28),P=0.0010]and amplitude of accommodation[MD=-2.54,95%CI(-4.49,-0.60),P=0.01].CONCLUSION:Low-concentrations atropine are effective in controlling spherical equivalent and axial length of myopia in adolescents,significantly affecting pupil diameter and amplitude of accommodation,and effectively delaying the progression of myopia.

关 键 词：近视 低浓度阿托品 青少年 疗效结果 META分析 

分 类 号：R778.11[医药卫生—眼科]