不同浓度阿托品滴眼液控制儿童近视进展的疗效观察  

Study on the Effect of Different Concentration of Atropine Eye Drops on Childhood Myopia

作　　者：王敏 崔云[2] 解瑞[2] 李聪慧[2] WANG Min;CUI Yun;XIE Rui;LI Conghui(First Clinical College,Changzhi Medical College)

机构地区：[1]长治医学院第一临床学院,山西长治046000 [2]长治医学院附属和平医院眼科

出　　处：《长治医学院学报》2024年第5期363-367,共5页Journal of Changzhi Medical College

基　　金：山西省卫生健康委科研课题计划项目(2023134);山西省基础研究计划项目(202203021221302)。

摘　　要：目的:探讨0.02%和0.04%阿托品滴眼液控制儿童近视进展的有效性和安全性。方法:纳入就诊的6~12岁近视儿童75例,按随机双盲方式分为0.02%阿托品组、0.04%阿托品组及安慰剂组,各25人。2个阿托品组及安慰剂组分别给予0.02%、0.04%阿托品滴眼液以及硫酸阿托品滴眼液溶媒,日间均佩戴单焦框架眼镜进行屈光矫正。每6个月对所有受试者进行一次复查,共随访18个月。睫状肌麻痹后用电脑验光仪获得等效球镜度数(SE),用IOL-Master测量眼轴长度(AL),采用问卷调查记录受试者不良反应情况。结果:治疗18个月后,3组受试者不同时间点SE比较,差异均有统计学意义(P<0.05),3组SE均较治疗前增加,差异有统计学意义(P<0.05);3组受试者治疗前后不同时间点AL比较,差异具有统计学意义(P<0.05);3组眼轴长度均较治疗前增加,差异有统计学意义(P<0.05);用药后1~4周,0.02%和0.04%阿托品组各有4例儿童出现畏光症状,分别占17.4%和16.7%,各有3例出现眼睛刺痛感,分别占13.0%和12.5%,0.02%阿托品组1例(4.3%)和0.04%阿托品组2例(8.3%)出现视近模糊,用药1月后0.02%阿托品组出现1例角膜上皮炎,0.04%阿托品组出现1例结膜炎。结论:0.02%和0.04%阿托品滴眼液均可减缓近视儿童SE进展和AL延长,且0.04%阿托品滴眼液控制近视进展疗效优于0.02%阿托品滴眼液;2种浓度阿托品滴眼液副作用较小,且安全性良好。Objective:To assess the safety and efficacy of 0.02%and 0.04%atropine eye drops in controlling myopia progression in children.Methods:Seventy-five myopic children aged 6~12 years were included.The subjects were randomly assigned to the 0.02%atropine group,0.04%atropine group,or placebo group,with 25 participants in each group.The two atropine groups and the placebo group were administered with 0.02%,0.04%atropine eye drops,and atropine sulfate eye drop solvent,respectively.Full-correction single-vision glasses were worn during the day.All participants were followed up every 6 months for 18 months.Equivalent spherical refractive error(SE)was obtained using a computerized autorefractor after cycloplegia,and axial length(AL)was measured using an IOL-Master.Adverse reactions were recorded using a questionnaire survey.Results:After the 18-month treatment period,statistically significant differences were observed in SE among the three groups across various time points(P<0.05).The SE increased in all three groups compared to baseline,with statistically significant differences(P<0.05).Similarly,the AL levels of the 3 groups were significantly different at different time points(P<0.05).The AL increased in all three groups compared to baseline,with statistically significant differences(P<0.05).There were 4 cases of photophobia in both the 0.02%and 0.04%atropine groups,accounting for 17.4%and 16.7%,respectively.3 cases of ocular discomfort occurred in each group,accounting for 13.0%and 12.5%,within 1~4 weeks after medication.One case of blurred vision occurred in the 0.02%atropine group,and two in the 0.04%atropine group.Additionally,one case of corneal epithelial inflammation occurred in the 0.02%atropine group and one case of conjunctivitis occurred in the 0.04%atropine group after 1 month of medication.Conclusion:Both 0.02%and 0.04%atropine eye drops are effective in slowing down the development of myopia in children,with better control of myopia progression achieved by the 0.04%atropine eye drops.The two concentrations

关 键 词：阿托品 近视 儿童 疗效 不良反应 

分 类 号：R778.11[医药卫生—眼科]