0.1 g·L-1阿托品不同给药频次对青少年屈光不正患者屈光度及调节功能的影响

Effects of different administration frequencies of 0.1 g·L-1 atropine on the diopter and accommodation function of adolescents with refraction error

目的 比较0.1 g·L-1阿托品不同给药频次对青少年屈光不正患者屈光度及调节功能的影响。方法 纳入2020年6月至2021年6月于山西省眼科医院斜视与小儿眼科门诊就诊的中度近视青少年患者123例(246眼),采用随机数字表法分为观察组(62例)、对照组(61例)。两组患者均接受0.1 g·L-1阿托品滴眼液治疗,其中对照组为每晚1滴,每天1次,观察组为每晚1滴,隔日1次,持续用药1年。比较治疗前和治疗后12个月两组患者眼轴长度、眼压、近视、等效球镜度数(SER)、瞳孔直径、前房深度、双眼调节功能等参数变化情况,并记录用药期间不良反应情况。结果 治疗后12个月,两组患者SER均较治疗前提高,差异均有统计学意义(均为P<0.05)。治疗后1个月、4个月、8个月,两组患者SER与治疗前比较差异均无统计学意义(均为P>0.05)。治疗前,治疗后1个月、4个月、8个月以及12个月,两组患者SER比较差异均无统计学意义(均为P>0.05)。治疗后12个月,两组患者瞳孔直径均高于治疗前(均为P<0.05),而眼轴长度、前房深度、眼压与治疗前比较差异均无统计学意义(均为P>0.05)。治疗前以及治疗后12个月,两组患者瞳孔直径、眼轴长度、前房深度、眼压比较差异均无统计学意义(均为P>0.05)。治疗前两组患者调节幅度、调节灵敏度比较差异均无统计学意义(均为P>0.05),治疗后12个月均高于治疗前(均为P<0.05)。治疗后12个月,两组患者调节幅度、调节灵敏度比较差异均无统计学意义(均为P>0.05)。不良反应多发生于用药后1个月内,主要为畏光、视近模糊、眼痒、眼胀,对照组、观察组患者不良反应发生率分别为19.67%、14.52%,差异无统计学意义(P>0.05)。结论 0.1 g·L-1阿托品不同滴眼频次(每天1次、隔日1次)均可有效改善青少年屈光不正患者屈光度及调节功能,且疗效一致,不良反应发生率相近,均具有良好的应用价值。

Objective To compare the effects of 0.1 g·L-1atropine eye drops on the diopter and accommodation function of adolescents with refraction error at different administration frequencies.Methods Totally 123 adolescents(246 eyes) with medium myopia attending the Strabismus and Pediatric Ophthalmology Clinic of Shanxi Eye Hospital from June 2020 to June 2021 were included.They were divided into the observation group(n=62) and control group(n=61) using the random number table method.All received 0.1 g·L-1atropine eye drops.Patients in the control group received 1drop per night,while those in the observation group received 1 drop once every other night.The treatment in both groups lasted for 1 year.The axial length,intraocular pressure,myopia,spherical equivalent refractive(SER),pupil diameter,anterior chamber depth,and binocular accommodation function before and 12 months after the treatment were compared,and adverse reactions during the treatment were recorded.Results The SER after 12 months of treatment in both groups was higher than that before the treatment,with statistically significant differences(both P <0.05),while SER at 1 month,4 months,and 8 months after treatment had no statistically significant difference with that at baseline(all P>0.05).The two groups had no significant difference in the SER before,1 month,4 months,8 months and 12 months after the treatment(all P> 0.05).The pupil diameter in the two groups 12 months after the treatment was larger than that at baseline(both P <0.05),while no statistically significant difference was found in the axial length,anterior chamber depth and intraocular pressure(all P>0.05).The two groups showed no significant difference in pupil diameter,axial length,anterior chamber depth and intraocular pressure before and 12 months after treatment(all P> 0.05).The amplitude and sensitivity of accommodation before and 12 months after the treatment showed no significant difference between the two groups(all P> 0.05);those significantly increased in both groups at 12 months after treatment(both P <0.05).Adverse reactions occurred mostly within 1 month after medication,mainly including photophobia,blurred near vision,eye itching and eye distension.The incidence rate of adverse reactions in the control group and observation group was 19.67% and 14.52%,with no significant difference(P> 0.05).Conclusion Different administration frequencies of 0.1 g·L-1atropine eye drops(once-daily vs.every-other-day) can effectively improve the diopter and accommodation function of refraction error adolescents with similar efficacy and incidence of adverse effects,as well as good application value.