0.01%阿托品滴眼液对近视青少年近视控制效果及其影响因素分析

Effect of 0.01%atropine eye drops on myopia control and its influencing factors in myopic teenagers

目的 青少年近视的发病率逐渐增加且M受体参与近视的整体发展过程,阿托品属于典型的M受体阻断剂,故探讨0.01%阿托品滴眼液对青少年近视的控制效果及其影响因素。方法 选取2021年3—8月海宁市人民医院收治的98例近视青少年为研究对象,均接受0.01%阿托品治疗。随访观察1年,将完成随访的82例近视青少年根据治疗效果分为有效组(近视年增长量<0.25 D或近视年增长量下降≥50%)50例和无效组(近视年增长量≥0.25 D)32例。应用多因素logistic回归模型分析影响0.01%阿托品治疗效果的相关因素并绘制ROC曲线评估预测价值。结果 2组年龄、基线等效球镜度SE、裸眼视力比较差异有统计学意义(均P<0.05);多因素logistic回归分析显示年龄(OR=1.395,95%CI:1.023~1.901)、裸眼视力(OR=2.134,95%CI:1.087~4.187)、等效球镜度SE(OR=0.349,95%CI:0.183~0.666)为近视0.01%阿托品治疗效果的影响因素(均P<0.05);ROC曲线显示,年龄、基线等效球镜度SE、裸眼视力预测0.01%阿托品治疗效果的AUC分别为0.708(95%CI:0.597~0.803)、0.799(95%CI:0.696~0.879)、0.714(95%CI:0.603~0.808)。结论 0.01%阿托品治疗近视青少年效果显著,年龄小、基线等效球镜度SE高、裸眼视力低更能从0.01%阿托品治疗中获益。

Objective The incidence of myopia in teenagers is gradually increasing,and the M receptor is involved in the whole process of myopia development.Atropine is a typical M receptor blocker.Therefore,the effect of 0.01%atropine eye drops on myopia control in adolescents with myopia and its influencing factors are discussed.Methods A total of 98 myopic adolescents admitted to Haining People's Hospital from March to August 2021 were selected as the research objects,and all received 0.01%atropine treatment.The 82 patients were followed up for 1 year.According to the treatment effect,they were divided into an effective group(50 cases,annual increase of myopia<0.25 D or decrease of myopia≥50%)and an ineffective group(32 cases,annual increase of myopia≥0.25 D).A multivariate logistic regression model was used to analyze the related factors affecting the treatment effect of 0.01%atropine,and a ROC curve was drawn to evaluate the predictive value.Results There were significant differences in age,baseline equivalent spherical mirror SE and naked eye visual acuity between the two groups(all P<0.05).Multivariate logistic regression analysis showed that age(OR=1.395,95%CI:1.023-1.901),naked eye visual acuity(OR=2.134,95%CI:1.087-4.187),equivalent spheroscope SE(OR=0.349,95%CI:0.183-0.666)were the factors influencing the therapeutic effect of 0.01%atropine(all P<0.05).The ROC curve showed that the AUCs of age,baseline equivalent spheroscope SE and naked eye visual acuity in predicting the effect of 0.01%atropine were 0.708(95%CI:0.597-0.803),0.799(95%CI:0.696-0.879)and 0.714(95%CI:0.603-0.808),respectively.Conclusion The effect of 0.01%atropine in the treatment of myopic adolescents is significant.Younger age,higher baseline spherical equivalent SE and lower naked eye visual acuity are more likely to benefit from 0.01%atropine.