[1]李静一,刘群,李长安,等.户外活动和0.1 g·L阿托品对学龄期儿童控制近视发展的疗效对比[J].眼科新进展,2019,39(2):158-161.[doi:10.13389/j.cnki.rao.2019.0036]
　LI Jing-Yi,LIU Qun,LI Chang-An,et al.Comparison of outdoor activities and 0.1 g·L atropine in preventing myopia progression in children[J].Recent Advances in Ophthalmology,2019,39(2):158-161.[doi:10.13389/j.cnki.rao.2019.0036]
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户外活动和0.1 g·L-1阿托品对学龄期儿童控制近视发展的疗效对比/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年2期
页码:
158-161
栏目:
应用研究
出版日期:
2019-02-05

文章信息/Info

Title:
Comparison of outdoor activities and 0.1 g·L-1 atropine in preventing myopia progression in children
作者:
李静一; 刘群; 李长安; 黄海虹; 戴旭
325000　浙江省温州市，温州市人民医院眼科
Author(s):
LI Jing-Yi; LIU Qun; LI Chang-An; HUANG Hai-Hong; DAI Xu
Department of Ophthalmology，Wenzhou People’s Hospital，Wenzhou 325000，Zhejiang Province，China
关键词:
近视; 阿托品; 户外活动; 儿童
Keywords:
myopia; atropine; outdoor activity; children
分类号:
R779.7
DOI:
10.13389/j.cnki.rao.2019.0036
文献标志码:
A
摘要:
目的　对比并分析户外活动和0.1 g·L-1阿托品对学龄期儿童控制近视发展的疗效。方法　选取2015年至2017年温州市人民医院眼科门诊收治的7~13岁近视小学生共计180例（360眼）为研究对象，随机平均分成3组：阿托品组、户外活动组和对照组。阿托品组儿童每晚睡前滴一次0.1 g·L-1阿托品滴眼液，一次一滴，由家长实施。0.1 g·L-1阿托品滴眼液由1.25 g·L-1阿托品滴眼液与新泪然滴眼液按标准比例稀释而成。户外活动组嘱托老师和家长督促儿童课间及下午放学后在户外自由活动至少1 h；对照组儿童这期间不做任何处理。随访时间为1 a。检查3组对象在干预前和干预1 a后的近视屈光度、眼轴、眼压变化，记录近视度数快速增长率及有无发生不良反应，进行分析并比较各组差异。结果　干预1 a后，3组的屈光度改变量差异有统计学意义（F=291.39，P<0.001）；进一步两两比较：阿托品组与户外活动组屈光度改变量差异无统计学意义（q=1.21，P>0.05）；阿托品组和户外活动组屈光度改变量均小于对照组，差异均有统计学意义（均为P<0.01）。对照组近视度数快速增长率为44.17%（53/120），阿托品组为12.50% （15/120），户外活动组为14.17%（17/120）。阿托品组与户外活动组的近视度数快速增长率差异无统计学意义（P= 0.704）；阿托品组和户外活动组近视度数快速增长率均小于对照组，差异均有统计学意义（均为P<0.017）。干预1 a后，3组的眼轴改变量差异有统计学意义（F=216.13，P<0.001）；进一步两两比较：阿托品组与户外活动组的眼轴改变量差异无统计学意义（P>0.05），阿托品组和户外活动组眼轴改变量均小于对照组，差异均有统计学意义（均为P<0.001）。对照组眼压改变量为（-0.23±4.17）mmHg(1 kPa=7.5 mmHg)，阿托品组为（0.25±3.81）mmHg，户外活动组为（0.33±3.72）mmHg，差异无统计学意义（F=0.72，P=0.487）。阿托品组儿童自诉未出现不能耐受的副作用。结论　局部使用0.1 g·L-1阿托品滴眼和增加户外时间能有效控制眼轴增长及近视度数增加，且两者在控制学龄期儿童近视进展的疗效无明显差异。
Abstract:
Objective　To compare the effects of outdoor activities and 0.1 g·L-1 atropine on prevention of myopia progression in school-age children.Methods　A total of 180 myopic children aged 7-13 years (360 eyes) were selected from the ophthalmological clinic of Wenzhou People’s Hospital from 2015 to 2017.They were randomly divided into 3 groups:the atropine group,the outdoor activity group and the control group.Children in the atropine group were given 0.1 g·L-1 atropine eye drops before bedtime every evening,one drop at one time,which was implemented by parents.The 0.1 g·L-1 atropine eye drops were diluted by 1.25 g·L-1 atropine eye drops and Tears Naturale eye drops according to the standard proportion;Children in the outdoor activity group were urged by the teachers and parents for outdoor activities during all class recesses and one hour after school;Children in the control group were without any treatment during this period.The time of follow-up was 1 year.The changes of myopia diopter,eye axis length and intraocular pressure (IOP) of the 3 groups of individuals before and after 1 year of intervention were examined and compared.The rapid growth rate of myopia diopter and the adverse reaction were recorded,and the differences were analyzed and compared.Results　After 1 year of follow-up,the diopter changes in the 3 groups were statistically significant (F=291.39,P<0.001);further comparison in pairs:there was no significant difference in diopter change between the atropine group and the outdoor activity group (q=1.21,P>0.05);The diopter changes in the atropine group and the outdoor activity group were smaller than the control group,and the differences were statistically significant (both P<0.01).The rapid growth rate of myopia was 44.17% (53/120) in the control group,12.50% (15/120) in the atropine group and 14.17% (17/120) in the outdoor activity group.There was no significant difference in the rapid growth rate of myopia between atropine group and outdoor activity group (P=0.704);The rapid growth rate of myopia between the atropine group and the outdoor activity group was lower than control group,and the differences were statistically significant (both P<0.017).After 1 year of follow-up,the eye axis changes in the 3 groups were statistically significant (F=216.13,P<0.001);Further comparison in pairs:there was no significant difference in the eye axis change between the atropine group and the outdoor activity group(P>0.05);The eye axis changes in the atropine group and the outdoor activity group were smaller than the control group,and the differences were statistically significant (both P<0.001).The change of IOP in the control group was (-0.23±4.17)mmHg(1 kPa=7.5 mmHg),the atropine group was (0.25±3.81)mmHg,and the outdoor activity group was (0.33±3.72)mmHg，there were no significant differences (F=0.72,P=0.487).All individuals in the atropine group had no intolerable side effects.Conclusion　Topical administration of 0.1 g·L-1 atropine eye drops and increasing outdoor time can effectively control eye axis length and myopia diopter,and there is no significant difference between the two groups in preventing of myopia progression in school-age children.

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备注/Memo

备注/Memo:
浙江省温州市科技局项目（编号：Y20170772）
更新日期/Last Update: 2019-02-18