作者：王晓丽，胡俊喜，李国兴 作者单位：新乡医学院第一附属医院眼科，河南 卫辉 453100
【摘要】目的：比较0.05%阿托品滴眼液与0.25%托品酰胺滴眼液预防青少年近视眼效果。方法：对近视可能者158人（302眼）随机分为三组：阿托品组：每晚睡前点用0.05%阿托品滴眼液；托品酰胺组：每晚睡前点用0.25%托品酰胺滴眼液；对照组：每晚睡前点用0.05%呋喃西林滴眼液。定期复查视力、屈光状态、眼轴。结果：①近视眼患病率：两治疗组的患病率均小于对照组，同时阿托品组的患病率较托品酰胺组更少；②用药前后眼轴的变化：阿托品组没有明显的变化，托品酰胺组和对照组均有显著的延长；③畏光症状：用药初期两治疗组均有不同程度的症状，用药2月后症状基本消失。结论：近视可能者坚持每天应用0.05%阿托品滴眼液可以预防近视眼的发生。
【关键词】 阿托品滴眼液 托品酰胺滴眼液 近视 青少年
To compare the effects of preventing myopia by using atropine eyedrop and tropicamide eyedrop in callan
WANG Xiao-li, HU Jun-xi, LI Guo-xing
(The department of Ophthalmology, the first affiliated hospital of Xinxiang medical university, Henan, 453100 China)
【Abstract】 Objective：To compare the effects of preventing myopia by using 0.05% atropine eyedrop and 0.25% tropicamide eyedrop in callan. Methods:158 possible myopia callan (302 eyes) were divided into 3 groups by freedom: atropine group: 0.05% atropine eyedrop was used in every-evening; tropicamide group: 0.25% tropicamide eyedrop was used in every-evening; control group: 0.05% furacilinum eyedrop was used in every-evening. The visual acuity, the estate of refraction and the axial length were examined on time.Results: (1) Morbidity rate of myopia. The two treatment groups were both lower than control group; the atropine group was lower than the tropicamide group; (2) the changes of axial length before and after using eyedrop. There was no evident change in the atropine group; the axial length was obvious prolonged in tropicamide group and control group. (3) The phengophobia symptom. In the initial stages the two treatment groups had difference symptom; after 2 month later the symptom was mostly dismissed.Conclusions: It can prevent myopia by using 0.05% atropine eyedrop every-day in possible myopia callan.
【Key words】Atropine eyedrop; Tropicamide eyedrop; Myopia; Callan
近视眼的发病率在逐年上升，而且向低龄化发展，已成为人们普遍关注的社会问题，一旦形成近视眼，目前除了配戴眼镜、激光手术外还没有有效的方法治疗，所以近视眼关键在于预防，对于儿童近视眼的预防，目前方法很多，但是预防效果不一。我们对一些“近视可能者”用0.25%托品酰胺滴眼液与0.05%阿托品滴眼液点眼，随访观察2年，以便寻找疗效较好、不良反应小的药物，现报告如下。
1 对象及方法
1.1 对象及方法
选12～13岁中学1年级新生中自愿接受试验的“近视可能者”158人, 302眼, 男82人, 女76人, 随机分为3组。阿托品组, 58人(108眼) , 点0.05%阿托品滴眼液（我们医院自己生产，豫药制字 H04070039）; 托品酰胺组, 58人(112眼) ,点0.25%托品酰胺滴眼液；对照组, 42人(82眼) ,点0.05%呋喃西林滴眼液（我们医院自己生产，豫药制字 H04070025）。各组均为每晚睡前点药，每日1次。
1.2 “近视可能者”的筛选
(1)远、近视力≥1.0者作视力负荷试验: 测远视力后, 戴+ 0.50D 球镜再测视力, 若视力表认读减少或上述视力较前模糊者, 评为下降, 初步定为“近视可能者”。(2)散瞳检影: 对上述初定的“近视可能者”点1% 阿托品眼膏，每日中午及晚睡前各一次，连续5天后行视网膜检影，屈光度0～+0.50D 者, 确定为“近视可能者”［1］。
1.3 眼球的生物学测量
在第一次检查和最后一次检查时用眼科超声检查仪测量眼轴长度。
1.4 观察
每半年复查视力1 次, 每年进行屈光状态检查1 次(方法同初查时) , 连续观察2年。
1.5 结果判定标准
屈光度≥-0.25D为近视。
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