摘要
目的探讨0.01%阿托品滴眼液联合框架眼镜对青少年近视控制的价值。方法回顾性选取2019年3月至2021年3月江西医学高等专科学校第一附属医院收治的118例青少年近视患者,根据治疗方法差异分为试验组和对照组,各59例,对照组给予框架眼镜治疗,试验组在此基础上联合0.01%阿托品滴眼液。比较两组患者眼压、泪膜破裂时间、眼轴长度、屈光度、不良反应[角膜上皮点染、结膜炎、畏光不适、角膜感染];试验组经0.01%阿托品滴眼液近视治疗后眼部药物不良反应发生患者纳入发生组,未发生患者纳入未发生组,比较两组患者基础资料。利用受试者工作特征(ROC)曲线分析0.01%阿托品给药时间预测近视治疗后眼部药物不良反应的价值,将两组患者有差异的信息纳入logistic回归分析模型,进行量化赋值,明确0.01%阿托品滴眼液近视治疗后眼部药物不良反应的危险因素。结果两组患者治疗前后眼压、泪膜破裂时间、眼轴长度、屈光度组间及组内比较,差异无统计学意义(P>0.05)。两组患者角膜上皮点染、结膜炎、畏光不适、角膜感染发生率比较,差异无统计学意义(P>0.05)。试验组经0.01%阿托品滴眼液近视治疗后眼部药物不良反应发生患者为8例,将其纳入发生组,未发生患者为51例纳入未发生组;单因素分析结果显示,两组患者年龄、性别、近视家族史比较,差异无统计学意义(P>0.05);0.01%阿托品滴眼液近视治疗后眼部药物不良反应发生率与定期视力检查、营养均衡、良好用眼习惯、给药时间有关,差异有统计学意义(P<0.05)。以0.01%阿托品滴眼液近视治疗后眼部药物不良反应发生为因变量,以单因素分析中有统计学意义的变量为自变量,采用logistic回归模型进行多因素分析,结果显示,未进行定期视力检查(β=0.436,OR=1.547,95%CI=1.186~2.018)、营养不均衡(β=0.555,OR=1.742,95%CI=1.279~2.373)、不良用眼习惯(β=0.393,OR=1.481,95%CI=1.037~2.115)、给药时间长(β=1.432,OR=1.540,95%CI=1.076~2.204)是0.01%阿托品滴眼液近视治疗后眼部药物不良反应发生的独立危险因素(P<0.05)。经ROC分析证实,定期视力检查、营养均衡、用眼习惯、给药时间预测的AUC分别为0.830、0.782、0.862、0.911(P<0.05)。结论0.01%阿托品滴眼液近视治疗后眼部药物不良反应发生的影响因素较多,应规律定期视力检查、保持良好的用眼习惯及严格控制用药时间来获得较好的控制近视效果。
Objective To explore the value of 0.01%Aropine Eye Drops combined with frame glasses in controlling adolescent myopia.Methods A total of 118 adolescent myopia patients admitted to the First Affiliated Hospital of Jiangxi Medical College from March 2019 to March 2021 were selected retrospectively as research objects.According to the different treatment methods,they were divided into experimental group and control group,with 59 cases in each group.The control group was treated with frame glasses,and the experimental group was treated with 0.01%Atropine Eye Drops on the basis of control group.The intraocular pressure,tear film rupture time,axial length,diopter and adverse reactions(corneal epithelial spot dyeing,conjunctivitis,photophobia and corneal infection)were compared between the two groups.Patients with ocular adverse drug reactions after myopia treatment with 0.01%Atropine Eye Drops in the experimental group were included in the occurrence group,and patients without adverse drug reactions were included in the non occurrence group.The basic data of the two groups were compared,receiver operating characteristic(ROC)curve was used to analyze the value of 0.01%Atropine administration time in predicting ocular adverse drug reactions after myopia treatment,and the difference information between the two groups was incorporated into logistic regression analysis model,and the quantitative assignment was made to clarify the risk factors of ocular adverse drug reactions after myopia treatment with 0.01%Atropine Eye Drops.Results There were no significant differences in intraocular pressure,tear film rupture time,axial length and diopter between the two groups before and after treatment(P>0.05).There was no significant difference in the incidence of corneal epithelial staining,conjunctivitis,photophobia and corneal infection between the two groups(P>0.05).In the experimental group,8 patients with eye drug adverse reactions after myopia treatment with 0.01%Atropine Eye Drops were included in the occurrence group,and 51 patients without occurrence were included in the non-occurrence group.Univariate analysis showed that there were no significant differences in age,sex and family history of myopia between the two groups(P>0.05).0.01%Atropine Eye Drops have statistically significant relationship with regular visual inspection,balanced nutrition,good eye habits and administration time(P<0.05).Taking the occurrence of ocular adverse drug reactions after myopia treatment with 0.01%Atropine Eye Drops as dependent variable and statistically significant variables in univariate analysis as independent variables,logistic regression model was used for multivariate analysis.The results showed that no regular visual examination(β=0.436,OR=1.547,95%CI=1.186-2.018),unbalanced nutrition(β=0.555,OR=1.742,95%CI=1.279-2.373),poor eye habit(β=0.393,OR=1.481,95%CI=1.037-2.115),long administration time(β=1.432,OR=1.540,95%CI=1.016-2.204)were the risk factors of ocular adverse drug reactions after myopia treatment with 0.01%Atropine Eye Drops.ROC analysis confirmed that the AUC predicted by regular visual inspection,nutritional balance,eye habits and administration time were 0.830,0.782,0.862 and 0.911 respectively(P<0.05).Conclusion There are many influencing factors of the occurrence of ocular adverse drug reactions after myopia treatment with 0.01%Atropine Eye Drops.We should regularly check the eyesight,keep good eye habits and strictly control the medication time to achieve better control of myopia.
作者
郑蕾
谭大鹏
张敏芝
杨媛媛
金婉卿
ZHENG Lei;TAN Dapeng;ZHANG Minzhi;YANG Yuanyuan;JIN Wanqing(Department of Optometry,the First Affiliated Hospital of Jiangxi Medical College,Jiangxi Province,Shangrao334300,China;Myopia Prevention and Control Specialty,Eye and Optometry Hospital Affiliated to Wenzhou University,Zhejiang Province,Wenzhou325000,China)
出处
《中国当代医药》
CAS
2022年第23期106-110,共5页
China Modern Medicine
基金
江西省卫生健康委科技计划项目(20204879)。
