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三种M受体阻滞剂对成年近视患者调节及像差的影响

发布时间:2018-09-01 07:43
【摘要】:第一部分三种M受体阻滞剂对成年近视患者调节的影响 目的探讨三种M受体阻滞剂对成年近视患者调节的影响。 方法自身对照研究。选取19名成年近视患者作为受试者,每位受试者分次滴2.5%洁霉素及三种M受体阻滞剂:1%盐酸环喷托酯、0.05%消旋山莨菪碱、0.5%托吡卡胺,2.5%洁霉素作为对照,两次用药至少间隔4天作为药物洗脱期。给药方法:滴双眼(先右眼后左眼,双眼间隔5分钟);每只眼睛滴药两次,两次滴药间隔5分钟,每次一滴。于滴药前及滴药后的10、20、30、45、60、75、90、120分钟采用Topcon电脑验光仪在暗室内测量药物干预前后受试者的瞳孔直径,在综合验光仪上采用负镜法测量药物干预前后的受试者右眼的调节幅度。使用SAS9.2统计软件对4种药物干预后的瞳孔直径及调节幅度进行方差分析,对1%盐酸环喷托酯及0.5%托吡卡胺干预后的最小调节幅度进行t检验,对0.05%消旋山莨菪碱及2.5%洁霉素干预后的最小调节幅度进行t检验。P0.05有统计学意义。 结果1、散瞳作用:滴用1%盐酸环喷托酯滴眼液及0.5%托吡卡胺滴眼液后120分钟瞳孔散至最大,与给药前相比瞳孔直径分别增大(1.34±0.81)mm及(1.59±0.89)mm,滴用0.05%消旋山莨菪碱滴眼液10分钟后瞳孔直径缩小,45分钟后瞳孔开始散大,120分钟后散至最大,与给药前相比瞳孑孔直径增大(0.63±0.30)mm,滴用2.5%洁霉素后瞳孔直径较给药前缩小,滴药后10分钟瞳孔直径最小较给药前缩小(0.27±0.15)mm,方差分析4种药物干预后不同时间点的瞳孔直径发现4种药物之间差别具有统计学意义(P0.05)。2、睫状肌麻痹作用:1%盐酸环喷托酯滴眼液干预后10分钟开始起效,60分钟调节幅度为(2.01±1.20)D,120分钟调节幅度最小为(1.67±0.85)D, 0.5%托吡卡胺滴眼液干预后10分钟开始起效,30分钟调节幅度最小为(1.94±0.72)D,60分钟调节幅度为(2.05±0.70)D,睫状肌麻痹作用开始减弱,120分钟调节幅度为(3.75±1.52)D,t检验分析干预后的最小调节幅度2种药物之间差别无统计学意义。0.05%消旋山莨菪碱滴眼液干预后的最小调节幅度为(9.48±2.21)D,2.5%洁霉素眼液干预后的最小调节幅度为(9.56±3.28)D,t检验分析干预后的最小调节幅度2种药物之间差别无统计学意义。 结论1.1%盐酸环喷托酯滴眼液对于成年近视患者的睫状肌麻痹效果并不明显优于0.5%托吡卡胺,但其睫状肌麻痹作用持续时间较长,适用于等待时间超过1小时的近视患者睫状肌麻痹验光。2.0.05%消旋山莨菪碱滴眼液有散瞳作用,无明显的睫状肌麻痹作用。 第二部分三种M受体阻滞剂对成年近视患者像差的影响 目的探讨三种M受体阻滞剂对成年近视患者像差的影响。 方法自身对照研究。选取12名成年近视患者作为受试者,每位受试者分次滴2.5%洁霉素及三种M受体阻滞剂:1%盐酸环喷托酯、0.05%消旋山莨菪碱、0.5%托吡卡胺,2.5%洁霉素作为对照,两次用药至少间隔4天作为药物洗脱期。给药方法:滴双眼(先右眼后左眼,双眼间隔5分钟);每只眼睛滴药两次,两次滴药间隔5分钟,每次一滴。于滴药前及滴药后的30分钟应用Schwind波前像差仪检查药物干预眼的全眼像差,提取瞳孔分析直径4.0mm、5.0mm、6.0mm时的像差值,比较4种药物干预前后及4种药物之间在总像差(RMSg)、总高阶像差(RMSh)、3阶、4阶像差的均方根(RMS)值及球差、彗差等方面的差异。采用SAS 9.2统计分析软件对数据进行方差分析。P0.05有统计学意义。 结果1、随着瞳孔分析直径增大,总像差(RMSg)、总高阶像差(RMSh)、3阶、4阶像差的均方根(RMS),彗差,球差均增加,方差分析发现除洁霉素干预后的球差外其余各项像差值的差别具有统计学意义(P0.05)。2、瞳孔分析直径为6mm时,药物干预前球差为(0.07±0.11)u m,1%盐酸环喷托酯干预后、0.5%托吡卡胺干预后、0.05%消旋由莨菪干预后及2.5%洁霉素干预黄后球差分别为(0.10±0.10)μm、(0.08±0.11)u m、(0.07±0.12)μm、(0.05±0.12)μm,1%盐酸环喷托酯及0.5%托吡卡胺药物干预后球差向正向方向增大,0.05%消旋山莨菪碱干预后球差无明显变化,方差分析比较药物干预前及4种药物干预后的球差显示差异无统计学意义。 结论成年近视患者准分子激光术术前应用1%盐酸环喷托酯眼液或0.5%托吡卡胺眼液散瞳时,应注意其对像差特别是球差的影响。
[Abstract]:Part 1 the effects of three M receptor blockers on the regulation of adult myopia
Objective to investigate the effects of three M receptor blockers on the regulation of adult myopia.
Methods A self-controlled study was conducted in 19 adult myopic patients. Each subject was given 2.5% lincomycin and three M-receptor blockers: 1% cyclopentolate hydrochloride, 0.05% racemic anisodamine, 0.5% topicamide, and 2.5% lincomycin at least 4 days intervals for elution. The pupil diameter of the subjects before and after the drug intervention was measured by Topcon computer refractometer in the darkroom, and the pupil diameter of the subjects before and after the drug intervention was measured by negative lens on the comprehensive refractometer. Adjustment amplitude of right eye was measured before and after intervention. The pupil diameter and adjustment amplitude were analyzed by SAS 9.2 statistical software. The minimum adjustment amplitude after 1% cyclopentolate hydrochloride and 0.5% topicamide intervention was tested by t test. The minimum adjustment amplitude after 0.05% anisodamine and 2.5% lincomycin intervention was tested. .P0.05 was statistically significant in t test.
Result 1. Mydriasis: After 1% cyclopentolate hydrochloride eye drops and 0.5% topicamide eye drops, the pupil size was maximal at 120 minutes. Compared with before administration, the pupil diameter was increased by (1.34 0.81) mm and (1.59 0.89) mm respectively. After 10 minutes, the pupil diameter of 0.05% racemic Anisodamine Eye Drops decreased, and after 45 minutes, the pupil began to dilate, and at 120 minutes, respectively. The pupil diameter increased (0.63 (P 0.05).2, ciliary muscle paralysis: 1% cyclopentolate hydrochloride eye drops began to take effect 10 minutes after intervention, the regulation range of 60 minutes was (2.01 (1.20) D, the regulation range of 120 minutes was (1.67 (0.85) D, 0.5% tropicamide eye drops began to take effect 10 minutes after intervention, the regulation range of 30 minutes was (1.94 (0.72) D, and the regulation range of 60 minutes was (1.94 (0.72) D). (2.05 [0.70] D, the effect of ciliary paralysis began to weaken, the regulatory range of 120 minutes was (3.75 [1.52] D, t test analysis showed that there was no significant difference between the minimum regulatory range after intervention between the two drugs. T test showed that there was no significant difference between the two drugs in the minimum amplitude of regulation after intervention.
Conclusion 1.1% cyclopentolate hydrochloride eye drops are not superior to 0.5% tropicamide in the treatment of adult myopic patients with ciliary muscle paralysis, but the effect of cyclopentolate hydrochloride eye drops on ciliary muscle paralysis lasts longer. 2.0.05% racemic Anisodamine Eye Drops are suitable for myopic patients with ciliary muscle paralysis who wait longer than 1 hour. Ciliary paralysis.
The second part: the influence of three M blockers on the aberrations of adult myopia patients.
Objective to investigate the effects of three M receptor blockers on aberrations in adult myopia patients.
Methods A self-controlled study was conducted in 12 adult myopic patients. Each subject was given 2.5% lincomycin and three M-receptor blockers: 1% cyclopentolate hydrochloride, 0.05% racemic anisodamine, 0.5% topicamide and 2.5% lincomycin at least 4 days intervals for elution. The whole eye aberrations of the drug-treated eyes were examined by Schwind wavefront aberration meter before and 30 minutes after the drug-treated eyes were dripped, and the aberrations of the pupils with diameters of 4.0mm, 5.0mm and 6.0mm were extracted and analyzed. Differences in total aberration (RMSg), total higher order aberration (RMSh), root mean square (RMS) values of third and fourth order aberrations, spherical aberration, coma, etc. were analyzed by statistical analysis software SAS 9.2. There was statistical significance in P 0.05.
Results 1. With the increase of pupil diameter, RMSg, RMSh, RMS, coma and spherical aberration, the difference of all the aberrations except for the spherical aberration after the intervention was statistically significant (P 0.05). 2. When the pupil diameter was 6 mm, the spherical aberration before the intervention was (0.05). After intervention with 1% cyclopentolate hydrochloride, 0.5% tropicamide, 0.05% racemic after intervention with scopolamine and 2.5% lincomycin, the spherical aberration was (0.10 + 0.10) micron, (0.08 + 0.11) micron, (0.07 + 0.12) micron, (0.05 + 0.12) micron, 1% cyclopentolate hydrochloride and 0.5% tropicamide, respectively, and the spherical aberration was positively increased with 0.05% racemic intervention. There was no significant change in spherical aberration after the intervention of anisodamine. There was no significant difference in spherical aberration before and after the intervention of four drugs by ANOVA.
Conclusion The effect of 1% cyclopentolate hydrochloride eye drops or 0.5% topicamide eye drops on astigmatism, especially spherical aberration, should be paid attention to in adult myopia patients before excimer laser surgery.
【学位授予单位】:复旦大学
【学位级别】:硕士
【学位授予年份】:2011
【分类号】:R779.63

【参考文献】

相关期刊论文 前7条

1 刘念;陈少芳;李赛群;聂昊辉;钟兴武;;国产盐酸环喷托酯滴眼液和托吡卡胺对眼睫状肌麻痹效果的比较研究[J];国际眼科杂志;2007年06期

2 姚润莲;艾育德;阿拉腾其木格;;盐酸环喷托酯对儿童睫状肌麻痹效果的观察[J];国际眼科杂志;2010年01期

3 马鲁新,潘秀华,鲁凤菊;透明晶体摘除联合人工晶体植入术后术眼波前像差的变化及意义[J];山东医药;2004年12期

4 金红颖,王勤美,王丹梅,孟觉天;角膜屈光手术对眼波前像差的影响[J];中华眼科杂志;2003年06期

5 褚仁远,瞿小妹;应当重视波前像差的应用研究[J];中华眼科杂志;2004年01期

6 于靖,陈辉,胡健艳,荀鹏程;三种常用散瞳剂对人眼像差的影响[J];中华眼科杂志;2005年09期

7 张丽;李镜海;刘兆强;;调节放松及调节状态人眼波前像差的研究[J];眼视光学杂志;2008年01期



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