發(fā)布時(shí)間：2018-03-21 03:33

  本文選題：非選擇性M受體阻滯劑　切入點(diǎn)：托吡卡胺　出處：《復(fù)旦大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：第一部分三種非選擇性M受體阻滯劑對(duì)豚鼠形覺剝奪性近視的影響 目的：探討非選擇性M受體阻滯劑在豚鼠形覺剝奪性近視中的作用。 材料和方法：將2～3周齡英國種短毛花色豚鼠60只,隨機(jī)分為6組,每組10只：Ⅰ組單純形覺剝奪組、Ⅱ組形覺剝奪+生理鹽水組即陰性治療組、Ⅲ組形覺剝奪+托吡卡胺組、Ⅳ組形覺剝奪+環(huán)戊通組、Ⅴ組形覺剝奪+阿托品組、Ⅵ組正常對(duì)照組。Ⅰ組僅右眼采用半透明眼罩進(jìn)行形覺剝奪；Ⅱ～Ⅴ組右眼采用半透明眼罩進(jìn)行形覺剝奪,相應(yīng)每組豚鼠右眼分別給予玻璃體腔注射0.9%生理鹽水、0.5%托吡卡胺、1%環(huán)戊通和0.5%阿托品,每次10μl,每4天注射1次,共7次；Ⅵ組豚鼠雙眼開放飼養(yǎng)。所有豚鼠左眼均作為自身對(duì)照。屈光度測(cè)量采用睫狀肌麻痹后帶狀光檢影；A超測(cè)量前房深度、晶體厚度和眼軸長度,算出玻璃體腔長度；干預(yù)后游標(biāo)卡尺測(cè)量離體眼球前后徑。組內(nèi)采用配對(duì)t檢驗(yàn),組間采用單因素方差分析(ANOVA),玻璃體腔長度差值和眼軸差值采用線性回歸分析。以P0.05作為差異有統(tǒng)計(jì)學(xué)意義的標(biāo)準(zhǔn)。 結(jié)果：形覺剝奪4周后,Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ組實(shí)驗(yàn)眼分別誘導(dǎo)出-5.11±1.78D、-5.75±2.27D、-5.50±1.47D、-4.20±2.06D和-2.13±0.48D相對(duì)近視；Ⅵ組相對(duì)近視量分別與Ⅰ、Ⅱ、Ⅲ、Ⅳ組存在統(tǒng)計(jì)學(xué)差異(P0.0001,P0.0001,P0.0001,P0.0001)。Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ組實(shí)驗(yàn)眼玻璃體腔比對(duì)側(cè)眼分別延長0.2907±0.1358mm、0.2886±0.0946mm、0.1208±0.1867mm、0.2259±0.2814mm和0.1268±0.1540mm；6組間實(shí)驗(yàn)眼與對(duì)側(cè)眼的玻璃體腔長度差值無統(tǒng)計(jì)學(xué)意義。Ⅰ、Ⅱ、Ⅲ、Ⅳ和Ⅴ組實(shí)驗(yàn)眼眼軸比對(duì)側(cè)眼分別延長0.2083±0.0758mm、0.2829±0.0765mm、0.0904±0.1740mm、0.0969±0.0647mm和0.0923±0.1304mm；Ⅵ組實(shí)驗(yàn)眼和對(duì)側(cè)眼眼軸差值分別與Ⅰ、Ⅱ組有統(tǒng)計(jì)學(xué)差異(P=0.003,P0.0001),分別與Ⅲ、Ⅳ、Ⅴ組無統(tǒng)計(jì)學(xué)差異。6組實(shí)驗(yàn)眼與對(duì)側(cè)眼玻璃體腔長度差值和眼軸長度差值呈顯著正相關(guān)(r=0.685,P0.0001)。游標(biāo)卡尺所測(cè)離體眼球前后徑(8.43±0.26mm)顯著大于A超所測(cè)活體眼軸長度值(8.09±0.12mm)(P0.0001)。 結(jié)論：三種非選擇性M受體阻滯劑均可減少豚鼠形覺剝奪性近視眼的眼軸延長；豚鼠形覺剝奪后玻璃體腔長度與眼軸長度的增加一致；游標(biāo)卡尺法的眼軸測(cè)量值大于A超法測(cè)量值。 第二部分近視兒童應(yīng)用0.05%消旋山莨菪堿的臨床觀察 目的：探討非選擇性M受體阻滯劑消旋山莨菪堿對(duì)兒童近視的控制作用。 對(duì)象與方法：復(fù)旦大學(xué)附屬眼耳鼻喉科醫(yī)院視光中心門診的近視兒童中選擇合理期待并簽署知情同意書的93名學(xué)齡兒童,符合以下條件：①6～14歲；②球鏡范圍為-0.50DS～-6.OODS,散光≤1.50DC；③雙眼屈光間質(zhì)清；④排除眼部器質(zhì)性疾病。被試兒童分為藥物干預(yù)組(n=50)和對(duì)照組(n=43)：①藥物干預(yù)組兒童滴用0.05%消旋山莨菪堿眼液,每晚睡前使用1次,使用1年；②對(duì)照組兒童不給予任何近藥物。藥物干預(yù)組平均年齡為9.94±1.97歲,對(duì)照組為10.64±1.52歲；藥物干預(yù)組平均等效球鏡和眼軸長度分別為-2.14±1.60D和24.23±0.80mm,對(duì)照組為-2.28±0.78D和24.59±0.72mm。隨訪期為1年,每半年隨訪1次,給予主覺驗(yàn)光(?)(?)IOL Master測(cè)量眼軸長度。兩組兒童不同時(shí)間點(diǎn)等效球鏡和眼軸長度采用獨(dú)立樣本t檢驗(yàn)。以P0.05作為差異有統(tǒng)計(jì)學(xué)意義的標(biāo)準(zhǔn)。 結(jié)果：6個(gè)月、12個(gè)月時(shí)藥物干預(yù)組平均等效球鏡分別為-2.60±1.69D、-3.35±1.40D,對(duì)照組分別為-2.64±0.82D、-3.09±0.90D,兩組間差異均無統(tǒng)計(jì)學(xué)意義(P=0.99,P=0.17)。藥物干預(yù)組平均等效球鏡分別增加-0.47±0.75D、-0.42±1.16D,對(duì)照組分別增加-0.33±0.37D、-0.45±0.35D,兩組間差異無統(tǒng)計(jì)學(xué)意義(P=0.11,P=0.79)。6個(gè)月、12個(gè)月時(shí)藥物干預(yù)組平均眼軸長度為24.52±0.80mm、24.97±0.76mm,對(duì)照組分別為24.75±0.72mm、24.88±0.74mm,兩組間差異均無統(tǒng)計(jì)學(xué)意義(P=0.06,P=0.55)。藥物干預(yù)組平均眼軸長度分別增加0.30±0.34mm、0.25±0.14mm,對(duì)照組分別增加0.17±0.10mm、0.12±0.09mm,兩組間差異均有統(tǒng)計(jì)學(xué)意義(P0.001,P0.001)。 結(jié)論：0.05%消旋山莨菪堿對(duì)兒童近視進(jìn)展和眼軸延長的控制作用不明顯；0.05%消旋山莨菪堿在部分兒童中的潛在有效性有待進(jìn)一步探討。
[Abstract]:The effect of three non selective M receptor blockers on form deprivation myopia in guinea pigs
Objective: To investigate the role of non selective M receptor blockers in the form deprivation myopia of guinea pigs.
Materials and methods: 2~3 week old British Shorthair color for 60 guinea pigs were randomly divided into 6 groups, 10 rats in each group: group I simplex deprivation group, group II deprivation + saline group: negative treatment group, III group deprivation + tropicamide group, group IV deprivation + cyclopentasiloxane the group V group form deprivation group VI + atropine group, normal control group. Group I only used translucent goggles for eye form deprivation; II to V group the right eyes of the translucent goggles for form deprivation, each group were given corresponding guinea pig right after intravitreal injection of 0.9% saline, 0.5% tropicamide and cyclopentolate 1%. 0.5% atropine, each 10 L, 1 injections every 4 days, a total of 7 times; VI group open eyes of guinea pigs. All guinea pigs were reared as control group. The left eye diopter measured by streak retinoscopy after cycloplegia; A ultrasound in measuring anterior chamber depth, thickness and axial length of crystal, Calculate the length of vitreous; after the intervention of vernier caliper to measure the eyeball in vitro. The group using paired t test, single factor analysis of variance between the groups (ANOVA), vitreous cavity length difference and axial difference using linear regression analysis. The difference was statistically significant with P0.05 as the standard.
Results: after 4 weeks of form deprivation, I, II, III, IV and V groups eyes were induced to -5.11 + 1.78D, -5.75 + 2.27D, -5.50 + 1.47D, -4.20 + 2.06D and -2.13 + 0.48D relative myopia; VI group relative myopic quantity and I, II, III, IV group, there was significant difference (P0.0001, P0.0001, P0.0001, P0.0001). I, II, III, IV and V groups extend into the vitreous side on the eyes of 0.2907 + 0.1358mm, 0.2886 + 0.0946mm, 0.1208 + 0.1867mm, 0.2259 + 0.2814mm and 0.1268 + 0.1540mm; the difference between the 6 groups of experimental vitreous length and the contralateral eyes without statistical significance. I, II, III, IV and V of experimental group prolonged ocular axial ratio lateral eye 0.2083 + 0.0758mm, 0.2829 + 0.0765mm, 0.0904 + 0.1740mm, 0.0969 + 0.0647mm and 0.0923 + 0.1304mm; VI group of experimental eyes and the contralateral eye axial difference respectively with I, II group was significantly different (P=0.003, P0.0001), respectively. III, IV, V group was positively related to no significant difference in the.6 group of experimental eyes and contralateral vitreous length difference and axial length difference (r=0.685, P0.0001). In vitro measured by vernier caliper eyeball (8.43 + 0.26mm) was significantly higher than that measured by in vivo A super axial length value (8.09. 0.12mm) (P0.0001).
Conclusion: three kinds of non selective M receptor blockers can reduce the axial lengthening of form deprivation myopia in guinea pigs. After the form deprivation in guinea pigs, the length of vitreous cavity is consistent with the increase of axial length. The axial measurement value of vernier caliper is larger than that of A.
Clinical observation on the application of 0.05% racemic anisodamine in second parts of myopic children
Objective: To investigate the control effect of non selective M receptor blocker racemic anisodamine on children's myopia.
Subjects and methods: select 93 school-age children of reasonable expectation and signed the informed consent of the Otolaryngological Hospital Affiliated to Fudan University outpatient optometry center of myopic children, meet the following conditions: 6~14 years old; the mirror ball is in the range of -0.50DS ~ -6.OODS, astigmatism less than 1.50DC; the refraction of interstitial Qing; the exclusion of ocular disease subjects. The children were divided into intervention group (n=50) and control group (n=43): drug intervention group children eye drops by 0.05% racanisodamine, every night before going to bed 1 times, 1 years; the control group not given any drug in drug intervention group. The average age was 9.94 + 1.97 years, control group 10.64 + 1.52 years; the drug intervention group average spherical equivalent and axial length were -2.14 + 1.60D and 24.23 + 0.80mm, the control group was -2.28 + 0.78D and 24.59 + 0.72mm. were followed up for a period of 1 years, every six months follow-up of 1 times, giving the main Jue Yanguang (IOL) Master measured the length of eye axis. The two groups of children were measured by the independent sample t test at different time points, and the P0.05 was used as a standard with statistically significant difference.
Results: 6 months, 12 months of drug intervention group average spherical equivalent were -2.60 + 1.69D, -3.35 + 1.40D, the control group was -2.64 + 0.82D, -3.09 + 0.90D, the difference between the two groups were not statistically significant (P=0.99, P=0.17). The drug intervention group the average spherical equivalent were increased -0.47. 0.75D, -0.42 + 1.16D, the control group increased in -0.33 + 0.37D, -0.45 + 0.35D, there was no significant difference between the two groups (P=0.11, P=0.79).6 months, 12 months of drug intervention group the mean axial length was 24.52 + 0.80mm, 24.97 + 0.76mm, the control group were 24.75 + 0.72mm, 24.88 + 0.74mm, the difference between the two groups were not statistically significant (P=0.06, P=0.55). The drug intervention group the mean axial length increased 0.30 + 0.34mm, 0.25 + 0.14mm, the control group were increased to 0.17 + 0.10mm, 0.12 + 0.09mm, there were significant differences between two groups (P0.001, P0.001).
Conclusion: 0.05%. The control effect of racanisodamine on myopia progression and axial lengthening in children is not obvious. 0.05%, the potential effectiveness of racanisodamine in some children needs further investigation.

【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R778.11

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 任亞琳;林郁;黃玉敏;曾駿文;;中山市小學(xué)生近視年患病率和發(fā)病率的流行病學(xué)調(diào)查[J];國際眼科雜志;2010年11期

2 董文娟;;消旋山莨菪堿滴眼液防治兒童假性近視的療效分析[J];山西醫(yī)藥雜志(下半月刊);2011年07期

3 王淑華 ,鄭海濤,衛(wèi)玉榮,張金嵩;阿托品抑制形覺剝奪性近視的作用機(jī)制[J];眼科新進(jìn)展;2002年05期

4 楊穎;周行濤;李濤;劉紅;;消旋山莨菪堿對(duì)豚鼠形覺剝奪性近視的作用和安全性[J];中國眼耳鼻喉科雜志;2011年05期

5 宋前方;宋前流;陳幼蓓;章微微;;阿托品治療近視眼患者的視覺電生理觀察[J];中國中醫(yī)眼科雜志;2007年01期

6 楊穎;李濤;陳志;周行濤;;球結(jié)膜下注射不同濃度消旋山莨菪堿液對(duì)雛雞形覺剝奪近視眼軸的影響[J];中國實(shí)驗(yàn)動(dòng)物學(xué)報(bào);2011年04期

7 李元元;楊靈萍;盧奕峰;;阿托品滴眼液干預(yù)青少年初發(fā)近視的5年縱向分析[J];中國斜視與小兒眼科雜志;2007年03期

8 歐陽朝祜,褚仁遠(yuǎn),胡文政;哌侖西平對(duì)豚鼠透鏡誘導(dǎo)性近視眼的作用[J];中華眼科雜志;2003年06期

9 樂琦驊;褚仁遠(yuǎn);吳偉;;哌侖西平滴眼液治療豚鼠形覺剝奪性近視[J];眼視光學(xué)雜志;2006年02期

10 戴怡康;吳偉;褚仁遠(yuǎn);;哌侖西平眼部離子導(dǎo)入治療近視的藥效學(xué)研究[J];眼視光學(xué)雜志;2008年04期

，

本文編號(hào)：1642074