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随着近视患病率以及高度近视患病率的逐年上升,青少年近视防控方法倍受关注.阿托品作为较早用于控制近视的药物,其临床效果已在循证医学方法中得到肯定,但是其作用机制不明.研究发现,阿托品抑制实验性近视进展的作用部位可能并不与睫状肌调节相关,或睫状肌并非主要作用靶点.目前阿托品近视控制机制的研究多关注在视网膜和巩膜.近年来应用高选择性毒蕈碱样(M)受体拮抗剂及其他药物的联合应用发现,阿托品控制近视进展可能与多个M受体相关,同时与多巴胺分泌、γ-氨基丁酸能通路蛋白改变、一氧化氮(N0)生成、早期生长反应(EGR)-1表达、巩膜蛋白改变等相关.本文就阿托品在实验性近视眼中发挥控制近视作用的作用部位,与胆碱能通路、多巴胺能通路、γ-氨基丁酸能通路、NO分泌、EGR-1表达、巩膜重塑过程等的关系进行综述,并对阿托品控制近视作用的研究进行展望.“,”The prevalence of myopia and high myopia has gradually increased,increased myopia is associated with an enhanced risk of pathological ocular complications and may lead to blinding disorders.The optometrists and parents initially pay more attention to juvenile myopia prevention and control.Atropine is the previous drug used to control myopia,and the evidence-based medicine has corroborated its clinical effect.However,its mechanism has been undetermined yet.It has been reported that the effective locations of atropine in inhibiting experimental myopia may be not related to the accommodation of ciliary muscle or the ciliary muscle is not the primary target,more and more attention is currently focused on the retina and sclera.Recently,the application of the highly selective muscarinic receptor antagonists and the combination of other drugs have been found that atropine exerts its myopia-controlling effect may be linked to multiple M receptors,and with the secretion and expression of dopamine,nitric oxide (NO),early grow response (EGR)-1,the protein change of the sclera and γ-aminobutyric acid (GABA) ergic signaling pathway.This paper reviewed the atropine on controlling experimental myopia in effective locations and its relationship with the cholinergic pathway,the dopamine pathway,the GABA pathway,the secretion of NO,the expression of EGR-1,and the process of scleral remodeling,hence offers the prospects for the study of atropine in myopia control.