西藏地区中小学生脊柱弯曲异常状况分析

李尚乐; 张强; 荣霞

doi:10.16835/j.cnki.1000-9817.2021.09.026

西藏地区中小学生脊柱弯曲异常状况分析

doi: 10.16835/j.cnki.1000-9817.2021.09.026

李尚乐¹,
张强²,
荣霞^1, ,

1.
四川大学华西公共卫生学院(华西第四医院)，成都 610041
2.
西藏自治区疾病预防控制中心

详细信息

作者简介:
李尚乐(1996-)，男，甘肃白银人，在读硕士，主要从事于卫生政策相关研究

通讯作者:
荣霞，E-mail：rongrongxia@yeah.net

中图分类号: R 179 G 478 R 726.8
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- 被引次数: 0
出版历程
- 收稿日期: 2021-03-19
- 修回日期: 2021-06-24
- 网络出版日期: 2021-09-24
- 刊出日期: 2021-09-24

Abnormal spinal curvature in primary and secondary school students in Tibet

1.
West China School of Public Health, Sichuan University (West China Fourth Hospital), Chengdu (610041), China

摘要

摘要: 目的了解西藏地区中小学生脊柱弯曲异常的发生率及其影响因素，为制定相关措施提供参考。方法基于2019年西藏自治区学生常见病监测与干预工作，涉及拉萨、日喀则、那曲、昌都、山南市和阿里地区，采用分层随机抽样，每个地级市选取1个城区和1个县，共监测中小学生19 023名。统计分析中小学生脊柱弯曲情况，采用二分类Logistic回归分析其影响因素。结果中小学生脊柱弯曲异常检出人数223人，检出率为1.17%。不同片区、不同性别的学生检出率的差异有统计学意义(χ²值分别为18.01，8.07，P值均 < 0.01)。多因素Logistic回归分析显示，监测点、学段、性别、身高、课桌椅分配符合率、黑板面平均照度是中小学生脊柱弯曲异常的影响因素(OR值分别为5.44，2.17，2.46，1.62，1.02，0.11，1.00，P值均 < 0.05)。结论应从影响因素出发，多种措施并举，减少中小学生脊柱弯曲异常的发生。
- 脊柱弯曲 /
- 患病率 /
- 回归分析 /
- 少数民族 /
- 儿童
Abstract: Objective To monitor the incidence of spinal curvature abnormalities among primary and secondary school students in Tibet, and to analyze the factors influencing spinal curvature abnormalities among primary and secondary school students in Tibet. Methods This study was based on the surveillance and intervention of common diseases among students in Tibet in 2019, involving Lhasa, Shigatse, Nagqu, Chamdo, Shannan and Ali regions, using stratified random sampling, with one urban area and one county selected in each prefecture-level city, and a total of 19 023 primary and secondary school students were monitored. The spinal curvature of primary and secondary school students was statistically analyzed, and the influencing factors were analyzed by dichotomous Logistic regression. Results The number of detected spinal curvature abnormalities in primary and secondary school students was 223, with a detection rate of 1.17%. From the results of the χ² test, the differences in detection rates among students of different districts and gender varied significant (χ²=18.01, 8.07, both P < 0.01). Multivariable Logistic regression showed that monitoring site, school section, gender, height, desk and chair allocation compliance rate, and average illumination of blackboard surface were associated with spinal curvature abnormalities in primary and secondary school students (OR=5.44, 2.17, 2.46, 1.62, 1.02, 0.11, 1.00, all P < 0.05). Conclusion Multiple measures should be taken to reduce the occurrence of spinal curvature abnormalities in primary and secondary school students, starting from the influencing factors.
- Spinal curvatures /
- Prevalence /
- Regression analysis /
- Minority groups /
- Child

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表 1 不同学段中小学生脊柱各段侧弯及前后弯曲异常检出率比较

Table 1. Detection rates of scoliosis and anterior-posterior curvature abnormalities in primary and secondary school students with sections

学段	性别	人数	胸段侧弯	腰胸段侧弯	腰段侧弯	前后弯曲异常
小学	男	6 056	7(0.12)	8(0.13)	10(0.17)	39(0.64)
	女	5 812	17(0.29)	13(0.22)	17(0.29)	43(0.74)
初中	男	1 958	4(0.20)	4(0.20)	4(0.20)	20(1.02)
	女	1 984	4(0.20)	9(0.45)	8(0.40)	9(0.45)
高中(含职高)	男	1 505	2(0.13)	3(0.20)	3(0.20)	5(0.33)
	女	1 708	7(0.41)	13(0.76)	17(1.00)	2(0.12)
Cochran-Mantel-Haenszel检验			4.71^**	6.75^**	9.18^**	0.54
注： **P < 0.01；()内数字为检出率/%。

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表 2 不同人口学特征学生脊柱弯曲异常检出率比较

Table 2. Comparison of the detection rate of spinal curvature abnormalities among students with different demographic characteristics

人口学指标	项目	人数	弯曲异常	χ²值
片区	好片	4 557	76(1.67)	18.01^**
	中片	9 008	106(1.18)
	差片	5 458	41(0.75)
性别	男	9 519	90(0.95)	8.07^**
	女	9 504	133(1.40)
学段	小学	11 868	131(1.10)	1.36
	初中	3 942	52(1.32)
	高中(含职高)	3 213	40(1.24)
注： **P < 0.01；()内数字为检出率/%。

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表 3 西藏地区中小学生脊柱弯曲异常影响因素Logistic回归分析结果(n=19 023)

Table 3. Results of Logistic regression analysis of factors influencing spinal curvature abnormalities in primary and secondary school students in Tibet (n=19 023)

常数与自变量		β值	标准误	P值	OR值(OR值95%CI)
常数			-5.77	1.51	0.00
片区	好片				1.00
	中片	0.02	0.22	0.94	1.02(0.66~1.55)
	差片	-0.40	0.24	0.10	0.67(0.42~1.07)
监测点	城区				1.00
	郊县	1.69	0.24	< 0.01	5.44(3.44~8.90)
学段	小学				1.00
	初中	0.78	0.26	< 0.01	2.17(1.32~3.59)
	高中/职高	0.90	0.31	< 0.01	2.46(1.35~4.51)
性别	男				1.00
	女	0.49	0.14	< 0.01	1.62(1.23~2.15)
身高		0.02	0.01	0.04	1.02(1.00~1.04)
体重		-0.01	0.01	0.38	0.99(0.96~1.01)
人均教室面积		-0.03	0.02	0.15	0.97(0.93~1.00)
课桌椅分配符合率		-2.24	0.50	< 0.01	0.11(0.04~0.27)
黑板面积		-0.23	0.17	0.18	0.80(0.52~1.03)
黑板反射比		-0.07	0.28	0.81	0.93(0.53~1.77)
黑板面平均照度		-0.00	0.00	0.04	1.00(1.00~1.00)
黑板面照度均匀度		-1.29	0.74	0.08	0.27(0.06~1.18)

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