中学生用眼行为与自我报告近视的关联

王蒙; 陶舒曼; 万宇辉; 伍晓艳; 许韶君; 陶芳标

doi:10.16835/j.cnki.1000-9817.2023.05.013

中学生用眼行为与自我报告近视的关联

doi: 10.16835/j.cnki.1000-9817.2023.05.013

王蒙¹,
陶舒曼^{2, 3, ,},
万宇辉³,
伍晓艳^{1, 3},
许韶君^{1, 3},
陶芳标^{1, 3}

1.
安徽医科大学儿少卫生与妇幼保健学系，合肥 230032
2.
安徽医科大学第二附属医院眼科
3.
出生人口健康教育部重点实验室/安徽人口健康与优生省级实验室

基金项目:

国家自然科学基金项目 82273653

国家重点研发计划 2021YFC2702104

国家重点研发计划 2021YFC2702105

详细信息

作者简介:
王蒙(1998-)，女，安徽淮南人，在读硕士，主要研究方向为儿童青少年健康

通讯作者:
陶舒曼，E-mail：shumantao@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R778.1⁺¹ R179
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- HTML全文浏览量: 117
- PDF下载量: 54
- 被引次数: 0
出版历程
- 收稿日期: 2023-02-16
- 修回日期: 2023-03-06
- 网络出版日期: 2023-05-25
- 刊出日期: 2023-05-25

Association between eye-use behaviors and self-reported myopia in middle and high school students

WANG Meng¹,
TAO Shuman^{2, 3
, ,},
WAN Yuhui³,
WU Xiaoyan^{1, 3},
XU Shaojun^{1, 3},
TAO Fangbiao^{1, 3}

1.
Department of Maternal with Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei(230032), China

摘要

摘要: 目的分析中学生用眼行为与自我报告近视间的关联性，为学生近视防控工作提供科学依据。方法于2015年12月至2016年3月分别选取江西省(南昌市、鹰潭市、德兴市)、辽宁省(沈阳市)、广东省(深圳市)、河南省(郑州市)4个省的14 872名中学生作为调查对象，采用自行编制问卷调查中学生的基本信息、自我报告近视情况以及用眼行为等信息。采用χ²检验比较不同特征中学生自我报告近视率的差异，采用多因素二分类Logistic回归模型分析中学生用眼行为情况与自我报告近视率的关联。结果中学生自我报告近视率为68.5%，其中初中生、高中生分别为59.7%和78.6%。进一步调整混杂因素后，二分类Logistic回归模型分析显示，读写时低头的初、高中生自我报告近视的风险更高(OR值分别为1.94，2.32)；躺着或趴着用眼的初、高中生自我报告近视的发生风险较高(OR值分别为1.27，1.28)；用眼距离(读写距离，眼睛至电视、手机或平板的距离)与初、高中生自我报告近视均呈负相关(OR值分别为0.73，0.70，0.81；0.61，0.66，0.76)(P值均 < 0.01)。此外，眼睛至电脑距离较远的初中生自我报告近视的发生风险较低(OR=0.77，P＜0.01)。结论用眼姿势、用眼距离与中学生自我报告近视存在关联，应积极推进针对近视风险行为因素的健康教育，保障儿童青少年视力健康。
- 眼 /
- 行为 /
- 近视 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the association between eye-use behavior and self-reported myopia in middle and high school students, and provide the scientific basis for the prevention and control of myopia. Methods A total of 14 872 middle and high school students was selected from four provinces and cities from December 2015 to March 2016, including Jiangxi(Nanchang, Yintan, Dexing), Liaoning(Shenyang), Guangdong(Shenzhen), Henan(Zhengzhou) provinces. A self-administrated questionnaire was used to collect the basic information, self-reported myopia and eye-use behaviors among middle and high school students. The Chi-square tests were applied to compare the differences in self-reported myopia among middle and high school students with different characteristics. Multivariate binary Logistic regression models were used to analyze the association between eye-use behavior and self-reported myopia in middle and high school students. Results The self-reported myopia rate of middle and high school students was 68.5%, with 59.7% and 78.6% for junior high school students and senior high school students, respectively. After adjusting for the potential confounders, the Logistic regression models showed that middle and high school students who read and write with their heads down (OR=1.94, 2.32), middle and high school students who lie down or lie on stomach when using their eyes (OR=1.27, 1.28) had a higher risk of self-reported myopia (P < 0.01). There was a negative correlation between eye-use distance (reading and writing distance, distance from eyes to TV, mobile phone, or tablet) and self-reported myopia (OR=0.73, 0.70, 0.81; 0.61, 0.66, 0.76) in middle and high school students (P < 0.01). In addition, the risk of self-reported myopia was lower in middle school students with longer eye-to-computer distance (OR=0.77, P < 0.01). Conclusion There is a significant association between eye-use postures, eye-use distance and self-reported myopia in middle and high school students. Health education for the risk and behavior factors of myopia should be actively promoted to ensure the visual health of children and adolescents.
- Eye /
- Behavior /
- Myopia /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同组别中学生自我报告近视率比较

Table 1. Comparison of the prevalence of self-reported myopia in different groups among middle and high school students

组别	选项	初中				高中
组别	选项	人数	近视报告人数	χ²值	P值	人数	近视报告人数	χ²值	P值
性别	男	4 106	2 262(55.1)	74.29	<0.01	3 576	2 713(75.9)	33.04	<0.01
	女	3 853	2 488(64.6)			3 337	2 721(81.5)
家庭居住地	农村	1 149	633(55.1)	11.76	<0.01	1 458	1 065(73.0)	33.97	<0.01
	城镇	6 810	4 117(60.5)			5 455	4 369(80.1)
地区	江西	2 586	1 471(56.9)	67.27	<0.01	2 138	1 588(74.3)	69.35	<0.01
	辽宁	1 341	855(63.8)			1 164	967(83.1)
	河南	2 630	1 477(56.2)			1 948	1 487(76.3)
	广东	1 402	947(67.5)			1 663	1 392(83.7)
学习日住校	是	1 529	906(59.3)	1.43	0.71	3 701	2 893(78.2)	0.91	0.34
	否	6 430	3 844(59.8)			3 212	2 541(79.1)
父母视力	双亲均不近视	4 966	2 522(50.8)	424.33^*	<0.01	4 361	3 180(72.9)	222.12^*	<0.01
	单亲近视	2 104	1 519(72.2)			1 815	1 577(86.9)
	双亲均近视	889	709(79.8)			737	677(91.9)
独生子女	是	2 717	1 736(63.9)	30.43	<0.01	2 708	2 167(80.0)	5.31	0.02
	否	5 242	3 014(57.5)			4 205	3 267(77.7)
父亲文化程度	小学及以下	968	554(57.2)	27.79^*	<0.01	858	654(76.2)	12.17^*	<0.01
	初中	2 899	1 652(57.0)			2 170	1 676(77.2)
	高中或中专	2 400	1 440(60.0)			2 190	1 726(78.8)
	大专及以上	1 692	1 104(65.2)			1 695	1 378(81.3)
母亲文化程度	小学及以下	1 527	887(58.1)	11.49^*	<0.01	1 485	1 139(76.7)	10.53^*	<0.01
	初中	2 892	1 667(57.6)			2 163	1 672(77.3)
	高中或中专	2 211	1 365(61.7)			1 947	1 558(80.0)
	大专及以上	1 329	831(62.5)			1 318	1 065(80.8)
家庭经济状况	差	619	359(58.0)	0.05^*	0.83	980	726(74.1)	3.59^*	0.06
	中等	5 674	3 412(60.1)			5 122	4 082(79.7)
	好	1 666	979(58.8)			811	626(77.2)
平均每天户外活动	＜2	4 044	2 422(59.9)	0.15^*	0.70	4 162	3 269(78.5)	0.02^*	0.88
时间/h	≥2	3 915	2 328(59.5)			2 751	2 165(78.7)
注：*为χ_趋势²值，()内数字为报告率/%。

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表 2 不同用眼行为中学生自我报告近视率比较

Table 2. Comparison of the prevalence of self-reported myopia in different eye-use behaviors among middle and high school students

用眼行为	选项	初中				高中
用眼行为	选项	人数	近视报告人数	χ²值	P值	人数	近视报告人数	χ²值	P值
读书写字时低头	否	2 263	1 058(46.8)	219.66	<0.01	1 724	1 154(66.9)	185.94	<0.01
	是	5 696	3 692(64.8)			5 189	4 280(82.5)
读写时翘二郎腿	否	3 859	2 194(56.9)	24.88	<0.01	2 449	1 877(76.6)	8.68	<0.01
	是	4 100	2 556(62.3)			4 464	3 557(79.7)
躺着或趴着用眼	否	1 544	838(54.3)	23.27	<0.01	870	645(74.1)	11.81	<0.01
	是	6 415	3 912(61.0)			6 043	4 789(79.2)
学习日做家庭作业时间/(h·d^-1)	<2	5 002	2 811(56.2)	67.88	<0.01	2 487	1 895(76.2)	13.41	<0.01
	≥2	2 957	1 939(65.6)			4 426	3 539(80.0)
学习日视屏时间/(h·d^-1)	<2	6 674	3 977(59.6)	1.44	0.71	5 612	4 395(78.3)	1.50	0.22
	≥2	1 285	773(60.2)			1 301	1 039(79.9)
周末家庭作业时间/(h·d^-1)	<2	4 012	2 233(55.7)	54.40	<0.01	3 094	2 334(75.4)	33.44	<0.01
	≥2	3 947	2 517(63.8)			3 819	3 100(81.2)
周末视屏时间/(h·d^-1)	<2	4 397	2 620(59.6)	0.04	0.85	3 653	2 891(79.1)	1.32	0.25
	≥2	3 562	2 130(59.8)			3 260	2 543(78.0)
读书写字/cm	<33	6 372	3 894(61.1)	27.16	<0.01	5 198	4 204(80.9)	64.29	<0.01
	≥33	1 587	856(53.9)			1 715	1 230(71.7)
眼睛至电视的距离/m	<3	4 289	2 724(63.5)	56.71	<0.01	3 641	2 974(81.7)	43.26	<0.01
	≥3	3 670	2 026(55.2)			3 272	2 460(75.2)
眼睛至电脑的距离/cm	<50	7 181	4 331(60.3)	12.16	<0.01	6 029	4 759(78.9)	3.05	0.08
	≥50	778	419(53.9)			884	675(76.4)
眼睛至手机或平板的距离/cm	<25	5 742	3 513(61.2)	19.27	<0.01	4 713	3 787(80.4)	26.86	<0.01
	≥25	2 217	1 237(55.8)			2 200	1 647(74.9)
()内数字为报告率/%。

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表 3 中学生用眼行为与自我报告近视关系的多因素二分类Logistic回归模型分析[OR值(OR值95%CI)]

Table 3. Multivariate binary Logistic regression model analysis of the relationship between eye-use behaviors and self-reported myopia among middle and high school students[OR(OR 95%CI)]

自变量	选项	初中(n=7 959)		高中(n=6 913)
自变量	选项	模型1	模型2	模型1	模型2
读书写字时低头	否	1.00	1.00	1.00	1.00
	是	2.03(1.83~2.25)^*	1.94(1.75~2.16)^*	2.36(2.08~2.68)^*	2.32(2.04~2.64)^*
读写时翘二郎腿	否	1.00	1.00	1.00	1.00
	是	1.16(1.06~1.28)^*	1.14(1.04~1.25)^*	1.12(1.00~1.91)	1.09(0.97~1.24)
躺着或趴着用眼	否	1.00	1.00	1.00	1.00
	是	1.29(1.15~1.45)^*	1.27(1.13~1.43)^*	1.27(1.08~1.92)^*	1.28(1.08~1.53)^*
学习日做家庭作业时间/(h·d^-1)	<2	1.00	1.00	1.00	1.00
	≥2	0.98(0.90~1.08)	1.03(0.94~1.14)	0.95(0.84~1.06)	0.92(0.82~1.04)
学习日视屏时间/(h·d^-1)	<2	1.00	1.00	1.00	1.00
	≥2	1.03(0.91~1.17)	1.01(0.89~1.14)	1.20(0.94~1.28)	1.16(1.00~1.36)
周末家庭作业时间/(h·d^-1)	<2	1.00	1.00	1.00	1.00
	≥2	1.01(0.93~1.11)	1.07(0.97~1.17)	1.00(0.89~1.24)	0.97(0.86~1.10)
周末视屏时间/(h·d^-1)	<2	1.00	1.00	1.00	1.00
	≥2	1.02(0.93~1.12)	1.00(0.91~1.10)	0.93(0.83~1.05)	0.94(0.84~1.06)
读书写字/cm	<33	1.00	1.00	1.00	1.00
	≥33	0.73(0.65~0.81)^*	0.73(0.65~0.83)^*	0.61(0.54~0.69)^*	0.61(0.53~0.69)^*
眼睛至电视的距离/m	<3	1.00	1.00	1.00	1.00
	≥3	0.70(0.64~0.77)^*	0.70(0.64~0.77)^*	0.66(0.59~0.75)^*	0.66(0.58~0.74)^*
眼睛至电脑的距离/cm	<50	1.00	1.00	1.00	1.00
	≥50	0.76(0.65~0.88)^*	0.77(0.66~0.90)^*	0.88(0.75~1.05)	0.89(0.75~1.06)
眼睛至手机或平板的距离/cm	<25	1.00	1.00	1.00	1.00
	≥25	0.80(0.73~0.89)^*	0.81(0.73~0.90)^*	0.75(0.66~0.85)^*	0.76(0.67~0.86)^*
注：*P<0.01。

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