天津市特殊教育学校学生筛查性近视现状及相关因素

席薇; 韩慧; 熊文娟; 韩钰; 王慧; 张欣

doi:10.16835/j.cnki.1000-9817.2025051

天津市特殊教育学校学生筛查性近视现状及相关因素

doi: 10.16835/j.cnki.1000-9817.2025051

席薇¹,
韩慧²,
熊文娟¹,
韩钰¹,
王慧¹,
张欣^1, ,

1.
天津医科大学公共卫生学院, 天津 300070
2.
蚌埠医科大学公共卫生学院

基金项目:

国家自然科学基金项目 82273655

天津市教委科研计划项目 2020KJ201

详细信息

作者简介:
席薇(1970-)，女，山西太原人，博士，讲师，主要研究方向为儿童少年身心健康

通讯作者:
张欣，E-mail：zhangxin@tmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G627.8 R778.1⁺¹ G479
计量
- 文章访问数: 52
- HTML全文浏览量: 38
- PDF下载量: 25
- 被引次数: 0
出版历程
- 收稿日期: 2024-08-13
- 修回日期: 2024-09-12
- 网络出版日期: 2025-04-03
- 刊出日期: 2025-03-25

Prevalence and related factors of screening myopia among students in special education schools in Tianjin

XI Wei¹,
HAN Hui²,
XIONG Wenjuan¹,
HAN Yu¹,
WANG Hui¹,
ZHANG Xin^{1
, ,}

1.
School of Public Health, Tianjin Medical University, Tianjin (300070), China

摘要

摘要: 目的了解天津市特殊教育(以下简称“特教”)学校学生筛查性近视发生现状及相关因素，为提高特教学生健康水平提供依据。方法 2021年11月至2023年12月，采用整群随机抽样方法从天津市5区6所特教学校抽取281名学生进行非睫状肌麻痹电脑验光视力检查和问卷调查，采用多因素Logistic回归分析特教学生筛查性近视相关因素。结果天津市特教学生筛查性近视检出率为27.0%，患孤独症、发育迟缓和智力障碍学生的筛查性近视检出率分别为22.4%，12.5%和33.0%。随年龄增长，近视程度增加(χ_趋势²=22.65，P < 0.01)。多因素Logistic回归分析结果显示，年龄(10~13岁：OR=5.40，14~17岁：OR=8.40，18~23岁：OR=6.02)、住宿情况(走读：OR=0.29)、每日看手机≥2 h(OR=2.37)、每日看电脑和平板时长≥2 h(OR=2.70)与特教学生筛查性近视的发生相关(P值均 < 0.05)。结论特教学生筛查性近视检出率和近视程度均随年龄升高，长时间视屏是特教学生筛查性近视相关因素，应结合特教学生特点开展精准近视防控。
- 近视 /
- 回归分析 /
- 学生 /
- 残疾人
Abstract: Objective To understand the current situation and related factors of screening myopia among students in special education schools, so as to provide evidence for promoting the health level of this population. Methods From November 2021 to December 2023, a total of 281 students from 6 special education schools in 5 districts of Tianjin were selected by cluster random sampling method for computer optometry visual acuity examination for non-ciliary paralysis and questionnaire survey. Multiple Logistic regression was performed to analyze the influencing factors of screening myopia among special education students. Results The screening myopia detection rate among these special education students in Tianjin was 27.0%, and the screening myopia detection rates of students with autism, developmental delays, and intellectual disabilities were 22.4%, 12.5%, and 33.0%, respectively. The degree of myopia increased with age (χ_trend²=22.65, P < 0.01). Multivariate Logistic regression analysis showed that age(10-13 years old: OR=5.40, 14-17 years old: OR=8.40, 18-23 years old: OR=6.02), accommodation(non-resident: OR=0.29), daily mobile phone usage ≥2 hours (OR=2.37), and daily computer/tablet usage ≥2 hours (OR=2.70) were the risk factors for screening myopia among special education students (P < 0.05). Conclusions The detection rate and degree of screening myopia increase with age in special education students. Prolonged screen time exposure is a primary risk factor for screening myopia in special education students. Effective myopia prevention and control strategies should be designed according to the characteristics of special education students.
- Myopia /
- Regression analysis /
- Students /
- Disabled persons
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 特殊教育学校学生筛查性近视单因素分析

Table 1. Univariate analysis of related factors of screening myopia among students in special education schools

影响因素	选项	人数	近视人数	χ²/H值	P值
年龄/岁	2~5	55	5(9.1)	28.26	< 0.01
	6~9	88	15(17.0)
	10~13	61	21(34.4)
	14~17	48	22(45.8)
	18~23	29	13(44.8)
住宿情况	住宿	19	11(57.9)	9.83	< 0.01
	走读	262	65(24.8)
父亲文化程度	大专及以上	141	28(19.9)	7.42	0.02
	高中、中专等	59	20(33.9)
	初中及以下	81	28(34.6)
母亲文化程度	大专及以上	139	28(20.1)	8.23	0.02
	高中、中专等	57	16(28.1)
	初中及以下	85	32(37.6)
读写时是否歪头	是	96	29(30.2)	0.74	0.39
	否	185	47(25.4)
眼睛与书本距离是否	是	104	29(27.9)	0.06	0.81
保持一尺	否	177	47(26.6)
胸部与课桌距离是否	是	147	40(27.2)	< 0.01	0.95
为一拳	否	134	36(26.9)
是否阳光直射下看书	是	77	20(26.0)	0.06	0.08
	否	204	56(27.5)
睡觉时是否开夜灯	是	53	13(24.5)	0.21	0.65
	否	228	63(27.6)
在暗环境或关灯后玩	是	83	31(37.3)	6.34	0.01
电子产品	否	198	45(22.7)
每日读写时长/h	< 1	107	25(23.4)	1.34	0.51
	1~ < 2	96	27(28.1)
	≥2	78	24(30.8)
每日看手机时长/h	< 1	163	35(21.5)	12.24	< 0.01
	1~ < 2	66	17(25.8)
	≥2	52	24(46.2)
每日看电脑和平板	< 1	188	41(21.8)	11.33	< 0.01
时长/h	1~ < 2	63	20(31.7)
	≥2	30	15(50.0)
每日看电视时长/h	< 1	146	38(26.0)	0.22	0.89
	1~ < 2	91	25(27.5)
	≥2	44	13(29.5)
每日睡眠时长/h	< 10	163	45(27.6)	0.06	0.80
	≥10	118	31(26.3)
每日户外活动	< 1	96	25(26.0)	1.24	0.54
时长/h	1~ < 2	106	26(24.5)
	≥2	79	25(31.6)
注： ()内数字为检出率/%。

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表 2 天津市特教学生筛查性近视多因素Logistic回归分析(n=281)

Table 2. Multivariate Logistic regression analysis of screening myopia among special education students in Tianjin(n=281)

影响因素	选项	β值	标准误	Wald χ²值	OR值(95%CI)	P值
年龄/岁	2~5				1.00
	6~9	0.87	0.64	1.85	2.38(0.68~8.30)	0.17
	10~13	1.69	0.66	6.56	5.40(1.49~19.63)	0.01
	14~17	2.13	0.68	9.84	8.40(2.22~31.75)	< 0.01
	18~23	1.80	0.72	6.15	6.02(1.46~24.91)	0.01
住宿情况	住宿				1.00
	走读	-1.26	0.63	3.98	0.29(0.08~0.98)	0.05
每日看手机	< 1				1.00
时长/h	1~ < 2	0.03	0.41	0.00	1.03(0.46~2.30)	0.95
	≥2	0.86	0.42	4.24	2.37(1.04~5.39)	0.04
每日看电脑和	< 1				1.00
平板时长/h	1~ < 2	0.09	0.39	0.05	1.09(0.51~2.32)	0.82
	≥2	0.93	0.47	4.42	2.70(1.07~6.81)	0.04

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参考文献(32)

[1]	中华人民共和国国务院办公厅关于转发教育部等部门特殊教育提升计划(2014—2016年)的通知[EB/OL]. (2014-01-20)[2024-07-02]. http://www.moe.gov.cn/jyb_xxgk/moe_1777/moe_1778/201401/t20140120_162822.html.
[2]	中华人民共和国教育部等七部门关于印发《第二期特殊教育提升计划(2017—2020年)》的通知[EB/OL]. (2017-07-20)[2024-07-02]. http://www.moe.gov.cn/srcsite/A06/s3331/201707/t20170720_309687.html.
[3]	WOLFFSOHN J S, FLITCROFT D I, GIFFORD K L, et al. IMI-Myopia control reports overview and introduction[J]. Invest Ophthalmol Vis Sci, 2019, 60(3): M1-M19.
[4]	MORGAN I G, WU P C, OSTRIN L A, et al. IMI risk factors for myopia[J]. Invest Ophthalmol Vis Sci, 2021, 62(5): 3.
[5]	中华人民共和国国家卫生健康委办公厅关于印发儿童青少年近视防控适宜技术指南的通知[EB/OL]. (2019-10-14)[2024-08-20]. http://www.nhc.gov.cn/jkj/s5898bm/201910/c475e0bd2de444379402f157523f03fe.shtml .
[6]	LI T, YANG J, YAN J, et al. Interaction between parental myopia and children lifestyle on the incidence of myopia among children aged 6-18 years: a cross-sectional study in Tianjin, China[J]. BMJ Open, 2024, 14(1): e80929.
[7]	罗春燕, 齐文娟, 何鲜桂, 等. 上海市中小学生近视相关因素分析[J]. 中国学校卫生, 2021, 42(2): 185-189. LUO C Y, QI W J, HE X G, et al. Analysis of myopia related factors among primary and secondary school students in Shanghai[J]. Chin J Sch Health, 2021, 42(2): 185-189. (in Chinese)
[8]	魏瑞华, 鹿大千, 金楠, 等. 国际近视研究学会(IMI)近视防控研究白皮书解读[J]. 眼科新进展, 2019, 39(8): 701-713. WEI R H, LU D Q, JIN N, et al. Interpretation of the International Myopia Institute white papers focusing on myopia prevention and control[J]. Adv Ophthalmol, 2019, 39(8): 701-713. (in Chinese)
[9]	张欣. 重视儿童青少年近视环境危险因素的防控[J]. 中国学校卫生, 2018, 39(1): 6-8. ZHANG X. Environmental factors and myopia: prospects for prevention[J]. Chin J Sch Health, 2018, 39(1): 6-8. (in Chinese)
[10]	中国残疾人联合会. 中国残疾人事业统计年鉴2022[M]. 北京: 中国统计出版社, 2022: 28. China Disabled Persons' Federation. China statistical yearbook for the cause of disabled persons 2022[M]. Beijing: China Statistics Press, 2022: 28. (in Chinese)
[11]	中华人民共和国国务院办公厅关于转发教育部等部门"十四五"特殊教育发展提升行动计划的通知[EB/OL]. (2021-12-31)[2024-07-02]. http://www.moe.gov.cn/jyb_xxgk/moe_1777/moe_1778/202201/t20220125_596312.html .
[12]	HOLDEN B A, FRICKE T R, WILSON D A, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology, 2016, 123(5): 1036-1042.
[13]	钟盼亮, 马宁, 刘云飞, 等. 2010—2019年中国7~18岁汉族儿童青少年近视的流行趋势[J]. 中华预防医学杂志, 2023, 57(4): 479-485. ZHONG P L, MA N, LIU Y F, et al. Trend of the detection rate of myopia among Chinese Han children and adolescents aged 7-18 years from 2010 to 2019[J]. Chin J Prev Med, 2023, 57(4): 479-485. (in Chinese)
[14]	中华人民共和国国家卫生健康委办公厅关于印发近视防治指南(2024年版)的通知[EB/OL]. (2024-05-31)[2024-07-02]. http://www.nhc.gov.cn/yzygj/s7653/202405/b6edbd0bf3a64ecc8cef30d72f80ed9e.shtml .
[15]	陶芳标. 《儿童青少年近视防控公共卫生综合干预技术指南》专题解读[J]. 中国学校卫生, 2023, 44(10): 1445-1449. TAO F B. Expert interpretation of Comprehensive Public Health Intervention Technical Guidelines for Prevention and Control of Myopia among Children and Adolescents[J]. Chin J Sch Health, 2023, 44(10): 1445-1449. (in Chinese)
[16]	CHOKRON S, DUTTON G N. From vision to cognition: potential contributions of cerebral visual impairment to neurodevelopmental disorders[J]. J Neural Transm (Vienna), 2023, 130(3): 409-424. doi: 10.1007/s00702-022-02572-8
[17]	BOUNTZIOUKA V, HORVAT-GITSELS L A, CORTINA-BORJA M, et al. Trends in the long-term impact of childhood visual impairment on health and social outcomes in the UK: a cross-cohort study across three decades of disability-related legislation and policy implementation[J]. Eur J Public Health, 2023, 33(6): 1035-1042.
[18]	REYNOLDS M, FARON N, HOEKEL J, et al. Refractive surgery to correct visual impairments in 267 children with autism spectrum and related neuro-developmental disorders: improvements in vision and behavior[J]. Med Hypoth Discov Innov Ophthalmol, 2024, 13(2): 88-95.
[19]	刘灵琳. 成都及绵阳两地青少年近视患病率及影响因素分析[D]. 成都: 电子科技大学, 2019. LIU L L. Analysis of prevalence rate and risk factors of myopia in adolescent in Chengdu and Mianyang[D]. Chengdu: University of Electronic Science and Technology of China, 2019. (in Chinese)
[20]	中国学生体质与健康研究组. 2019年中国学生体质与健康调研报告[M]. 北京: 高等教育出版社, 2022: 167-173. Chinese School Student Physique and Health Research Group. Report on the physical fitness and health surveillance of Chinese school students in 2019[M]. Beijing: Higher Education Press, 2022: 167-173. (in Chinese)
[21]	陶俊, 郝瑞, 郭雅图, 等. 孤独症谱系障碍合并智力障碍患儿视功能特征分析[J]. 中华眼科杂志, 2022, 58(12): 1051-1057. TAO J, HAO R, GUO Y T, et al. Characteristics of visual function in children with autism complicated with mental retardation[J]. Chin J Ophthalmol, 2022, 58(12): 1051-1057. (in Chinese)
[22]	TAO J, HAO R, GUO Y, et al. Characteristics of visual function in children with cerebral palsy and intellectual disabilities in urban Beijing[J]. Transl Vis Sci Technol, 2024, 13(2): 7.
[23]	CHANG M Y, GANDHI N, O'HARA M. Ophthalmologic disorders and risk factors in children with autism spectrum disorder[J]. J AAPOS, 2019, 23(6): 331-337.
[24]	KAVITHA V, GANGRADE A K, HERALGI M M, et al. Ocular abnormalities in children with developmental delay[J]. Ind J Ophthalmol, 2023, 71(10): 3328-3334.
[25]	陶芳标. 中华医学百科全书·儿童少年卫生学[M]. 北京: 中国协和医科大学出版社, 2017: 279. TAO F B. Chinese medical encyclopedia·child and adolescent health[M]. Beijing: Peking Union Medical College Press, 2017: 279. (in Chinese)
[26]	国际近视研究院, 著. 国际近视研究院关于近视危险因素的报告[J]. 刘康, 高建华, 陈卓, 译. 中华实验眼科杂志, 2022, 40(6): 562-573. International Myopia Research Institute. Report of International Myopia Research Institute on risk factors of myopia[J]. LIU K, GAO J H, CHEN Z, translant. Chin J Exp Ophthalmol, 2022, 40(6): 562-573. (in Chinese)
[27]	刘盛鑫, 杜蓓, 金楠, 等. 天津市小学生生活方式与近视风险的列线图预测模型构建[J]. 中国学校卫生, 2024, 45(1): 21-24. LIU S X, DU B, JIN N, et al. Construction of nomogram prediction model of myopia risk and lifestyle among primary school students in Tianjin[J]. Chin J Sch Health, 2024, 45(1): 21-24. (in Chinese)
[28]	郝莉, 郑吉, 朱冰, 等. 杭州市中小学生近视与用眼卫生情况[J]. 中华健康管理学杂志, 2023, 17(1): 52-54. HAO L, ZHENG J, ZHU B, et al. Study on the current status of myopia and vision care habits of primary and middle school students in Hangzhou[J]. Chin J Health Manage, 2023, 17(1): 52-54. (in Chinese)
[29]	中华医学会眼科学分会眼视光学组, 中国医师协会眼科医师分会眼视光专业委员会, 中国非公立医疗机构协会眼科专业委员会视光学组, 等. 高度近视防控专家共识(2023)[J]. 中华眼视光学与视觉科学杂志, 2023, 25(6): 401-407. Chinese Ophthalmological Society of Chinese Optometric Association, Chinese Doctor Association of Ophthalmology and Optometry Committee Ophthalmologists Association, Ophthalmology and Optometry Group of Ophthalmologic Committee Chinese Non-Government Medical Institutions Association, et al. Expert consensus on prevention and control of high myopia (2023)[J]. Chin J Optom Vision Sci, 2023, 25(6): 401-407. (in Chinese)
[30]	何鲜桂, 朱剑锋, 邹海东, 等. 上海市小学生近视相关读写姿势现况及影响因素分析[J]. 临床眼科杂志, 2017, 25(3): 214-218. HE X G, ZHU J F, ZOU H D, et al. Reading and writing postures of primary school students in Shanghai and associated factors[J]. J Clin Ophthalmol, 2017, 25(3): 214-218. (in Chinese)
[31]	中华人民共和国国务院.残疾人教育条例[EB/OL].(2017-02-23)[2024-07-01].https://www.gov.cn/zhengce/zhengceku/2017-02/23/content_5170264.htm .
[32]	温世博, 郭芷琪, 王天倚, 等. 中国儿童青少年视屏时间与健康风险的Meta分析[J]. 中国预防医学杂志, 2023, 24(7): 662-667. WEN S B, GUO Z Q, WANG T Y, et al. Screen time and health risks among children and adolescents in China: a Meta-analysis[J]. Chin J Prev Med, 2023, 24(7): 662-667. (in Chinese)