上海市虹口区儿童青少年脊柱弯曲异常现状及影响因素分析

亓德云; 李丽平; 江艳微; 周媛

doi:10.16835/j.cnki.1000-9817.2021.03.030

上海市虹口区儿童青少年脊柱弯曲异常现状及影响因素分析

doi: 10.16835/j.cnki.1000-9817.2021.03.030

上海市虹口区疾病预防控制中心儿少眼防科，200082

详细信息

作者简介:
亓德云(1981-)，女，山东淄博人，硕士，副主任医师，主要研究方向为儿童青少年身心发育

中图分类号: R 726.8 R 682.3
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- 被引次数: 0
出版历程
- 收稿日期: 2020-10-29
- 修回日期: 2020-11-11
- 网络出版日期: 2021-04-20
- 刊出日期: 2021-03-25

Abnormal spinal curvature and influencing factors in children and adolescents in Hongkou District, Shanghai

School Health and Ophthalmic Disease Prevention Department, Shanghai Hongkou District Center for Disease Control and Prevention, Shanghai(200082), China

摘要

摘要: 目的了解上海市虹口区中小学生脊柱弯曲异常发生率及影响因素，为脊柱弯曲异常防治工作提供科学依据。方法采取分层整群随机抽样方法，抽取虹口区7所学校1 884名小学四年级至高中三年级中小学生进行脊柱弯曲异常筛查和影响因素的问卷调查。结果虹口区中小学生脊柱弯曲异常检出率为7.2%，随着学段的升高，脊柱弯曲异常检出率升高，普通高中(15.7%)>职业高中(8.1%)>初中(3.4%)>小学(1.8%)，差异有统计学意义(χ²=91.24，P < 0.01)；男生脊柱弯曲异常率为5.9%，女生为8.6%，女生高于男生(χ²=5.27，P < 0.05)。多因素Logistic回归分析显示, 影响脊柱弯曲异常发生的因素有学段、营养状况、每天户外活动时间(P值均<0.05)。结论脊柱弯曲异常是危害儿童青少年健康的常见疾病之一。需要学校、学生、家长的共同参与，加强筛查、预防工作。
- 脊柱弯曲 /
- 患病率 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To investigate the incidence of abnormal spinal curvature and related factors in primary and secondary school students in the Hongkou District of Shanghai, so as to provide evidence for abnormal spinal curvature prevention and treatment. Methods Using a stratified cluster random sampling method, 1 884 students of grade 4 to grade 12 from seven schools were investigated via questionnaires for abnormal spinal curvature in Hongkou District. Results The detectable rate of abnormal spinal curvature was 7.2%, The detectable rate of abnormal spinal curvature increased with increasing age(P < 0.01): senior high school (15.7%) > vocational high school (8.1%) > junior high school (3.4%) > primary school(1.8%)(χ²=91.24, P < 0.01). The detectable rate of spinal curvature among female students was 8.6%, which was higher than that among male students(5.9%), and the difference was significant(χ²=5.27, P < 0.05). Multivariate Logistic regression analysis showed that the factors influencing abnormal spinal curvature included phase of studying, nutritional status and time spent engaged in outdoor activities every day(P < 0.05). Conclusion Abnormal spinal curvature is one of the common conditions that endangers the health of children and adolescents. The collaboration of the school, students and parents is required to strengthen screening and prevention.
- Spinal curvatures /
- Prevalence /
- Regression analysis /
- Child /
- Adolescent

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表 1 不同学段不同性别学生脊柱弯曲异常检出率比较

Table 1. Comparison of the detectable rate of abnormal spinal curvature of different genders in different sections

学段与性别	选项	人数	检出人数	χ²值	P值
学段	小学	398	7(1.8)	91.24	< 0.01
	初中	685	23(3.4)
	普高	542	85(15.7)
	职高	259	21(8.1)
性别	男	982	58(5.9)	5.27	0.02
	女	902	78(8.6)
注：()内数字为检出率/%。

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表 2 上海市虹口区儿童青少年脊柱弯曲异常单因素分析

Table 2. Single factor analysis of abnormal spinal curvature in children and adolescents in Hongkou District, Shanghai

影响因素	选项	人数	脊柱弯曲异常人数	χ²值	P值
营养状况	消瘦	143	13(9.1)	14.33	0.00
	正常	1 121	98(8.7)
	超重	341	12(3.5)
	肥胖	279	13(4.7)
课桌椅高度根据身高调整频率	从不或课桌椅不可调	1 266	102(8.1)	11.21	0.11
	1次/学年	301	8(2.7)
	1次/学期	237	20(8.4)
	1次/2~3个月	80	6(7.5)
平均每周体育课节数	0~2	342	30(8.8)	11.88	0.00
	3~4	994	84(8.5)
	≥5	548	22(4.0)
过去1周，每天白天户外活动时间/h	< 1	472	41(8.7)	6.46	0.09
	1~ < 2	807	61(7.6)
	2~ < 3	302	22(7.3)
	≥3	303	12(4.0)
过去1周，每天至少60 min及以上中高强度运动天数/d	0~2	781	63(8.1)	2.32	0.31
	3~5	807	57(7.1)
	6~7	296	16(5.4)
读写时，胸口离桌子边沿一拳频率	从不、偶尔	883	61(6.9)	0.24	0.63
	经常、总是	1 001	75(7.5)
读写时，眼睛距离书本一尺频率	从不、偶尔	933	64(6.9)	0.36	0.55
	经常、总是	951	72(7.6)
读写时，手指距离笔尖一寸频率	从不、偶尔	806	52(6.5)	1.24	0.27
	经常、总是	1 078	84(7.8)
老师经常提醒注意读写姿势	从不、偶尔	1 167	98(8.4)	6.36	0.01
	经常、总是	717	38(5.3)
父母经常提醒注意读写姿势	从不、偶尔	831	67(8.1)	1.58	0.21
	经常、总是	1 053	69(6.6)
躺着或趴着看书或电子屏幕频率	从不、偶尔	1 446	109(7.5)	0.95	0.33
	经常、总是	438	27(6.2)
过去1周，每天看电视时间/h	没有看过	485	37(7.6)	0.39	0.57
	< 1	733	55(7.5)
	1~ < 2	358	27(7.5)
	2~ < 3	182	13(7.1)
	3~ < 4	65	1(1.5)
	≥4	61	3(4.9)
过去1周，每天用电脑时间/h	没有用过	599	39(6.5)	1.56	0.91
	< 1	686	50(7.3)
	1~ < 2	346	27(7.8)
	2~ < 3	149	11(7.4)
	3~ < 4	46	5(10.9)
	≥4	58	4(6.9)
过去1周，每天使用移动电子设备	从未用过	252	7(2.8)	8.57	0.00
	用过	1 632	129(7.9)
注：()内数字为检出率/%。

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表 3 上海市虹口区儿童青少年脊柱弯曲异常影响因素的Logistic回归分析(n=1 884)

Table 3. Logistic regression analysis of the influencing factors of abnormal spinal curvature in children and adolescents in Hongkou District, Shanghai(n=1 884)

影响因素	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
性别	0.27	0.19	1.90	0.17	1.31(0.89~1.91)
学段
初中	0.69	0.43	2.39	0.12	1.98(0.83~4.73)
高中	2.47	0.44	32.00	0.00	11.76(5.01~27.63)
职高	1.50	0.54	7.72	0.01	4.49(1.56~12.95)
营养状况
正常	-0.24	0.33	0.53	0.47	0.79(0.41~1.50)
超重	-1.17	0.43	7.39	0.01	0.31(0.13~0.72)
肥胖	-0.72	0.42	2.88	0.09	0.49(0.21~1.12)
平均每周体育课次数/节
3~4	-0.27	0.32	0.73	0.39	0.76(0.41~1.42)
≥5	0.09	0.41	0.05	0.82	1.09(0.50~2.42)
过去1周，每天白天户外活动时长/h
1~ < 2	-0.19	0.22	0.72	0.40	0.83(0.53~1.28)
2~ < 3	-0.29	0.29	1.03	0.31	0.75(0.42~1.31)
≥3	-0.92	0.35	6.77	0.01	0.40(0.20~0.80)
过去1周，每天至少60 min及以上中高强度运动天数/d
3~5	-0.02	0.31	0.00	0.96	0.98(0.53~1.82)
6~7	-0.00	0.31	0.00	0.99	1.00(0.55~1.82)
读写时，胸口距桌子边缘经常或总是超过一拳	0.07	0.22	0.09	0.76	1.07(0.70~1.64)
读写时，眼睛距书本经常或总是超过一尺	0.13	0.23	0.32	0.57	1.14(0.73~1.78)
读写时，手指距笔尖经常或总是超过一寸	0.31	0.22	1.95	0.16	1.36(0.88~2.11)
老师经常或总是提醒读写姿势	-0.16	0.25	0.43	0.51	0.85(0.52~1.38)
父母经常或总是提醒读写姿势	0.06	0.22	0.07	0.79	1.06(0.69~1.64)
过去1周，每天使用电子移动设备	0.55	0.41	1.76	0.19	1.73(0.77~3.90)

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