武汉市中小学生2019—2020年视力不良现况

谢新艳; 杨莉华; 杨长春; 徐婷; 李凌云; 苏厚华; 顾宏; 胡亚萍; 黄艳; 项景; 王景胜; 宋然然

doi:10.16835/j.cnki.1000-9817.2021.08.027

武汉市中小学生2019—2020年视力不良现况

doi: 10.16835/j.cnki.1000-9817.2021.08.027

谢新艳¹,
杨莉华²,
杨长春²,
徐婷²,
李凌云³,
苏厚华⁴,
顾宏⁵,
胡亚萍⁶,
黄艳⁷,
项景⁸,
王景胜⁹,
宋然然^1, ,

1.
华中科技大学同济医学院公共卫生学院儿少卫生与妇幼保健学系，湖北武汉 430030
2.
武汉市青少年视力低下防制(预防控制)中心
3.
武汉市硚口区教育局
4.
武汉市江夏区教育局
5.
武汉市洪山区教育局
6.
武汉市江汉区教育局
7.
武汉市武昌区教育局
8.
武汉市青山区教育局
9.
武汉市汉阳区教育局

详细信息

作者简介:
谢新艳(1995-)，女，湖北荆州人，在读博士，主要研究方向为儿童心理发展与心理卫生

通讯作者:
宋然然，E-mail：songranran@hust.edu.cn

中图分类号: R778.1 G478 R179
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- 文章访问数: 1422
- HTML全文浏览量: 614
- PDF下载量: 153
- 被引次数: 0
出版历程
- 收稿日期: 2021-03-23
- 修回日期: 2021-04-29
- 网络出版日期: 2021-08-20
- 刊出日期: 2021-08-25

Prevalence and trend of low vision among primary and secondary school students in Wuhan from 2019 to 2020

1.
Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (430030) China

摘要

摘要: 目的了解新型冠状病毒肺炎(新冠肺炎)疫情居家隔离及线上学习后，武汉市中小学生视力不良检出率情况，为中小学生视力防控提供科学依据。方法 2020年6月19日至7月6日，利用武汉市青少年视力低下防制(预防控制)中心设计的在线视力筛查工具对156 783名中小学生进行视力筛查，同时调查前1周学生室内外活动及视屏时间。学生相应的2019年新冠肺炎疫情暴发前的裸眼视力从学校视力监测记录中获取。结果 2020年视力不良检出率(51.04%)高于2019年(43.04%)(χ²=68 944.95，P < 0.01)。经协变量调整后，相对于低分位数的网课时间、视屏娱乐时间、室内活动时间、室外活动时间，高分位数的各类活动时间对于视力不良OR值(OR值95%CI)分别为1.17(1. 13~1 .20)、1.07(1.04~1.10)、0.67(0.65~0.69)、0.62(0.60~0.64)。结论武汉市中小学生2020年视力不良检出率较2019年显著增高，应加强中小学生视力保护的广泛干预，优先考虑改善体育活动机会和减少多种屏幕行为的政策措施。
- 视力，低 /
- 冠状病毒属 /
- 患病率 /
- 回归分析 /
- 学生
Abstract: Objective To provide a large-scale assessment the prevalence of poor vision in 2020 among children and adolescents in Wuhan City, Hubei province and to provide basis for healthy vision promotion. Methods This cross-sectional epidemiological study was conducted among 156 783 students, who lived in Wuhan during the COVID-19 period participated the vision screening through the online applet designed by Wuhan Center for Adolescent Poor Vision Prevetion and Control under the guidance of their guardians between June 19 and July 6, 2020. The demographic information and daily hours spent on various activities in the past week were investigated. The corresponding visual acuity data of students in 2019 before the COVID-19 outbreak was extracted from school vision monitoring records for each semester, which was measured by the experienced eye care professionals. Results The detection rate of poor vision (51.04%) in 2020 was significantly higher than that in 2019(43.04%)(χ²=68 944.95, P < 0.01). After adjustment for covariates, the odds ratio and 95% confidence interval for poor vision were 1.17(1.13-1.20), 1.07(1.04-1.10), 0.67(0.65-0.69) and 0.62(0.60-0.64) in students with online class time, recreational screen time, indoor and outdoor activity time in the highest tertile, compared with the lowest tertile groups. Conclusion Increased rate of poor vision among primary and secondary schoool students deserves further concern. It is necessary to strengthen intervention of eyesight protection. Policies and programs aimed at improving opportunities for physical activities and decreasing multiple screen behaviors should be given priority.
- Vision, low /
- Coronavirus /
- Prevalence /
- Regression analysis /
- Students

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表 1 不同组别学生过去1周平均每天各项活动时间比较/h

Table 1. Daily hours spent on the screen and physical activities during the past week of participants/h

组别	人数	网络课程			视屏娱乐			室内活动			室外活动
组别	人数	x ±s	t/F值	P值	x ±s	t/F值	P值	x ±s	t/F值	P值	x ±s	t/F值	P值
性别
男	84 419	4.74±2.87	-9.13	< 0.01	1.82±1.71	13.53	< 0.01	2.61±2.38	6.41	< 0.01	1.54±1.44	15.43	< 0.01
女	72 364	4.87±2.87			1.70±1.63			2.54±2.25			1.43±1.37
学段
小学	112 057	4.14±2.50	12 888.52	< 0.01	1.60±1.56	2 340.61	< 0.01	2.71±2.26	628.28	< 0.01	1.57±1.38	756.54	< 0.01
初中	30 122	6.13±3.07			2.03±1.82			2.27±2.35			1.29±1.43
高中	14 604	7.13±2.98			2.49±1.96			2.22±2.59			1.23±1.54
班级排名
前1/3	42 306	4.57±2.81	661.52	< 0.01	1.47±1.52	1 712.10	< 0.01	2.28±2.13	482.76	< 0.01	1.33±1.32	337.62	< 0.01
中间1/3	92 621	4.76±2.82			1.78±1.63			2.68±2.32			1.54±1.41
后1/3	21 856	5.42±3.11			2.28±1.97			2.73±2.61			1.55±1.56
父亲教育程度
初中及以下	53 828	5.00±2.95	216.70	< 0.01	2.04±1.77	1 255.92	< 0.01	2.75±2.50	403.33	< 0.01	1.57±1.48	238.09	< 0.01
高中或同等学历	43 430	4.87±2.87			1.83±1.67			2.70±2.35			1.54±1.42
大专	23 851	4.64±2.81			1.61±1.58			2.43±2.10			1.42±1.34
大学本科及以上	35 674	4.53±2.76			1.37±1.49			2.26±2.09			1.34±1.32
母亲教育程度
初中及以下	61 170	5.03±2.95	276.61	< 0.01	2.02±1.77	1 184.07	< 0.01	2.73±2.48	333.47	< 0.01	1.55±1.47	194.88	< 0.01
高中或同等学历	41 841	4.79±2.85			1.79±1.66			2.67±2.31			1.54±1.42
大专	25 322	4.58±2.77			1.56±1.55			2.42±2.12			1.40±1.33
大学本科及以上	28 450	4.51±2.77			1.36±1.49			2.26±2.11			1.34±1.34
2019年视力筛查^a
正常视力	71 538	4.42±2.70	-63.97	< 0.01	1.66±1.59	-31.40	< 0.01	2.74±2.34	22.94	< 0.01	1.59±1.41	26.14	< 0.01
视力不良	54 055	5.47±3.02			1.96±1.78			2.43±2.34			1.38±1.41
2020年视力筛查
正常视力	76 761	4.30±2.67	-69.03	< 0.01	1.62±1.57	-33.79	< 0.01	2.80±2.36	36.49	< 0.01	1.62±1.42	38.41	< 0.01
视力不良	80 022	5.28±2.97			1.90±1.76			2.37±2.26			1.35±1.39
总计	156 783	4.80±2.87			1.77±1.67			2.58±2.32			1.48±1.41
注：a为参与2020年视力筛查的学生中，从学校视力监测记录中提取的125 593名学生2019年视力数据。日常活动时间数据为非正态分布，因样本量较大，仍使用t检验/方差分析进行统计推断。

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表 2 不同组别学生视力不良检出率比较

Table 2. Detection rate of poor vision among different groups of students

组别	选项	2019年		2020年		χ²值	P值
组别	选项	人数	视力不良人数	人数	视力不良人数	χ²值	P值
性别	男	67 613	27 875(41.23)	84 419	41 803(49.52)	36 782.92	< 0.01
	女	57 980	26 180(45.15)	72 364	38 219(52.81)	32 098.82	< 0.01
年级	小学	87 953	27 954(31.78)	112 057	45 768(40.84)	42 583.54	< 0.01
	初中	25 434	16 855(66.27)	30 122	22 297(74.02)	14 128.14	< 0.01
	高中	12 206	9 246(75.75)	14 604	11 957(81.87)	6 781.35	< 0.01
班级排名	前1/3	33 682	14 494(43.03)	42 306	22 021(52.05)	17 249.57	< 0.01
	中间1/3	74 429	30 591(41.10)	92 621	45 060(48.65)	41 432.31	< 0.01
	后1/3	17 482	8 970(51.31)	21 856	12 941(59.21)	10 088.61	< 0.01
父亲文化程度	初中及以下	44 183	20 016(45.30)	53 828	27 819(51.68)	26 546.26	< 0.01
	高中或同等学历	35 197	15 094(42.88)	43 430	21 777(50.14)	20 082.52	< 0.01
	大专	18 718	7 783(41.58)	23 851	11 921(49.98)	9 739.19	< 0.01
	大学本科及以上	27 495	11 162(40.60)	35 674	18 505(51.87)	12 762.06	< 0.01
母亲文化程度	初中及以下	50 189	23 145(46.12)	61 170	32 123(52.51)	30 305.32	< 0.01
	高中或同等学历	33 802	14 022(41.48)	41 841	20 509(49.02)	18 922.76	< 0.01
	大专	19 684	7 958(40.43)	25 322	12 597(49.75)	9 882.12	< 0.01
	大学本科及以上	21 918	8 930(40.74)	28 450	14 793(52.00)	9 988.80	< 0.01
合计		125 593	54 055(43.04)	156 783	80 022(51.04)	68 944.95	< 0.01
注：()内数字为检出率/%。

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参考文献(23)

[1]	WANG G, ZHANG Y, ZHAO J, et al. Mitigate the effects of home confinement on children during the COVID-19 outbreak[J]. Lancet, 2020, 395(10228): 945-947. http://www.sciencedirect.com/science/article/pii/S014067362030547X
[2]	MOORE S A, FAULKNER G, RHODES R E, et al. Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey[J]. Int J Behav Nutr Phys Act, 2020, 17(1): 85. doi: 10.1186/s12966-020-00987-8
[3]	JAN C, XU R, LUO D, et al. Association of visual impairment with economic development among Chinese schoolchildren[J]. JAMA Pediatr, 2019, 173(7): e190914. doi: 10.1001/jamapediatrics.2019.0914
[4]	RAINEY L, ELSMAN E B M, VAN NISPEN R M A, et al. Comprehending the impact of low vision on the lives of children and adolescents: a qualitative approach[J]. Q Life Res, 2016, 25(10): 2633-2643. doi: 10.1007/s11136-016-1292-8
[5]	WONG C W, TSAI A, JONAS J B, et al. Digital screen time during COVID-19 pandemic: risk for a further myopia boom?[J]. Am J Ophthalmol, 2021, 223: 333-337. doi: 10.1016/j.ajo.2020.07.034
[6]	国家卫生和计划生育委员会. 标准对数视力表GB /T 11533—2011[S]. 2012-05-01. National Health and Family Planning Commission of People's Republic of China. Standard for logarithmic visual acuity charts GB/T 11533-2011[S]. 2012-05-01.
[7]	朱冰, 刘辉, 李莉, 等. 杭州市中小学生视力不良状况及影响因素研究[J]. 中国社会医学杂志, 2021, 38(2): 176-179. doi: 10.3969/j.issn.1673-5625.2021.02.015 ZHU B, LIU H, LI L, et al. Study on the status of poor eyesight and its influencing factors among primary and middle school students in Hangzhou[J]. Chin J Soc Med, 2021, 38(2): 176-179. doi: 10.3969/j.issn.1673-5625.2021.02.015
[8]	胡昊, 刘硕. 教育部: 中小学生近视率半年增加11.7%[EB/OL]. [2020-08-27]. https://baijiahao.baidu.com/s?id=1676163770859599822&wfr=spider&for=pc. HU H, LIU S. Xinhua News. The Ministry of Education: the rate of myopia among primary and middle school students increased by 11.7 in half a year[EB/OL]. [2020-08-27]. https://baijiahao.baidu.com/s?id=1676163770859599822&wfr=spider&for=pc.
[9]	WANG J, LI Y, MUSCH D C, et al. Progression of myopia in school-aged children after COVID-19 home confinement[J]. JAMA Ophthalmol, 2021, 139(3): 293-300. doi: 10.1001/jamaophthalmol.2020.6239
[10]	杜丹丹, 许文龙, 徐婷, 等. 武汉市92所视力健康管理的中小学生学生视力低下状况动态监测[J]. 华中科技大学学报(医学版), 2017, 46(4): 480-483. doi: 10.3870/j.issn.1672-0741.2017.04.022 DU D D, XU W L, XU T, et al. A Dynamic monitoring analysis on poor vision status of primary and middle school students from 92 schools with visual health-management in Wuhan[J]. J Huazhong Univ Sci Technol(Med Ed), 2017, 46(4): 480-483. doi: 10.3870/j.issn.1672-0741.2017.04.022
[11]	樊泽民, 刘立京, 王海涛. 扎实推进全国儿童青少年近视防控工作[J]. 中国学校卫生, 2018, 39(11): 1605-1608, 1612. doi: 10.16835/j.cnki.1000-9817.2018.11.002 FAN Z M, LIU L J, WANG H T. Increased efforts to myopia prevention and control among children and adolescents in China[J]. Chin J Sch Health, 2018, 39(11): 1605-1608, 1612. doi: 10.16835/j.cnki.1000-9817.2018.11.002
[12]	教育部. 教育部等八部门关于印发《综合防控儿童青少年近视实施方案》的通知[A/OL]. [2018-08-30]. http://www.moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t20180830_346672.html. Ministry of Education of the People's Republic of China. Notice by the Ministry of Education and other eight departments on the issuance of the "Implementation Plan for the Prevention and Control of Myopia in Children and Adolescents"[A/OL]. [2018-08-30]. http://www.moe.gov.cn/srcsite/A17/moe_943/s3285/201808/t20180830_346672.html.
[13]	LIN Z, GAO T Y, VASUDEVAN B, et al. Near work, outdoor activity, and myopia in children in rural China: the Handan offspring myopia study[J]. BMC Ophthalmol, 2017, 17(1): 203. doi: 10.1186/s12886-017-0598-9
[14]	GUO Y, LIU L J, TANG P, et al. Outdoor activity and myopia progression in 4-year follow-up of Chinese primary school children: the Beijing children eye study[J]. PLoS One, 2017, 12(4): e0175921. doi: 10.1371/journal.pone.0175921
[15]	LIN Z, VASUDEVAN B, CIUFFREDA K J, et al. Myopigenic activity change and its risk fgctors in urban students in Beijing: three-year report of Beijing myopia progression study[J]. Ophthal Epidemiol, 2017, 24(6): 388-393. doi: 10.1080/09286586.2017.1307994
[16]	刘志浩, 刘志业, 吕书红. 中国五省小学生视屏时间与自我伤害行为的关联[J]. 中国学校卫生, 2021, 42(3): 363-366. doi: 10.16835/j.cnki.1000-9817.2021.03.011 LIU Z H, LIU Z Y, LYU S H. Association of screen time with self-injury behavior among primary school students in five provinces in China[J]. Chin J Sch Health, 2021, 42(3): 363-366. doi: 10.16835/j.cnki.1000-9817.2021.03.011
[17]	QIN F, SONG Y, NASSIS G P, et al. Physical activity, screen time, and emotional well-being during the 2019 novel coronavirus outbreak in China[J]. Int J Environ Res Public Health, 2020, 17(14): 5170. doi: 10.3390/ijerph17145170
[18]	HE M, XIANG F, ZENG Y, et al. Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial[J]. JAMA, 2015, 314(11): 1142-1148. doi: 10.1001/jama.2015.10803
[19]	FRENCH A N, MORGAN I G, MITCHELL P, et al. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study[J]. Ophthalmology, 2013, 120(10): 2100-2108. doi: 10.1016/j.ophtha.2013.02.035
[20]	KATAPALLY T R, LAXER R E, QIAN W, et al. Do school physical activity policies and programs have a role in decreasing multiple screen time behaviours among youth?[J]. Prev Med, 2018, 110: 106-113. doi: 10.1016/j.ypmed.2017.11.026
[21]	武汉视防. 上半年, 儿童青少年近视防控有哪些新动作?权威回答来了![EB/OL]. [2020-08-27]. https://mp.weixin.qq.com/s/lla62hw_5soDPLIyMYAIng. Wuhan Center for Adolescent Poor Vision Prevention and Control. What new actions were taken to prevent and control myopia in children and adolescents?[EB/OL]. [2020-08-27]. https://mp.weixin.qq.com/s/lla62hw_5soDPLIyMYAIng.
[22]	MARQUES A, SANTOS D A, HILLMAN C H, et al. How does academic achievement relate to cardiorespiratory fitness, self-reported physical activity and objectively reported physical activity: a systematic review in children and adolescents aged 6-18 years[J]. Br J Sports Med, 2018, 52(16): 1039. doi: 10.1136/bjsports-2016-097361
[23]	JANSSEN I, LEBLANC A G. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth[J]. Int J Behav Nutr Phys Act, 2010, 7: 40. doi: 10.1186/1479-5868-7-40