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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参考文献(15)

[1]	张小琴. 浅析儿童青少年脊柱弯曲异常的预防[J]. 中国卫生产业, 2012, 9(2): 155. https://www.cnki.com.cn/Article/CJFDTOTAL-WSCY201202133.htm ZHANG X Q. Prevention of abnormal spinal curvature in children and adolescents[J]. Chin Health Ind, 2012, 9(2): 155. https://www.cnki.com.cn/Article/CJFDTOTAL-WSCY201202133.htm
[2]	国家教育委员会, 卫生部. 学校卫生工作条例[A]. 1990-06-04. State Education Commission of the PRC, Ministry of Public Health. The regulations of school hygiene[A]. 1990-06-04.
[3]	邓万霞, 张金枝, 杜锐, 等. 襄阳市区中小学生脊柱弯曲异常现状及影响因素分析[J]. 中国校医, 2016, 30(4): 285-287. https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI201604025.htm DENG W X, ZHANG J Z, DU R, et al. Abnormal spinal curvature situation and influencing factors in schoolchildren in Xiangyang City[J]. Chin J School Doctor, 2016, 30(4): 285-287. https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI201604025.htm
[4]	韦春霞, 卢祖能, 黄肖群, 等. 宜昌市3483名青少年脊背倾斜角度异常的筛查[J]. 中华全科医师杂志, 2018, 17(1): 59-62. doi: 10.3760/cma.j.issn.1671-7368.2018.01.013 WEI C X, LU Z N, HUANG X Q, et al. Screening of abnormal spinal tilt angle in 3483 adolescents in Yichang[J]. Chin J Gen Pract, 2018, 17(1): 59-62. doi: 10.3760/cma.j.issn.1671-7368.2018.01.013
[5]	任凯, 龚晓明, 章荣, 等. 自贡市城乡中小学生特发性脊柱侧弯调查[J]. 中国学校卫生, 2014, 35(12): 1901-1902. http://www.cjsh.org.cn/article/id/zgxxws201412050 REN K, GONG X M, ZHANG R, et al. Investigation on idiopathic scoliosis of primary and secondary school students in Zigong City[J]. Chin J Sch Health, 2014, 35(12): 1901-1902. http://www.cjsh.org.cn/article/id/zgxxws201412050
[6]	董彬, 霍卓平. 儿童青少年脊柱弯曲异常的防治[J]. 中国学校卫生, 2008, 29(12): 1163-1165. doi: 10.3969/j.issn.1000-9817.2008.12.052 DONG B, HUO Z P. Prevention and treatment of spinal curvature abnormalities in children and adolescents[J]. Chin J Sch Health, 2008, 29(12): 1163-1165. doi: 10.3969/j.issn.1000-9817.2008.12.052
[7]	国家卫生和计划生育委员会. 儿童青少年脊柱弯曲异常的筛查GB/T 16133—2014[S]. 2014-09-03. National Health and Family Planning Commission of the People's Republic of China. Screening of spinal curvature abnormality of children and adolescents GB/T 16133-2014[S]. 2014-09-03.
[8]	LOWE T G, EDGAR M, MARGULIES J Y, et al. Etiology of idiopathic scoliosis: current trends in research[J]. J Bone Joint Surg, 2000, 82(8): 1157. doi: 10.2106/00004623-200008000-00014
[9]	LIU S L, HUANG D S. Scoliosis in China: a general review[J]. Clin Orthop Relat Res, 1996, 323: 113-118. doi: 10.1097/00003086-199602000-00015
[10]	季成叶. 儿童青少年卫生学[M]. 7版. 北京: 人民卫生出版社, 2012: 149. JI C Y. Child and adolescent hygiene[M]. 7th. Beijing: People's Medical Publishing House, 2012: 149.
[11]	郝士兰, 杨双林, 王桂杰. 中小学生4168名脊柱弯曲异常调查分析[J]. 职业与健康, 2002(7): 102-103. doi: 10.3969/j.issn.1004-1257.2002.07.098 HAO S L, YANG S L, WANG G J. Analysis of 4168 primary and secondary school students with abnormal spinal curvature[J]. Occup Health, 2002(7): 102-103. doi: 10.3969/j.issn.1004-1257.2002.07.098
[12]	曾晓东, 谢峥能, 钟小梅, 等. 泉州市21668名中小学生脊柱弯曲异常调查[J]. 中国公共卫生, 2006(8): 912. doi: 10.3321/j.issn:1001-0580.2006.08.010 ZENG X D, XIE Z N, ZHONG X M, et al. Survey on abnormal spinal curvature in 21668 primary and secondary school students in Quanzhou City[J]. Chin Public Health, 2006(8): 912. doi: 10.3321/j.issn:1001-0580.2006.08.010
[13]	吴琼. 北京市小学高年级学生驼背的致因及干预研究[D]. 北京: 北京体育大学, 2019. WU Q. Study on the causes and interventions of hunchback in upper elementary school students in Beijing[D]. Beijing: Beijing Sports University, 2019.
[14]	亓德云, 李丽平, 江艳微, 等. 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[J]. 中国学校卫生, 2021, 42(3): 444-447, 453. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS202103031.htm QI D Y, LI L P, JIANG Y W, et al. Abnormal spinal curvature and influencing factors in children and adolescents in Hongkou District, Shanghai[J]. Chin J Sch Health, 2021, 42(3): 444-447, 453. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS202103031.htm
[15]	刘华山. 中学生脊柱弯曲异常的调查分析[J]. 疾病监测与控制, 2017, 11(10): 808-809. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJK201710021.htm LIU H S. Investigation and analysis of abnormal spinal curvature in secondary school students[J]. Dis Surveill Control, 2017, 11(10): 808-809. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJK201710021.htm