Epidemiological characteristics and influencing factors of scoliosis in primary and secondary school students in Guangdong Province
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摘要:
目的 了解广东省中小学生脊柱侧凸流行特征,探讨其相关影响因素,为脊柱侧凸的预防控制提供依据。 方法 采用分层随机整群抽样的方法,于2020年9—10月在珠三角和非珠三角城市抽取132所中小学校,共38 649名9~18岁学生进行脊柱侧凸筛查和相关影响因素问卷调查。 结果 调查学生中有1 440名检出脊柱侧凸,检出率为3.73%。女生检出率为4.90%,高于男生的2.66%(χ2=134.72,P < 0.01)。珠三角地区检出率为4.09%,高于非珠三角地区的3.38%(χ2=13.22,P < 0.01)。城区检出率为4.51%,高于县区的2.79%(χ2=78.70,P < 0.01)。检出率随着学段的升高而升高,高中(5.94%)>初中(4.50%)>小学(1.35%)(χ2=386.89,P < 0.01)。多因素Logistic回归分析显示,地区、城乡、性别、学段、中高强度运动、使用电子移动设备、营养状况是学生脊柱侧凸的相关因素(OR=0.41~3.78,P值均 < 0.05)。 结论 广东省中小学生脊柱侧凸检出率在性别、城乡、学段等方面均存在差异,需重点关注女生、初中学段、高中学段学生,并探索有针对性的科学干预策略。 Abstract:Objective To investigate the epidemiological characteristics and associated factors of scoliosis in primary and secondary school students in Guangdong, and to provide guidance for scoliosis control. Methods Using a stratified cluster random sampling method, a total of 38 649 students aged 9-18 were selected from 132 primary and secondary schools in the Pearl River Delta and non-Pearl River Delta cities for scoliosis screening and related associated factors questionnaire survey from September to October 2020. Results A total of 1 440 students were detected with scoliosis, with a detection rate of 3.73%. The detection rate of girls was 4.90%, which was higher than that of boys at 2.66%(χ2=386.89, P < 0.01). The detection rate in the Pearl River Delta region was 4.09%, which was higher than the non-Pearl River Delta region at 3.38%(χ2=13.22, P < 0.01). The detection rate in urban areas was 4.51%, which was higher than counties at 2.79%(χ2=78.70, P < 0.01). The detection rate increased with the increase of the school period, high school (5.94%)>junior high school (4.50%)>elementary school (1.35%)(χ2=386.89, P < 0.01). Multivariate Logistic regression analysis showed that region, urbanicity, gender, educational stage, exercise, using electronic mobile devices, nutritional status are the influencing factors for scoliosis (OR=0.41-3.78, P < 0.05). Conclusion The detection rate of scoliosis in primary and secondary school students in Guangdong Province varies by gender, urbanicity and educational stages. Female students, as well as junior and senior high school students should be paid more attention. -
Key words:
- Scoliosis /
- Prevalence /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同组别中小学生脊柱侧凸检出率比较
Table 1. Comparison of the detection rate of scoliosis among different groups of primary and middle school students
组别 选项 人数 检出人数 χ2值 P值 地区 珠三角 18 909 773(4.09) 13.22 < 0.01 非珠三角 19 740 667(3.38) 城乡 城区 21 010 947(4.51) 78.70 < 0.01 县区 17 639 493(2.79) 性别 男 20 237 538(2.66) 134.72 < 0.01 女 18 412 902(4.90) 学段 小学 14 231 192(1.35) 386.89 < 0.01 初中 14 070 633(4.50) 高中 10 348 615(5.94) 营养状况 正常 26 727 1 106(4.14) 111.87 < 0.01 超重 4 818 103(2.14) 肥胖 3 262 44(1.35) 营养不良 3 842 187(4.87) 注: ()内数字为检出率/%。 表 2 中小学生脊柱侧凸相关因素Logistic回归分析(n=38 649)
Table 2. Logistic regression analysis of the influencing factors of scoliosis in primary and middle students(n=38 649)
自变量 选项 β值 P值 OR值(OR值95%CI) 地区 珠三角 1.00 非珠三角 -0.23 < 0.01 0.79(0.71~0.88) 城乡 城区 1.00 县区 -0.45 < 0.01 0.64(0.57~0.71) 性别 男 1.00 女 0.58 < 0.01 1.79(1.60~2.00) 学段 小学 1.00 初中 1.17 < 0.01 3.23(2.73~3.85) 高中 1.33 < 0.01 3.78(3.18~4.51) 过去1周内有超过60 min中高 是 1.00 强度运动 否 0.16 0.03 1.18(1.02~1.36) 过去1周内平均每天使用电子 未使用 1.00 移动设备的时间/h < 2 0.07 0.35 1.08(0.92~1.26) ≥2 0.26 < 0.01 1.29(1.10~1.51) 营养状况 正常 1.00 超重 -0.57 < 0.01 0.56(0.45~0.69) 肥胖 -0.88 < 0.01 0.41(0.30~0.56) 营养不良 0.32 < 0.01 1.38(1.16~1.62) -
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