近视队列江苏省中部地区2年追踪调查结果

黄立民; 王艳; 潘臣炜; 张凤云; 姚庆兵; 朱月潜; 朱维维; 李子林; 徐迎娣; 陈少春; 茆在平; 张锡彦; 杨婕

doi:10.16835/j.cnki.1000-9817.2022.09.005

近视队列江苏省中部地区2年追踪调查结果

doi: 10.16835/j.cnki.1000-9817.2022.09.005

黄立民¹,
王艳^{2, 3},
潘臣炜⁴,
张凤云^{2, 3},
姚庆兵⁵,
朱月潜⁵,
朱维维⁵,
李子林¹,
徐迎娣¹,
陈少春¹,
茆在平¹,
张锡彦^{2, 3, ,},
杨婕^{2, 3, ,}

1.
江苏省仪征市疾病预防控制中心学校卫生科，210009
2.
江苏省疾病预防控制中心儿童青少年健康促进所
3.
江苏省公共卫生研究院
4.
苏州大学苏州医学院公共卫生学院
5.
扬州市疾病预防控制中心

基金项目:

中心科研发展-科研发展基金 004001

详细信息

作者简介:
黄立民(1971-)，男，江苏仪征人，大学本科，副主任医师，主要研究方向为儿童青少年卫生及健康教育

王艳(1982-)，女，江苏常熟人，大学本科，副主任医师，主要研究方向为儿童青少年健康促进

通讯作者:
张锡彦，E-mail：240762 2173@qq.com

杨婕，E-mail：51478536@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R778.11 R179 G627.8
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- 被引次数: 0
出版历程
- 收稿日期: 2022-02-12
- 修回日期: 2022-03-02
- 网络出版日期: 2022-09-23
- 刊出日期: 2022-09-25

Two-year follow-up of myopia cohort in central Jiangsu Province

HUANG Limin¹,
WANG Yan^{2, 3},
PAN Chenwei⁴,
ZHANG Fengyun^{2, 3},
YAO Qingbing⁵,
ZHU Yueqian⁵,
ZHU Weiwei⁵,
LI Zilin¹,
XU Yingdi¹,
CHEN Shaochun¹,
MAO Zaiping¹,
ZHANG Xiyan^{2, 3
, ,},
YANG Jie^{2, 3
, ,}

1.
Department of School Health, Yizheng Center for Disease Control and Prevention, Yizheng(210009), Jiangsu Province, China

摘要

摘要: 目的基于江苏省学生常见病监测、队列及干预研究探索生长参数与近视发生发展的关系，为城市化进程较快地区儿童屈光档案的建立提供理论依据。方法采用以学校为单位的分层整群抽样方法，共选取江苏省仪征市学生1 187名，并对2019—2020年追踪人群近视及其相关参数进行差异性比较，采用Cox回归多元统计模型探索儿童青少年生长参数与近视发生发展的关系。结果 2019年一年级至三年级学生近视率分别为5.4%，21.5%，37.3%，2020年各学段近视率分别增长至25.3%，43.3%，58.1%(χ²值分别为53.59，49.63，32.52，P值均＜0.01)。2019年右眼/左眼散瞳后屈光度均值分别为(0.30±1.24/0.39±1.26)D，2020年右眼/左眼散瞳后屈光度均值分别为(-0.33±1.54/-0.19±1.55)D。基于Cox多元回归结果显示，年龄(HR=1.21，95%CI=1.09~1.34)、裸眼视力(HR=0.08，95%CI=0.07~0.11)、身高(HR=0.98，95%CI=0.97~0.99)与近视发生发展呈现相关性(P值均 < 0.05)。结论江苏省中部地区近视增长速度快，建议屈光度、眼轴长度、裸眼视力、年龄、身高等指标纳入地区儿童青少年屈光档案。
- 近视 /
- 队列研究 /
- 患病率 /
- 模型, 统计学 /
- 学生
Abstract: Objective Based on observational, longitudinal and intervention study of common diseases among students in Jiangsu Province, this paper presents the current progress of two-year follow up of myopia cohort regarding the association between growth parameters with progression of myopia among children and adolescents in areas with rapid economic growth. Methods This survey adopted the stratified cluster sampling method for school selection. The full-automatic computer optometry (TOPCON RM800) was used to track myopia-related parameters for all participants from 2019 to 2020 under the condition of mydriasis (compound topicamide eye drops). Relationship between growth parameters of children and adolescents and the incidence and progression of myopia was analyzed by using Cox regression multiple statistical model. Results The myopia rates of students from grade 1 to grade 3 in 2019 were 5.4%, 21.5% and 37.3% respectively. After one year, the myopia rates of all school stages increased to 25.3%, 43.3% and 58.1% respectively(χ²=53.59, 49.63, 32.52, P < 0.01). The mean diopter of right eye and left eye after mydriasis were (0.30±1.24/0.39±1.26)D in 2019 and (-0.33±1.54/-0.19±1.55)D in 2020, respectively based on Cox multiple regression results, age (HR=1.21, 95%CI=1.09-1.34), naked eye vision (HR=0.08, 95%CI=0.07-0.11), height (HR=0.98, 95%CI=0.97-0.99) showed a strong correlation with the incidence and progression of myopia(P < 0.05). Conclusion Myopia is growing rapidly in the central region of Jiangsu Province. It is suggested that diopter, axial length, naked eye vision, age, height and other indicators should be included in the refractive archives of children and adolescents in the region.
- Myopia /
- Cohort studies /
- Prevalence /
- Models, statistical /
- Students
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 仪征市不同年级学生散瞳后等效球镜值/D

Table 1. Spherical equivalent value after mydriasis in different grades in Yizheng City/D

年份	年级	人数	右眼	左眼
2019	一	352	0.86±1.04	0.94±1.12
	二	460	0.23±1.18	0.31±1.17
	三	375	-0.14±1.30	-0.03±1.30
	合计	1 187	0.30±1.24	0.39±1.26
2020	二	352	0.23±1.33	0.35±1.37
	三	460	-0.39±1.53	-0.26±1.54
	四	375	-0.78±1.57	-0.47±1.59
	合计	1 187	-0.33±1.54	-0.19±1.55

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表 2 基于多元统计模型儿童青少年生长参数与近视发生发展的关系

Table 2. Relationship between growth parameters of children and adolescents and onset/development of myopia based on multivariate statistical model

自变量	模型	β值	标准误	Wald χ²值	P值	HR值(HR值95%CI)
年龄	1	0.19	0.05	13.02	< 0.01	1.21(1.09~1.34)
	2	0.19	0.05	13.02	< 0.01	1.21(1.09~1.34)
	3	0.19	0.05	12.62	< 0.01	1.21(1.09~1.34)
性别	1	0.06	0.08	0.63	0.43	1.06(0.92~1.23)
	2	0.06	0.08	0.67	0.41	1.06(0.92~1.24)
	3	0.08	0.08	1.00	0.32	1.08(0.93~1.26)
裸眼视力	1	-2.47	0.13	365.55	< 0.01	0.08(0.07~0.11)
	2	-2.47	0.13	366.04	< 0.01	0.08(0.07~0.11)
	3	-2.47	0.13	365.12	< 0.01	0.09(0.07~0.11)
角膜曲率	1	-0.00	0.03	0.01	0.93	1.00(0.94~1.06)
	2	-0.00	0.03	0.01	0.98	1.00(0.95~1.06)
	3	-0.00	0.03	< 0.01	0.97	1.00(0.94~1.06)
身高	1	-0.02	0.01	8.97	< 0.01	0.98(0.97~0.99)
	2	-0.02	0.01	9.10	< 0.01	0.98(0.97~0.99)
	3	-0.02	0.01	6.22	0.01	0.99(0.97~1.00)
收缩压	1	0.00	0.00	0.66	0.42	1.00(0.99~1.01)
舒张压	1	-0.01	0.01	1.23	0.27	0.99(0.98~1.00)
BMI	3	-0.02	0.01	1.55	0.21	0.99(0.96~1.01)
注：模型1纳入协变量年龄、性别、裸眼视力、角膜曲率、身高、收缩压、舒张压；模型2纳入协变量年龄、性别、裸眼视力、角膜曲率、身高；模型3纳入协变量年龄、性别、裸眼视力、角膜曲率、身高、BMI。

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