上海地区6~8岁儿童近视前期流行病学调查

戚紫怡; 何鲜桂; 潘臣炜; 陈军; 谢辉; 杨金柳行; 杜林琳; 张波; 许迅; 王菁菁

doi:10.16835/j.cnki.1000-9817.2022.09.009

上海地区6~8岁儿童近视前期流行病学调查

doi: 10.16835/j.cnki.1000-9817.2022.09.009

戚紫怡^{1, 2},
何鲜桂^{1, 2},
潘臣炜³,
陈军¹,
谢辉¹,
杨金柳行¹,
杜林琳¹,
张波¹,
许迅^{1, 2},
王菁菁^1, ,

1.
上海市眼病防治中心/上海市眼科医院/上海市视觉健康中心, 200040
2.
上海交通大学附属第一人民医院/ 上海市眼底病重点实验室/国家眼部疾病临床医学研究中心
3.
苏州大学苏州医学院公共卫生学院

基金项目:

国家重点研发计划课题 2021YFC2702100

国家重点研发计划课题 2021YFC2702104

国家重点研发计划课题 2019YFC0840607

2019年上海市卫生健康委员会科研课题项目 21094Y0308

详细信息

作者简介:
戚紫怡(1996-), 女, 上海市人, 在读博士, 主要研究方向为儿童青少年近视防控

通讯作者:
王菁菁, E-mail: 13011220922@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G627.8 R778.11 R179
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出版历程
- 收稿日期: 2022-03-08
- 修回日期: 2022-04-16
- 刊出日期: 2022-09-25

Epidemiology of premyopia among children aged 6-8 in Shanghai

QI Ziyi^{1, 2},
HE Xiangui^{1, 2},
PAN Chenwei³,
CHEN Jun¹,
XIE Hui¹,
YANG Jinliuxing¹,
DU Linlin¹,
ZHANG Bo¹,
XU Xun^{1, 2},
WANG Jingjing^{1
, ,}

1.
Shanghai Eye Disease Prevention and Treatment Center/Shanghai Eye Hospital/Shanghai Vision Health Center, Shanghai (200040), China

摘要

摘要: 目的了解上海市6~8岁儿童近视前期的分布现状及进展规律, 并分析相关影响因素, 为中国儿童青少年近视防控工作的开展提供理论依据。方法采用随机整群抽样方法, 选取上海市8个区8所小学一、二年级2 037名学生开展2年随访调查研究, 基线及每年随访时进行视力、睫状肌麻痹电脑验光和眼轴长度等眼科检查, 收集相关因素问卷信息, 分析近视前期流行病学特征, 运用多元Logistic回归分析近视前期和远视儿童发生近视的影响因素。结果基线、第1年和第2年随访的总体近视前期检出率分别为26.2%, 37.3%, 41.3%, 其中基线时6, 7, 8岁儿童近视前期检出率分别为20.7%, 37.0%, 42.6%, 2年随访时8, 9, 10岁儿童为31.5%, 38.3%, 41.4%, 性别间差异无统计学意义(χ²=0.01~2.66, P值均>0.05)。基线近视前期儿童随访1年后近视发病率为31.5%, 随访2年后累计近视发病率为62.0%, 远高于远视儿童(0.6%和9.0%)。多因素分析结果显示, 基线近视前期、女生、父母均近视、基线AL与随访2年新发近视呈正相关(P值均 < 0.05)。结论近视前期低龄儿童2年内近视发生风险大, 是开展监测与近视预防干预的重点人群。
- 近视 /
- 流行病学研究 /
- 发病率 /
- 回归分析 /
- 儿童
Abstract: Objective To understand the distribution and progress of premyopia among children aged 6-8 years in Shanghai, and to analyze the related influencing factors in order to provide a theoretical basis for the prevention and control of myopia among children and adolescents in China. Methods Using a random cluster sampling method, a 2-year follow-up study was conducted among 2 037 students in grades 1 and 2 from eight primary schools in eight districts of Shanghai. At baseline and annual follow-up, ophthalmological examinations such as visual acuity, cycloplegic autorefraction and axial length were performed, and questionnaires on related factors were collected. The epidemiological characteristics of premyopia were analyzed, and the influencing factors of incident myopia in premyopic and hyperopic children were examined by multivariate Logistic regression. Results The prevalence of overall premyopia at baseline, first-year follow-up, and second-year follow-up were 26.2%, 37.3%, and 41.3%, respectively. Among them, the prevalence of premyopia in children aged 6, 7, and 8 at baseline were 20.7%, 37.0%, and 42.6%, and in children aged 8, 9, and 10 at the second-year follow-up were 31.5%, 38.3%, and 41.4%, respectively. There was no statistical difference between boys and girls (χ²=0.01-2.66, P>0.05). The incidence of myopia in children with premyopia at baseline was 31.5% after 1 year of follow-up, and the cumulative incidence of myopia after 2 years of follow-up was 62.0%, which was much higher than that in children with hyperopia (0.6% and 9.0%). Multivariate analysis showed that premyopia at baseline, female, having two parents with myopia, and AL at baseline were negatively associated with incidence of myopia at 2 years of follow-up (P < 0.05). Conclusion Premyopic children are at high risk of developing myopia within 2 years and are a priority group for surveillance and myopia prevention interventions.
- Myopia /
- Epidemiologic studies /
- Incidence /
- Regression analysis /
- Child
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 6~8岁儿童基线等效球镜和眼轴随访变化(x±s)

Table 1. Changes in spherical equivalent and axial length in children aged 6 to 8 years from baseline to follow-up(x±s)

基线年龄/岁	SE/D					AL/mm
基线年龄/岁	基线	第1年随访	第2年随访	F值	P值	基线	第1年随访	第2年随访	F值	P值
6	1.23±0.81	0.80±1.00	0.34±1.24	136.81	< 0.01	22.69±0.69	22.98±0.74	23.30±0.81	119.02	< 0.01
7	0.85±1.07	0.38±1.34	-0.13±1.59	120.38	< 0.01	22.96±0.76	23.24±0.83	23.55±0.91	113.31	< 0.01
8	0.75±1.22	0.26±1.40	-0.29±1.56	32.76	< 0.01	23.15±0.83	23.44±0.88	23.76±0.93	28.17	< 0.01
合计	0.98±1.02	0.52±1.25	0.03±1.48	268.16	< 0.01	22.88±0.76	23.16±0.82	23.48±0.89	246.31	< 0.01
F值	40.03	28.69	24.19			47.90	35.90	27.26
P值	< 0.01	< 0.01	< 0.01			< 0.01	< 0.01	< 0.01
注：基线时6，7，8岁分别为784，993，260人，第1年随访分别为713，914，230人，第2年随访分别为655，832，215人。

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表 2 基线及2年随访儿童近视前期检出率比较

Table 2. Comparison of prevalence of premyopia among primary school students in Shanghai at baseline and two-year follow-up

时间	年龄/岁	统计值	男生		女生		总体		χ²值	P值
时间	年龄/岁	统计值	人数	检出人数	人数	检出人数	人数	检出人数	χ²值	P值
基线	6		408	88(21.6)	376	74(19.7)	784	162(20.7)	0.43	0.51
	7		528	149(28.2)	465	140(30.1)	993	289(29.1)	0.43	0.51
	8		139	45(32.4)	121	37(30.6)	260	82(31.5)	0.10	0.76
	合计		1 075	282(26.2)	962	251(26.1)	2 037	533(26.2)	0.01	0.94
		χ²值		8.37		13.17		20.61
		P值		0.02		< 0.01		< 0.01
第1年随访	7		366	125(34.2)	347	139(40.1)	713	264(37.0)	2.66	0.10
	8		484	176(36.4)	430	1 728(40.0)	914	348(38.1)	1.23	0.26
	9		123	51(41.5)	107	3(34.6)	230	88(38.3)	1.15	0.28
	合计		973	352(36.2)	884	348(39.4)	1 857	700(37.3)	2.01	0.16
		χ²值		2.15		1.17		0.22
		P值		0.34		0.56		0.89
第2年随访	8		336	148(44.0)	319	131(41.1)	655	279(42.6)	0.60	0.44
	9		438	178(40.6)	394	157(39.8)	832	335(40.3)	0.05	0.82
	10		114	45(39.5)	101	44(43.6)	215	89(41.4)	0.37	0.54
	合计		888	371(41.8)	814	332(40.8)	1 702	703(41.3)	0.17	0.68
		χ²值		1.19		0.48		0.82
		P值		0.55		0.79		0.66
注：()内数字为检出率/%。

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表 3 基线近视前期和远视儿童新发近视的多因素Logistic回归分析(n=1 879)

Table 3. Multivariate Logistic regression analysis of myopia onset in children with premyopia and hyperopia at baseline(n=1 879)

自变量	选项	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
基线年龄		0.11	0.13	0.76	0.38
性别	男					1.00
	女	0.67	0.17	15.62	< 0.01	1.96(1.40~2.74)
父母近视人数	0					1.00
	1	0.16	0.18	0.80	0.37
	2	0.98	0.20	25.29	< 0.01	2.66(1.82~3.90)
基线屈光状态	远视					1.00
	近视前期	2.77	0.16	304.95	< 0.01	15.89(11.65~21.68)
基线AL		0.28	0.13	4.76	0.03	1.32(1.03~1.69)
随访期间户外时长		-0.14	0.09	2.72	0.10	0.87(0.71~1.03)
随访期间近距离用眼时长		0.03	0.04	0.42	0.52	0.97(0.89~1.06)

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