呼和浩特市中小学生脊柱弯曲异常现状

赵菊芳; 魏娜娜; 赵静; 杨田; 李国峰; 高建琼; 张秀红

doi:10.16835/j.cnki.1000-9817.2023.02.031

呼和浩特市中小学生脊柱弯曲异常现状

doi: 10.16835/j.cnki.1000-9817.2023.02.031

内蒙古自治区综合疾病预防控制中心学校卫生科，呼和浩特 010031

基金项目:

内蒙古自治区科技计划项目 2020GG0022

详细信息

作者简介:
赵菊芳(1989-)，女，内蒙古呼和浩特市人，硕士，主治医师，主要从事学校卫生工作

通讯作者:
张秀红，E-mail：1097011949@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R179 R726.8
计量
- 文章访问数: 351
- HTML全文浏览量: 157
- PDF下载量: 49
- 被引次数: 0
出版历程
- 收稿日期: 2022-09-16
- 修回日期: 2022-11-17
- 网络出版日期: 2023-03-02
- 刊出日期: 2023-02-25

Spinal curvature disorders among primary and middle school students in Hohhot

School Health Department, Inner Mongolia Center for Comprehensive Disease Control and Prevention, Hohhot(010031), China

摘要

摘要: 目的了解呼和浩特市中小学生脊柱弯曲异常的发生率及其相关因素，为制定相关措施提供参考依据。方法依据内蒙古自治区学生常见病监测与干预工作方案，于2021年9月采用分层随机整群抽样方法，选取13 586名呼和浩特市中小学生开展脊柱侧弯检查。结果脊柱弯曲异常检出538人，检出率4.0%；多因素Logistic回归分析结果显示，监测点、学段、过去1个月内背部出现过持续酸痛是中小学生脊柱弯曲异常的相关因素(OR值分别为0.33，1.74，1.28，1.51，P值均 < 0.05)。结论呼和浩特市中小学生脊柱弯曲异常不容忽视。应积极控制影响因素，采取有效措施，减少中小学生脊柱弯曲异常的发生率。
- 脊柱弯曲 /
- 患病率 /
- 回归分析 /
- 学生 /
- 少数民族
Abstract: Objective To investigate the incidence and associated factors of spinal curvature disorders among primary and middle school students in Hohhot, so as to provide reference for relevant prevention strategies. Methods According to the monitoring and intervention work of students' common diseases in Inner Mongolia Autonomous, 13 586 primary and middle school students in Hohhot were selected by random sampling method to carry out scoliosis examination in September 2021. Results A total of 538(4.0%) students were found to have spinal curvature disorder. Multivariate Logistic regression analysis showed that monitoring site, phases of studying, and persistent back pain in the past 1 month were associated of spinal curvature disorder in primary and middle school students (OR=0.33, 1.74, 1.28, 1.51, P < 0.05). Conclusion Conclusion Spinal curvature disorder is relatively common in primary and middle school students in Hohhot. Effective measures should be taken to reduce the burden of spinal curvature disorders in primary and middle school students.
- Spinal curvatures /
- Prevalence /
- Regression analysis /
- Students /
- Minority groups
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 呼和浩特市不同人口统计学特征中小学生脊柱弯曲异常检出率比较

Table 1. Comparison of the detection rate of abnormal spinal curvature among students with different demographic characteristics in Hohhot

人口统计学指标		人数	检出人数	χ²值	P值
监测点	县区	6 543	132(2.0)	125.2	< 0.01
	城区	7 043	406(5.8)
性别	男	6 849	278(4.1)	0.3	0.55
	女	6 737	260(3.9)
学段	小学	5 385	158(2.9)	34.4	< 0.01
	初中	5 048	207(4.1)
	普通高中/职业高中	3 153	173(5.5)
注： ()内数字为检出率/%。

下载: 导出CSV

表 2 呼和浩特市中小学生脊柱弯曲异常单因素分析

Table 2. Univariate analysis of abnormal spinal curvature in primary and middle school students in Hohhot

因素	人数	检出人数	χ²值	P值
平时背书包习惯
双肩包背胸前	484	27(5.6)	9.8	0.04
双肩包背背后	12 128	410(3.4)
双肩包背在一侧	453	22(4.9)
背单肩包	418	14(3.3)
使用带轮书包	103	6(5.8)
书包重量
很轻	827	40(4.8)	10.9	0.05
较轻	1 672	74(4.4)
中等	7 139	241(3.4)
较重	2 610	78(3.0)
很重	1 071	33(3.1)
没感觉	267	11(4.1)
班级座位是否进行左右轮转
是	11 151	378(3.4)	1.5	0.22
否	2 435	97(4.0)
床垫(床)柔软度
偏软	1 784	77(4.4)	7.5	0.02
适中	10 556	345(3.3)
偏硬	1 246	54(4.4)
左右脚鞋底磨损情况
没有差别	12 530	434(3.5)	2.0	0.36
左脚磨损严重	435	21(4.8)
右脚磨损严重	621	22(3.5)
鞋底内外侧磨损情况
没有	11 562	394(3.4)	2.2	0.33
内测磨损严重	754	32(4.2)
外侧磨损严重	1 270	52(4.1)
平时对坐姿、站姿的自我要求
无所谓，舒服就行	2 734	120(4.4)	8.9	0.03
还好，有时会监督自己一下	5 425	180(3.3)
时常会提醒自己	2 529	93(3.7)
时刻保持良好的姿势	2 898	85(2.9)
过去1个月身体出现酸痛部位
颈肩部
是	3 561	148(4.2)	4.5	0.03
否	10 025	331(3.3)
背部
是	2 019	111(5.5)	25.0	< 0.01
否	11 567	368(3.2)
腰部
是	3 139	139(4.4)	8.3	< 0.01
否	10 447	340(3.3)
BMI/(kg·m^-2)
< 18.5	4 034	168(4.2)	15.0	< 0.01
18.5~ < 24	6 405	233(3.6)
≥24	3 147	79(2.5)
平均每周上体育课数/节
0	140	3(2.1)	52.5	< 0.01
1	825	42(5.1)
2	4 017	129(3.2)
3	4 242	163(3.8)
4	2 359	37(1.6)
≥5	2 003	105(5.2)
过去1周每天用电脑的时间/h
没用过	7 809	246(3.2)	14.3	0.01
< 1	4 169	149(3.6)
1~ < 2	936	50(5.3)
2~ < 3	392	18(4.6)
3~ < 4	119	6(5.0)
≥4	161	9(5.6)
注： ()内数字为检出率/%。

下载: 导出CSV

表 3 呼和浩特市中小学生脊柱弯曲异常多因素Logistic回归分析(n=13 586)

Table 3. Multivariate Logistic regression analysis of abnormal spinal curvature in primary and middle school students in Hohhot(n=13 586)

自变量	β值	Wald χ²值	P值	OR值(OR值95%CI)
监测点
县区	-1.11	105.22	< 0.01	0.33(0.27~0.41)
学段
初中	0.55	16.79	< 0.01	1.74(1.33~2.26)
高中	0.25	4.46	0.04	1.28(1.02~1.60)
过去1个月背部出现
持续酸痛
是	0.41	10.73	< 0.01	1.51(1.18~1.93)
注：监测点以城区为参照组，学段以小学为参照组，过去1个月背部出现持续酸痛以否为参照组。

下载: 导出CSV

参考文献(19)

[1]	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 health[M]. 7 th. Beijing: People's Medical Publishing House, 2012: 149. (in Chinese)
[2]	张银昌, 沙士甫, 姜恩泽, 等. 青少年Chiari畸形伴脊柱侧弯与特发性脊柱侧弯患者肺功能损害的特征[J]. 中华医学杂志, 2018, 98(6): 418-421. doi: 10.3760/cma.j.issn.0376-2491.2018.06.004 ZHANG Y C, SHA S F, JIANG E Z, et al. Characteristics of pulmonary function impairment in adolescents with Chiari malformation and idiopathic scoliosis[J]. Chin Med J, 2018, 98(6): 418-421. (in Chinese) doi: 10.3760/cma.j.issn.0376-2491.2018.06.004
[3]	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 abnormal spinal curvature in children and adolescents[J]. Chin J Sch Health, 2008, 29(12): 1163-1165. (in Chinese) doi: 10.3969/j.issn.1000-9817.2008.12.052
[4]	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. Analysis on the prevention of abnormal spinal curvature in children and adolescents[J]. Chin Health Ind, 2012, 9(2): 155. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WSCY201202133.htm
[5]	杨田, 张凯文, 高昇, 等. 内蒙古地区学生肥胖现状及影响因素分析[J]. 中国学校卫生, 2021, 42(4): 611-614. doi: 10.16835/j.cnki.1000-9817.2021.04.030 YANG T, ZHANG K W, GAO S, et al. Analysis of the status quo and influencing factors of student obesity in Inner Mongolia[J]. Chin J Sch Health, 2021, 42(4): 611-614. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.04.030
[6]	国家卫生健康委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 2018-08-01. National Health Commission of the PRC. Screening for overweight and obesity in school-age children and adolescents: WS/T 586-2018[S]. 2018-08-01. (in Chinese)
[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]. 北京: 中国标准出版社, 2014. National Health and Family Planning Commission of the PRC. Screening for abnormal spinal curvature in children and adolescents: GB/T 16133-2014[S]. Beijing: Standards Press of China, 2014. (in Chinese)
[8]	国家卫生健康委员会宣传司. 2021年7月13日新闻发布会文字实录[EB/OL]. (2021-07-13)[2021-11-29]. http://www.nhc.gov.cn/xcs/s3574/202107/2fef24a3b77246fc9fb36dc8943af700.shtml. Publicity Department of the National Health Commission of the PRC. Transcript of the press conference 2021.7.13[EB/OL]. (2021-07-13)[2021-11-29]. http://www.nhc.gov.cn./xcs/s3574/202107/2fef24a3b77246fc9fb36dc8943af700.shtml. (in Chinese)
[9]	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. doi: 10.16835/j.cnki.1000-9817.2021.03.030 QI D Y, LI L P, JIANG Y W, et al. Current status and influencing factors of abnormal spinal curvature in children and adolescents in Hongkou District of Shanghai[J]. Chin J Sch Health, 2021, 42(3): 444-447, 453. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.03.030
[10]	吴春丽, 李东方, 张晓辉. 郑州市儿童青少年脊柱侧弯现状及影响因素[J]. 华南预防医学, 2021, 47(5): 673-675. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202105033.htm WU C L, LI D F, ZHANG X H. Current status and influencing factors of scoliosis in children and adolescents in Zhengzhou[J]. South Chin Prev Med, 2021, 47(5): 673-675. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GDWF202105033.htm
[11]	李尚乐, 张强, 荣霞. 西藏地区中小学生脊柱弯曲异常状况分析[J]. 中国学校卫生, 2021, 42(9): 1384-1387. doi: 10.16835/j.cnki.1000-9817.2021.09.026 LI S L, ZHANG Q, RONG X. Analysis of abnormal spinal curvature in primary and middle school students in Tibet[J]. Chin J Sch Health, 2021, 42(9): 1384-1387. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.09.026
[12]	唐倩倩, 陈玉华. 大学新生脊柱侧弯患者的生活行为习惯调查[J]. 湖北理工学院学报, 2021, 37(3): 51-54. https://www.cnki.com.cn/Article/CJFDTOTAL-HSGD202103011.htm TANG Q Q, CHEN Y H. Study on the life behavior of college freshmen with scoliosis[J]. J Hubei Polytech Univ, 2021, 37(3): 51-54. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HSGD202103011.htm
[13]	滕功伟. 小学生脊柱异常弯曲调查结果分析[J]. 承德医学院学报, 1999, 10(4): 67-68. https://www.cnki.com.cn/Article/CJFDTOTAL-CDYX199904034.htm TENG G W. Analysis of the investigation results of abnormal spinal curvature in primary school students[J]. J Chengde Med Univ, 1999, 10(4): 67-68. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-CDYX199904034.htm
[14]	郝士兰, 杨双林, 王桂杰. 中小学生4 168名脊柱弯曲异常调查分析[J]. 职业与健康, 2002, 18(7): 102-103. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJK200207097.htm HAO S L, YANG S L, WANG G J. Investigation and analysis of abnormal spinal curvature in 4 168 primary and middle school students[J]. Occup Health, 2002, 18(7): 102-103. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJK200207097.htm
[15]	汤钰婷. 2006—2010年某校初中生脊柱异常弯曲检出结果分析[J]. 中国校医, 2011, 25(5): 335-336. https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI201105010.htm TANG Y T. An analysis of the detection results of abnormal spinal curvature in junior high school students from 2006 to 2010[J]. Chin J School Doctor, 2011, 25(5): 335-336. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIYI201105010.htm
[16]	SEDREZ J, DA ROSA M, NOLL M, et al. Risk factors associated with structural postural changes in the spinal column of children and adolescents[J]. Rev Paul Pediatr, 2015, 33(1): 72-81.
[17]	李超群, 韩旭, 赵玉琪, 等. 不良读写姿态对青少年脊柱矢状面角度的影响[C]//中国体育科学学会运动生物力学分会. 第二十一届全国运动生物力学学术交流大会论文摘要汇编, 2021: 24-25. LI C Q, HAN X, ZHAO Y Q, et al. Effects of poor reading and writing posture on sagittal Angle of spine in adolescents[C]//Chinese Society of Sports Science Sports Biomechanics Branch. Compilation of Abstracts of the 21st National Conference on Sports Biomechanics, 2021: 24-25. (in Chinese)
[18]	唐锡麟. 关于"儿童少年脊柱弯曲异常的初筛"标准研制的说明[J]. 中国学校卫生, 1995, 16(3): 171-173. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS199503006.htm TANG X L. Note on the development of the standard for the screening of Vertebral Column Defects in Children[J]. Chin J Sch Health, 1995, 16(3): 171-173. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS199503006.htm
[19]	蒋志成, 徐慧琼, 万宇辉, 等. 儿童青少年脊柱弯曲异常筛查研究进展[J]. 中国学校卫生, 2021, 42(2): 312-315, 320. doi: 10.16835/j.cnki.1000-9817.2021.02.037 JIANG Z C, XU H Q, WAN Y H, et al. Research progress of screening for spinal curvature abnormalities in children and adolescents[J]. Chin J Sch Health, 2021, 42(2): 312-315, 320. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.02.037