内蒙古自治区中学生脊柱弯曲异常现状及影响因素分析

杨田; 张秀红; 高昇; 李国峰; 赵静; 赵菊芳

doi:10.16835/j.cnki.1000-9817.2023.03.029

内蒙古自治区中学生脊柱弯曲异常现状及影响因素分析

doi: 10.16835/j.cnki.1000-9817.2023.03.029

内蒙古自治区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:
杨田(1989-), 女, 内蒙古呼和浩特人, 硕士, 副主任医师, 主要研究方向为学生常见病监测与干预、青少年健康促进

通讯作者:
张秀红, E-mail: jsfkkp@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R 726.8
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- 被引次数: 0
出版历程
- 收稿日期: 2022-10-07
- 修回日期: 2023-01-13
- 刊出日期: 2023-03-25

Abnormal spinal curvature and its influencing factors among middle and high school students in Inner Mongolia Autonomous Region

School Health Department of the Center for Disease Control and Prevention of Inner Mongolia Autonomous Region, Hohhot(010031), China

摘要

摘要: 目的了解内蒙古自治区中学生脊柱弯曲异常现状，并分析健康影响因素，为有效开展脊柱弯曲异常防控提供科学依据。方法采用分层随机整群抽样的方法，覆盖内蒙古自治区全部12个盟市(103个旗县区)，在每个城区随机抽取2所初中、2所普通高中、1所职业高中，每个郊县区随机抽取2所初中、1所普通高中，共纳入87 908名学生进行脊柱弯曲异常筛查和健康影响因素问卷调查。采用χ²检验进行人口学特征和单因素分析，采用二元多因素Logistic回归模型，筛选中学生脊柱弯曲异常的危险因素。结果共检出脊柱弯曲异常中学生3 131名，检出率为3.56%；男生(3.69%)脊柱弯曲检出率高于女生(3.44%)，城区(6.15%)高于郊县(2.50%)，高中生(4.97%)高于初中生(2.73%)，差异均有统计学意义(χ²值分别为4.10，702.19，299.36，P值均 < 0.05)；中学生脊柱弯曲异常率随年级升高而上升，年级越高，脊柱弯曲异常率越高(χ_趋势²=309.29，P < 0.05)。二元多因素Logistic回归结果显示，近视、超重、肥胖、班级座位调换频次、每天放学后做作业或读书写字时间、白天户外活动时间、平时对坐姿站姿自我要求、学段、性别、片区是中学生脊柱弯曲异常的相关因素(OR=0.53~2.55，P值均 < 0.05)。结论中学生脊柱弯曲异常与营养状况、近视、读写姿势、久坐时间、户外活动时长等密切相关，需要多部门齐抓共管，共建护脊环境，早发现早干预。
- 脊柱弯曲 /
- 患病率 /
- 回归分析 /
- 少数民族 /
- 学生
Abstract: Objective To investigate the incidence of abnormal spinal curvature and related factors among middle school students in the Inner Mongolia Autonomous Region, so as to provide evidence for abnormal spinal curvature prevention and treatment. Methods By using a random stratified cluster sampling method, 87 908 students of middle and high school students from all 12 counties(districts) were investigated via questionnaires for abnormal spinal curvature and health influencing factors in Inner Mongolia Autonomous Region. Chi-square test was used to perform demographic characteristics and univariate analysis, and binary multivariate Logistic regression model was used to screen the risk factors for spinal curvature abnormalities in middle school students. Results A total of 3 131(3.56%) students with spinal curvature abnormalities were detected, with boys (3.69%) higher than that of girls(3.44%), urban areas (6.15%) higher than that of the suburban counties (2.50%), and high school students (4.97%) higher than that of junior high school(2.73%) students(χ²=4.01, 702.19, 299.36, P < 0.05). The detectable rate of spinal curvature abnormalities increased with grade (χ_trend²=309.29, P < 0.05). Logistic regression analysis showed that factors influencing abnormal spinal curvature included myopia, overweight, obesity, the frequency of classroom seating arrangements, time spent on homework/reading after school every day, time spent in daytime outdoor activities, self-imposed requirements for posture of sitting and standing, phase of studying, gender, and area (OR=0.53-2.55, P < 0.05). Conclusion Abnormal spinal curvature is strongly correlated to nutritional status, myopia, sitting posture when reading and writing, sedentary time, and time spent in outdoor activities. The collaboration of multiple departments is required to establish anenvironment to protect the spine, early detection and early intervention.
- Spinal curvatures /
- Prevalence /
- Regression analysis /
- Minority groups /
- Students
注释:

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表 1 不同组别内蒙古自治区中学生脊柱弯曲异常情况

Table 1. Comparison of the prevalence of scoliosis among different groups of Inner Mongolia secondary school students

组别	选项	人数	脊柱弯曲人数	χ²/χ_趋势²值	P值
性别	男	43 641	1 610(3.69)	4.10	0.04
	女	44 267	1 521(3.44)
监测点	城区	25 523	1 570(6.15)	702.19	< 0.01
	郊县	62 385	1 561(2.50)
片区	好片	23 634	930(3.94)	87.89	< 0.01
	中片	37 788	1 494(3.95)
	差片	26 486	707(2.67)
学段	初中	55 213	1 507(2.73)	299.36	< 0.01
	高中(含职高)	32 695	1 624(4.97)
年级	初一	18 415	466(2.53)	309.29	< 0.01
	初二	18 461	516(2.80)
	初三	18 337	525(2.86)
	高一	11 146	526(4.72)
	高二	10 928	531(4.86)
	高三	10 621	567(5.34)
近视	否	19 219	563(2.93)	29.03	< 0.01
	是	68 355	2 560(3.75)
超重	否	71 439	2 626(3.68)	14.48	< 0.01
	是	16 469	505(3.07)
肥胖	否	72 782	2 784(3.83)	85.47	< 0.01
	是	15 126	347(2.29)
一周内，每天≥60 min中高强度运动天数/d	0~1	35 228	1 362(3.87)	23.03	< 0.01
	2~4	32 038	1 022(3.19)
	5~7	19 205	706(3.68)
周末或节假日，每天≥60 min中高强度运动	少数或几乎做不到	40 406	1 533(3.79)	12.20	< 0.01
	一半日子能做到	15 162	539(3.55)
	都能或多数能做到	30 899	1 021(3.30)
班级座位调换频次	从不或一学期1次	11 681	497(4.25)	59.46	< 0.01
	每月1~2次	31 400	1 251(3.98)
	每周1次	43 228	1 339(3.10)
课桌椅高度根据身高调整频次	从不或课桌椅不可调	58 661	2 185(3.72)	13.91	< 0.01
	一学年1次	6 984	249(3.57)
	一学期1~2次	20 726	656(3.17)
每天放学后做作业或读书写字时间/h	没有作业或 < 1	16 783	551(3.28)	10.03	0.01
	1~ < 3	54 053	1 924(3.56)
	≥3	15 554	612(3.93)
读写时，胸口离桌子边沿超过一拳	偶尔或经常	64 608	2 358(3.65)	3.70	0.05
	总是	21 754	733(3.37)
父母提醒注意读写姿势	偶尔或经常	55 297	1 922(3.48)	4.76	0.03
	总是	31 065	1 169(3.76)
一周里每天白天户外活动时间/h	< 1	25 166	939(3.73)	14.15	< 0.01
	1~ < 3	45 985	1 683(3.66)
	≥3	15 258	468(3.07)
对坐姿、站姿的自我要求	无所谓或有时会监督自己	58 226	2 198(3.77)	20.41	< 0.01
	时常或时刻提醒自己	28 233	894(3.17)
注：()内数字为检出率/%；部分项目数据有缺失。

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表 2 内蒙古自治区中学生脊柱弯曲异常相关因素的Logistic回归分析(n=87 908)

Table 2. Logistics regression analysis of related factors of spinal curvature abnormalities among middle school students in Inner Mongolia Autonomous Region(n=87 908)

自变量与常量	选项	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
近视	是	0.16	0.05	11.04	< 0.01	1.17(1.07~1.30)
超重	是	-0.34	0.05	43.66	< 0.01	0.71(0.65~0.79)
肥胖	是	-0.64	0.06	116.52	< 0.01	0.53(0.47~0.59)
班级座位调换频次				61.02	< 0.01
	每月1~2次	-0.05	0.06	0.67	0.41	0.96(0.86~1.07)
	每周1次	-0.33	0.06	35.23	< 0.01	0.72(0.65~0.80)
每天放学后做作业或读书写字时间/h				4.24	0.12
	1~ < 3	0.10	0.05	4.19	0.04	1.11(1.00~1.23)
	≥3	0.09	0.06	2.20	0.14	1.10(0.97~1.24)
一周里每天白天户外活动时间/h				8.12	0.02
	1~ < 3	0.02	0.04	0.19	0.67	1.02(0.94~1.11)
	≥3	-0.14	0.06	5.06	0.03	0.87(0.78~0.98)
学段	高中	0.44	0.04	122.19	< 0.01	1.55(1.43~1.67)
片区				142.35	< 0.01
	好片	0.28	0.05	27.79	< 0.01	1.32(1.19~1.46)
	中片	0.56	0.05	137.47	< 0.01	1.75(1.59~1.92)
监测点	城区	0.94	0.04	582.18	< 0.01	2.55(2.36~2.75)
性别	男	0.15	0.04	14.15	< 0.01	1.16(1.07~1.25)
常量		-4.09	0.09	1 967.40	< 0.01	0.02

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