四川省中小学生脊柱弯曲异常现状及影响因素分析

曾婕; 周亮; 任悄悄; 朱鸿斌; 张丽

doi:10.16835/j.cnki.1000-9817.2023.08.003

四川省中小学生脊柱弯曲异常现状及影响因素分析

doi: 10.16835/j.cnki.1000-9817.2023.08.003

曾婕¹,
周亮¹,
任悄悄¹,
朱鸿斌¹,
张丽^2, ,

1.
四川省疾病预防控制中心环境与学校卫生研究所，成都 610041
2.
四川省疾病预防控制中心

详细信息

作者简介:
曾婕(1987-)，女，四川成都人，硕士，副主任医师，主要从事学校卫生与环境卫生工作

通讯作者:
张丽，E-mail：657096242@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R682.3 R726.8 R179
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- 被引次数: 0
出版历程
- 收稿日期: 2023-04-11
- 修回日期: 2023-05-21
- 网络出版日期: 2023-08-26
- 刊出日期: 2023-08-25

Abnormal spinal curvature and associated factors among primary and secondary school students in Sichuan Province

1.
Institute of Environmental and School Health, Sichuan Center for Disease Control and Provention, Chengdu (610041), China

摘要

摘要: 结论了解四川省中小学生脊柱弯曲异常现状及其影响因素，为科学开展防控工作提供依据。方法采用分层整群随机抽样的方法，于2022年9—11月抽取四川省21个市(州)小学四年级至高中三年级210 713名学生进行脊柱弯曲异常筛查和问卷调查。采用χ²检验、多因素Logistic回归分析脊柱弯曲异常的影响因素。结果四川省中小学生脊柱弯曲异常检出率为3.42%，城区(4.54%)高于郊县(2.57%)，女生(3.86%)高于男生(2.98%)，高中生(4.70%)高于初中生(3.80%)和小学生(2.21%)，差异均有统计学意义(χ²值分别为606.96，123.81，645.24，P值均 < 0.01)。多因素Logistic回归分析结果显示，城区、学段(初中、高中)、女生、平时单肩背书包、每学年课桌椅高度根据身高进行调整次数≤1次、每周至少进行1 h中高强度运动0 d、每天室内静坐时长≥10 h与脊柱弯曲异常呈正相关(OR值分别为1.72，1.75，1.87，1.26，1.09，1.07，1.10，1.25，P值均 < 0.05)。结论四川省中小学生脊柱弯曲异常检出率可能受地区、学段、性别等因素影响。应重点关注城市中学女生，制定有针对性的防控策略，降低中小学生脊柱弯曲异常发生率。
- 脊柱弯曲 /
- 生长和发育 /
- 回归分析 /
- 学生
Abstract: Objective To investigate abnormal spinal curvature among primary and secondary school students in Sichuan Province, so as to provide evidence for scientific prevention. Methods Using a stratified cluster random sampling method, a total of 210 713 students of grade 4 to grade 12 from 21 cities (prefectures) in Sichuan Province were selected for spinal curvature screening and questionnaire survey from September to November 2022. Chi-square test and multivariate Logistic regression model were used to analyze the influencing factors of abnormal spinal curvature. Results The detection rate of abnormal spinal curvature was 3.42%, with urban areas (4.54%) higher than that in suburban areas(2.57%), girls (3.86%) higher than that in boys(2.98%), high school students (4.70%) higher than that in middle school students (3.80%) and elementary school students(2.21%), the differences were statistically significant (χ²=606.96, 123.81, 645.24, P < 0.01). Multivariate Logistic regression analysis showed that urban area, junior and senior high school, girl, carrying backpack on one shoulder, desks and chairs adjusted for student height less than ≤1 time every school year, moderate-to-vigorous physical activity less than 1 h per week, and indoors sedentary time more than 10 h/d were positively associated with abnormal spinal curvature (OR=1.72, 1.75, 1.87, 1.26, 1.09, 1.07, 1.10, 1.25, P < 0.05). Conclusion The detection rate of abnormal spinal curvature of primary and secondary school students may be affected by the urbanicity, educational stage as well as gender in Sichuan Province. More attention should be paid to urban high school girls, and targeted strategies should be explored to reduce the incidence of abnormal spinal curvature.
- Spinal curvatures /
- Growth and development /
- Regression analysis /
- Students
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表 1 四川省中小学生脊柱弯曲异常单因素分析

Table 1. Univariate analysis of the detection rates of spinal curvature abnormalities among primary and secondary school students in Sichuan Province

变量	选项	人数	检出人数	χ²值	P值
平时背书包习惯^*	双肩	188 653	6 347(3.36)	17.07	< 0.01
	单肩	22 031	859(3.90)
书包重量^*	轻	64 702	2 197(3.40)	4.16	0.13
	中	102 523	3 455(3.37)
	重	43 465	1 555(3.58)
班级座位是否左右轮转^*	是	159 602	5 736(3.59)	60.34	< 0.01
	否	51 074	1 469(2.88)
每学年课桌椅高度根据身高调整次数^*	≤1	163 037	5 763(3.53)	31.03	< 0.01
	>1	47 580	1 431(3.01)
读写姿势	较好	137 993	4 778(3.46)	1.97	0.16
	较差	72 720	2 433(3.35)
平时对坐姿和站姿的自我要求^*	无所谓	44 941	1 633(3.63)	77.12	< 0.01
	有时会监督自己	91 458	3 362(3.68)
	时常会提醒自己	39 449	1 246(3.16)
	时刻保持良好的姿势	34 841	965(2.77)
每天白天户外活动时长/h^*	< 2	129 608	4 465(3.45)	1.76	0.18
	≥2	72 778	2 426(3.33)
每周至少进行1 h中高强度运动的天数/d^*	0	31 333	1 272(4.06)	47.90	< 0.01
	≥1	179 362	5 938(3.31)
每天室内静坐时长/h	< 10	176 120	5 497(3.12)	294.12	< 0.01
	≥10	34 593	1 714(4.95)
消瘦^*	否	191 047	6 589(3.45)	3.51	0.06
	是	10 155	387(3.81)
注：()内数字为检出率/%；*变量有缺失值。

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表 2 四川省中小学生脊柱弯曲异常多因素Logistic回归分析(n=210 713)

Table 2. Multivariate Logistic regression analysis of associated factors of spinal curvature abnormalities among primary and secondary school students in Sichuan Province(n=210 713)

自变量	选项	β值	标准误	Wald χ²值	P值	OR值(95%CI)
地区	城区	0.54	0.03	487.12	< 0.01	1.72(1.64~1.80)
学段	初中	0.56	0.03	305.79	< 0.01	1.75(1.64~1.86)
	高中	0.63	0.04	294.51	< 0.01	1.87(1.74~2.01)
性别	女	0.24	0.03	91.49	< 0.01	1.26(1.21~1.33)
平时背书包习惯	单肩	0.09	0.04	5.14	0.02	1.09(1.01~1.17)
每学年课桌椅高度根据身高调整次数	≤1	0.06	0.03	4.29	0.04	1.07(1.01~1.13)
每周至少进行1 h中高强度运动的天数/d	0	0.09	0.03	8.05	< 0.01	1.10(1.03~1.17)
每天室内静坐时长/h	≥10	0.23	0.03	53.28	< 0.01	1.25(1.18~1.33)

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参考文献(22)

[1]	陶芳标. 儿童少年卫生学[M]. 8版. 北京: 人民卫生出版社, 2017: 175-176. TAO F B. Child and adolescent health[M]. 8 ed. Beijing: People's Medical Publishing House, 2017: 175-176. (in Chinese)
[2]	中华人民共和国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)[2023-04-06]. http://www.nhc.gov.cn/xcs/s3574/202107/2fef24a3b77246fc9fb36dc8943af700.shtml. Publicity Department of National Health Commission of the PRC. Transcript of press conference on July 13, 2021[EB/OL]. (2021-07-13)[2023-04-06]. http://www.nhc.gov.cn/xcs/s3574/202107/2fef24a3b77246fc9fb36dc8943af700.shtml. (in Chinese)
[3]	儿童青少年脊柱弯曲异常防控技术指南编写组, 马军. 《儿童青少年脊柱弯曲异常防控技术指南》解读[J]. 中国学校卫生, 2022, 43(2): 165-170, 175. doi: 10.16835/j.cnki.1000-9817.2022.02.002 Expert Group of Editorial Committee of Technical Guide for Prevention and Control of Abnormal Spinal Curvature in Chinese Children and Adolescents, MA J. Interpretation of Technical Guide for Prevention and Control of Abnormal Spinal Curvature in Children and Adolescents[J]. Chin J Sch Health, 2022, 43(2): 165-170, 175. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.02.002
[4]	HAN J, PARK S, KIM Y, et al. Effects of forward head posture on forced vital capacity and respiratory muscles activity[J]. J Phys Ther Sci, 2016, 28(1): 128-131. doi: 10.1589/jpts.28.128
[5]	中华人民共和国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 of spinal curvature abnormality of children and adolescents: GB/T 16133-2014[S]. Beijing: China Standards Press, 2014. (in Chinese)
[6]	中华人民共和国卫生部. 学生健康检查技术规范: GB/T 26343—2010[S]. 北京: 中国标准出版社, 2010. Ministry of Health of the PRC. Technical standard for physical examination for students: GB/T 26343-2010[S]. Beijing: China Standards Press, 2010. (in Chinese)
[7]	中华人民共和国国家卫生和计划生育委员会. 学龄儿童青少年营养不良筛查: WS/T 456—2014[S]. 北京: 中国标准出版社, 2014. National Health and Family Planning Commission of the PRC. Screening standard for malnutrition of school-age children and adolescents: WS/T 456-2014[S]. Beijing: China Standards Press, 2014. (in Chinese)
[8]	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. Abnormal spinal curvature in primary and secondary 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
[9]	许馨文, 周巧玲, 樊玉芳, 等. 甘肃省中小学生脊柱弯曲异常情况分析[J]. 中国初级卫生保健, 2022, 36(6): 93-94, 98. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW202206029.htm XU X W, ZHOU Q L, FAN Y F, et al. Analysis of abnormal spinal curvature among primary and secondary school students in Gansu Province[J]. Chin Prim Health Care, 2022, 36(6): 93-94, 98. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCW202206029.htm
[10]	陈静静, 孙锡杰, 李婉. 长三角地区中学生脊柱弯曲现状及影响因素[J]. 中国学校卫生, 2023, 44(1): 135-138. doi: 10.16835/j.cnki.1000-9817.2023.01.030 CHEN J J, SUN X J, LI W. Spinal curvature and associated factors among middle school students in the Yangtze River Delta Region[J]. Chin J Sch Health, 2023, 44(1): 135-138. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.01.030
[11]	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. Abnormal spinal curvature and influencing factors in children and adolescents in Hongkou District, Shanghai[J]. Chin J Sch Health, 2021, 42(3): 444-447, 453. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.03.030
[12]	赵菊芳, 魏娜娜, 赵静, 等. 呼和浩特市中小学生脊柱弯曲异常现状[J]. 中国学校卫生, 2023, 44(2): 295-298. doi: 10.16835/j.cnki.1000-9817.2023.02.031 ZHAO J F, WEI N N, ZHAO J, et al. Spinal curvature disorders among primary and middle school students in Hohhot[J]. Chin J Sch Health, 2023, 44(2): 295-298. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.02.031
[13]	文献英, 徐浩天, 刘念, 等. 2019年绵阳市7~18岁中小学生脊柱弯曲异常调查结果分析[J]. 预防医学情报杂志, 2021, 37(6): 828-832. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202106018.htm WEN X Y, XU H T, LIU N, et al. Investigation on abnormal spinal curvature of students of 7 to 18 years old in Mianyang City[J]. J Prev Med Inf, 2021, 37(6): 828-832. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202106018.htm
[14]	孙艺, 刘伟佳, 熊莉华, 等. 广州市中学生脊柱侧弯现状及影响因素分析[J]. 中国学校卫生, 2021, 42(12): 1865-1870, 1873. doi: 10.16835/j.cnki.1000-9817.2021.12.026 SUN Y, LIU W J, XIONG L H, et al. Scoliosis and associated factors among middle school students in Guangzhou City[J]. Chin J Sch Health, 2021, 42(12): 1865-1870, 1873. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.12.026
[15]	BYLSKI-AUSTROW D I, GLOS D L, WALL E J, et al. Scoliosis vertebral growth plate histomorphometry: comparisons to controls, growth rates, and compressive stresses[J]. J Orthop Res, 2018, 36(9): 2450-2459.
[16]	申翠梅, 朱厚伟, 张勇. 书包重量对小学生身体姿态影响的生物力学分析[C]//中国体育科学学会. 第十一届全国体育科学大会论文摘要汇编. 北京, 2019: 3427-3429. SHEN C M, ZHU H W, ZHANG Y. Biomechanical analysis of the influence of schoolbag weight on pupils' body posture[C]//China Sport Science Society. Compendium of abstracts of the Eleventh National Sports Science Congress. Beijing, 2019: 3427-3429. (in Chinese)
[17]	张献伟, 孙志颖, 刘忠慧, 等. 天津市中学生脊柱侧弯流行特征及影响因素分析[J]. 中国学校卫生, 2023, 44(1): 115-118. doi: 10.16835/j.cnki.1000-9817.2023.01.025 ZHANG X W, SUN Z Y, LIU Z H, et al. Analysis of epidemiological characteristics and influencing factors of scoliosis among middle school students in Tianjin[J]. Chin J Sch Health, 2023, 44(1): 115-118. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.01.025
[18]	张帅, 赵莉, 杨阳, 等. 青少年脊柱弯曲异常危险因素的Meta分析[J/OL]. 中国儿童保健杂志. (2023-03-14)[2023-04-06]. https://kns.cnki.net/kcms/detail/61.1346.R.20230313.1613.064.html. ZHANG S, ZHAO L, YANG Y, et al. Meta-analysis of risk factors for abnormal spinal curvature in adolescents[J/OL]. Chin J Child Health Care. (2023-03-14)[2023-04-06]. https://kns.cnki.net/kcms/detail/61.1346.R.20230313.1613.064.html. (in Chinese)
[19]	KARIIPPANON K E, CLIFF D P, OKELY A D, et al. Flexible learning spaces reduce sedentary time in adolescents[J]. J Sci Med Sport, 2019, 22(8): 918-923.
[20]	王富百慧, 王元超, 谭芷晔. 同伴支持行为对青少年身体活动的影响研究[J]. 中国体育科技, 2018, 54(5): 18-24. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTY201805003.htm WANG F B H, WANG Y C, TAN Z Y. The influence of partner support behavior on adolescents' physical activity[J]. Chin Sport Sci Technol, 2018, 54(5): 18-24. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGTY201805003.htm
[21]	WHO. Global recommendations on physical activity for health[EB/OL]. (2010-01-01)[2023-04-06]. https://www.who.int/publications/i/item/9789241599979.
[22]	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. Investigation on life and behavioral habits of scoliosis patients among college freshmen[J]. J Hubei Polytechnic Univ, 2021, 37(3): 51-44. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HSGD202103011.htm