海南省2021年中小学生筛查性近视风险因素

柏红梅; 黄小君

doi:10.16835/j.cnki.1000-9817.2023.08.028

海南省2021年中小学生筛查性近视风险因素

doi: 10.16835/j.cnki.1000-9817.2023.08.028

柏红梅¹,
黄小君^2, ,

1.
海南省疾病预防控制中心公共卫生研究所学校卫生室，海口 570203
2.
海南医学院管理学院

基金项目:

2022年度(第二批)海南省卫生健康行业科研项目 19A200189

详细信息

作者简介:
柏红梅(1968-)，女，湖北襄阳人，大学本科，副研究员，主要从事学校卫生与健康教育相关工作

通讯作者:
黄小君，E-mail：hyh1132769910@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R778.1⁺1 R179 R193
计量
- 文章访问数: 219
- HTML全文浏览量: 100
- PDF下载量: 41
- 被引次数: 0
出版历程
- 收稿日期: 2023-03-10
- 修回日期: 2023-06-29
- 网络出版日期: 2023-08-26
- 刊出日期: 2023-08-25

Study on risk factors of screening myopia among primary and middle school students in Hainan Province in 2021

BAI Hongmei¹,
HUANG Xiaojun^{2
, ,}

1.
School Health Office of Public Health Research Institute, Hainan Center For Disease Control and Prevention, Haikou(570203), China

摘要

摘要: 目的分析2021年海南省中小学生筛查性近视状况及影响因素风险评估，为制定海南省学校近视防控干预策略和措施提供参考依据。方法按国家项目监测方案要求，2021年9—12月采用分层整群随机抽样方法对海南省学生常见病监测5个监测点中小学校进行近视筛查及相关因素调查，最终获取12 075份有效问卷进行分析。采用分层随机的方法，将全部的样本按照7∶3的比例划分为训练数据集和测试数据集，采用回归分析验证结果的稳健性。结果 2021年海南省中小学生筛查性近视检出率为44.3%，其中好片区学生筛查性近视检出率较高(53.5%)，城区学生(52.6%)高于郊县学生(34.9%)，女生(51.7%)高于男生(37.3%)，汉族学生(47.7%)相对于少数民族检出率较高，组间差异均有统计学意义(χ²值分别为152.71，378.77，167.81，251.94，P值均 < 0.01)；学生的筛查性近视检出率随着学段的增加不断提高(χ²=1 421.66，P < 0.01)。多因素Logistic回归分析结果显示，两组数据集构建的结果一致，年级较高、每天做眼保健操频率 < 2次、不良的近距离用眼习惯(躺着或趴着看书或电子屏幕)、父母一人近视或均近视均与筛查性近视发生呈正相关；男生、每天放学后做作业/读书写字时长 < 2 h、每天使用移动电子设备时长 < 1 h、每天睡眠时长≥9 h的学生与筛查性近视发生呈负相关(P值均 < 0.05)。结论海南省学生筛查性近视风险随着学龄段的升高呈上升趋势，相关部门应加大力度对筛查性近视发生风险较高的学生进行针对性干预防控工作。
- 近视 /
- 患病率 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the screening myopia status and risk assessment of influencing factors among primary and secondary school students in Hainan Province in 2021, so as to providea reference for formulating myopia prevention and control intervention strategies and measures of school in Hainan Province. Methods According to the requirements of the national project monitoring plan, the stratified cluster random sampling method was used to investigate the myopia screening and related influencing factors in 5 monitoring points of common diseases monitoring of students in Hainan Province from September to December 2021, and 12 075 valid questionnaires were obtained for analysis. Using stratified random method, all samples were divided into training data set and test data set according to the ratio of 7∶3, and regression analysis was conducted to verify the robustness of the results. Results In 2021, the screening myopia detection rate of primary and secondary school students in Hainan Province was 44.3%, among which the screening myopia detection rate of students in the middle and good districts was higher (53.5%), that of students in urban areas (52.6%) was higher than that of students in suburban counties (34.9%), and that of girls (51.7%) was higher than that of boys (37.3%). The detection rate of Han students (47.7%) was higher than that of ethnic minorities, and the difference between groups was statistically significant(χ²=152.71, 378.77, 167.81, 251.94, P < 0.01); The detection rate of screening myopia increased with the increase of the school level(χ²=1 421.66, P < 0.01). Multivariate Logistic regression analysis showed that the results of the two sets of data were consistent, and being in a higher grade, daily frequency of eye exercises < 2 times, poor habit of short-distance use of eyes (lying or lying on the stomach reading or watching electronic screen), having one or both parents with myopia were positively correlated with screening myopia(P < 0.05). For boys, time spent doing homework/reading and writing after school every day < 2 h, time spent using mobile electronic devices per day < 1 h, students with 1 h and daily sleep duration≥9 h were negatively correlated with the incidence of screening myopia(P < 0.05). Conclusion The risk of screening myopia increases with the increase of school age in Hainan, and relevant departments should strengthen targeted intervention and prevention for students with high risk of screening myopia.
- Myopia /
- Prevalence /
- Regression analysis /
- Students
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 不同组别中小学生筛查性近视检出率比较

Table 1. Comparison of the detection rate of screening myopia in primary and middle school students

组别	人数	筛查性近视人数	χ²值	P值
片区
好	3 106	1 663(53.5)	152.71	< 0.01
中	4 504	1 925(42.7)
差	4 465	1 766(39.6)
监测点
城区	6 448	3 389(52.6)	378.77	< 0.01
郊县	5 627	1 965(34.9)
性别
男	6 163	2 299(37.3)	167.81	< 0.01
女	5 912	3 055(51.7)
民族
汉族	8 755	4 175(47.7)	251.94	< 0.01
黎族	3 176	1 119(35.2)
苗族	104	46(44.2)
其他民族	40	14(35.0)
学段
小学	4 168	1 077(25.8)	1 421.66	< 0.01
初中	4 174	1 918(46.0)
普高	2 898	2 051(70.8)
职高	835	308(36.9)
注： ()内数字为检出率/%。

下载: 导出CSV

表 2 总体70%中小学生筛查性近视影响因素的Logistic回归分析(n=8 453)

Table 2. Logistic regression analysis of influencing factors of screening myopia among 70% of primary and secondary school students(n=8 453)

自变量	β值	标准误	Wald χ²值	P值	OR值(95%CI)
年级	0.06	0.00	221.79	< 0.01	1.06(1.05~1.07)
性别
男	-0.39	0.05	69.88	< 0.01	0.67(0.62~0.74)
每天做眼保健操频率/次
< 2	0.12	0.05	6.41	0.01	1.13(1.03~1.24)
每天放学后做作业/读书写字时长/h
< 2	-0.31	0.05	34.11	< 0.01	0.73(0.66~0.81)
每天使用移动电子设备时长/h
< 1	-0.11	0.05	5.16	0.02	0.89(0.81~0.99)
躺着或趴着看书或电子屏幕
是	0.28	0.06	24.33	< 0.01	1.32(1.18~1.45)
每天睡眠时长/h
≥9	-0.27	0.06	24.57	< 0.01	0.76(0.68~0.85)
父母近视
一人近视	0.52	0.06	74.20	< 0.01	1.68(1.49~1.89)
均近视	0.71	0.10	48.11	< 0.01	2.03(1.66~2.47)

下载: 导出CSV

表 3 总体30%中小学生筛查性近视影响因素的Logistic回归分析(n=3 622)

Table 3. Logistic regression analysis of influencing factors of screening myopia among 30% of primary and secondary school students(n=3 622)

自变量	β值	标准误	Wald χ²值	P值	OR值(95%CI)
年级	0.06	0.01	86.83	< 0.01	1.06(1.05~1.07)
性别
男	-0.45	0.07	37.70	< 0.01	0.64(0.55~0.74)
每天做眼保健操频率/次
< 2	0.21	0.08	7.61	0.01	1.23(1.06~1.42)
每天放学后做作业/读书写字时长/h
< 2	-0.36	0.08	18.80	< 0.01	0.83(0.73~0.94)
每天使用移动电子设备时长/h
< 1	-0.17	0.76	4.96	0.03	0.85(0.73~0.98)
躺着或趴着看书或电子屏幕
是	0.31	0.09	12.12	< 0.01	1.36(1.14~1.62)
每天睡眠时长/h
≥9	-0.36	0.09	17.10	< 0.01	0.70(0.59~0.83)
父母近视
一人近视	0.60	0.10	40.01	< 0.01	1.83(1.52~2.20)
均近视	0.74	0.16	21.91	< 0.01	2.09(1.54~2.85)

下载: 导出CSV

参考文献(19)

[1]	BOURNE R R A, STEVENS G A, WHITE R A, et al. Causes of vision loss worldwide, 1990-2010:a systematic analysis[J]. Lancet Global Health, 2013, 1(6): e339-e349. doi: 10.1016/S2214-109X(13)70113-X
[2]	陶芳标, 潘臣炜, 伍晓艳, 等. 户外活动防控儿童青少年近视专家推荐[J]. 中国学校卫生, 2019, 40(5): 641-643. doi: 10.16835/j.cnki.1000-9817.2019.05.001 TAO F B, PAN C W, WU X Y, et al. Expert recommendation for outdoors activities as myopia prevention and control in children and adolescents[J]. Chin J Sch Health, 2019, 40(5): 641-643. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.05.001
[3]	崔鹏, 石磊. 共同呵护好孩子的眼睛, 让他们拥有一个光明的未来[N]. 人民日报, 2018-08-28(1). CUI P, SHI L. Take good care of children's eyes and let them have a bright future[N]. People's Daily, 2018-08-28(1). (in Chinese)
[4]	中华人民共和国教育部办公厅等十五部门关于印发《儿童青少年近视防控光明行动工作方案(2021-2025年)》的通知[EB/OL]. (2021-04-28)[2022-12-20]. http://www.gov.cn/zhengce/zhengceku/2021-05/11/content_5605840.htm. Fifteen Departments Including the Office of the Ministry of Education of the PRC had issued a notice on the Tssuance of the Work Plan of Action to Prevent and Control Myopia in Children and Adolescents(2021-2025)[EB/OL]. (2021-04-28)[2022-12-20]. http://www.gov.cn/zhengce/zhengceku/2021-05/11/content_5605840.htm. (in Chinese)
[5]	黎鹏. 今年海南将对公办普通高中3700余间教室进行照明改造进一步提升学生视觉舒适度[N]. 海南日报, 2023-02-07(A5). LI P. This year, Hainan will renovate the lighting of more than 3700 classrooms in public ordinary high schools to further improve the visual comfort of students[N]. Hainan Daily, 2023-02-07(A5). (in Chinese)
[6]	中国疾病预防控制中心儿少/学校卫生中心, 北京大学儿童青少年卫生研究所. 2021年全国学生常见病和健康影响因素监测与干预工作方案[EB/OL]. (2021-06-14)[2023-08-08]. http://www.pingyi.gov.cn/info/5324/130034.htm. Chinese Center for Disease Control and Prevention Children/School Health Center, Institute of Child and Adolescent Health, Peking University. National student common diseases and the factors influencing the health monitoring and intervention work plan in 2021[EB/OL]. (2021-06-14)[2023-08-08]. http://www.pingyi.gov.cn/info/5324/130034.htm. (in Chinese)
[7]	中华人民共和国国家卫生健康委办公厅, 中华人民共和国教育部办公厅, 中华人民共和国财政部办公厅, 等. 关于开展2018年儿童青少年近视调查工作的通知[EB/OL]. (2018-10-25)[2023-08-08]. http://www.nhc.gov.cn/jkj/s5898bm/201810/08e2b45092d346a8a8c960d3e3d98b62.shtml. Notice of the General Office of the National Health Commission of the PRC, General Office of the Ministry of Education of the PRC, General Office of the Ministry of Finance of the PRC, et al. Launching the myopia survey of children and adolescents in 2018[EB/OL]. (2018-10-25)[2023-08-08]. http://www.nhc.gov.cn/jkj/s5898bm/201810/08e2b45092d346a8a8c960d3e3d98b62.shtml. (in Chinese).
[8]	中华人民共和国国家卫生健康委员会. 中小学生屈光不正筛查规范: WS/T 663—2020[S]. 2020-01-11. National Health Commission of the PRC. Standard for screening ametropia of primary and secondary school students: WS/T 663-2020[S]. 2020-01-11. (in Chinese)
[9]	刘晓惠. 海南: 学生综合近视率低于全国平均水平[N]. 中国教育报, 2020-11-06(3). LIU X H. Hainan: the comprehensive myopia rate of students is lower than the national average[N]. China Education Daily, 2020-11-06(3). (in Chinese)
[10]	陈蔚林. 海南评定首批儿童青少年近视防控示范学校[N]. 海南日报, 2021-10-20(A6). CHEN W L. Hainan awarded the first batch of demonstration schools for the prevention and control of myopia among children and adolescents[N]. Hainan Daily, 2021-10-20(A6). (in Chinese)
[11]	刘力勇, 安欣华, 胡晓凤. 2019年与2021年北京市某区儿童青少年筛查性近视率调查结果分析[J]. 安徽预防医学杂志, 2022, 28(5): 410-413, 424. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF202205016.htm LIU L Y, AN X H, HU X F. Analysis of the monitoring results of screening myopia rate among children and adolescents in a district of Beijing in 2019 and 2021[J]. Anhui J Prev Med, 2022, 28(5): 410-413, 424. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-AHYF202205016.htm
[12]	张辉, 董洪, 苏继艳, 等. 2019—2021年德阳市儿童青少年视力筛查结果分析[J]. 预防医学情报杂志, 2022, 38(8): 1088-1092. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202208009.htm ZHANG H, DONG H, SU J Y, et al. Analysis of visual screening results of childrenand adolescents in Deyang City from 2019 to 2021[J]. J Prev Med Inf, 2022, 38(8): 1088-1092. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202208009.htm
[13]	田向杰, 李江, 张静, 等. 2019年蒙自市中小学生近视影响因素分析[J]. 国际眼科杂志, 2022, 22(4): 652-656. https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK202204028.htm TIAN X J, LI J, ZHANG J, et al. Analysis of the influencing factors of myopia among primary and middle school students in Mengzi City in 2019[J]. Int Eye Sci, 2022, 22(4): 652-656. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK202204028.htm
[14]	张一, 周高祥, 苗超, 等. 浙江省余姚市中小学生近视流行现况分析[J]. 疾病监测, 2021, 36(12): 1347-1350. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202112032.htm ZHANG Y, ZHOU G X, MIAO C, et al. Prevalence of myopia in school students in Yuyao, Zhejiang[J]. Dis Surveill, 2021, 36(12): 1347-1350. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202112032.htm
[15]	陈黎黎, 吴岩, 石荣兴, 等. 2018—2020年北京市丰台区儿童青少年近视筛查结果分析[J]. 中国健康教育, 2021, 37(6): 507-510. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202106007.htm CHEN L L, WU Y, SHI R X, et al. Myopia prevalence in children and adolescents in Fengtai District of Beijing during 2018-2020[J]. Chin J Health Educ, 2021, 37(6): 507-510. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJK202106007.htm
[16]	常洋, 张宗辉, 苟铁军, 等. 某市2019年中小学生近视现状及影响因素分析[J]. 现代预防医学, 2021, 48(9): 1595-1599. https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202109015.htm CHANG Y, ZHANG Z H, GOU T J, et al. The current status and influencing factors of myopia among primary and middle school students in a city, 2019[J]. Mod Prev Med, 2021, 48(9): 1595-1599. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XDYF202109015.htm
[17]	WU P C, CHEN C T, LIN K K, et al. Myopia prevention and outdoor iight intensity in a school-based cluster randomized trial[J]. Ophthalmology, 2018, 125(8): 1239-1250.
[18]	DENG L, PANG Y. Effect of outdoor activities in myopia control: Meta-analysis of clinical studies[J]. Optom Vis Sci, 2019, 96(4): 276-282.
[19]	海南省教育厅等八部门. 海南省综合防控儿童青少年近视实施方案[EB/OL]. (2019-02-21)[2022-12-20]. http://www.moe.gov.cn/jyb_xwfb/xw_zt/moe_357/jyzt_2019n/2019_zt7/zcjj/df/201904/t20190430_380248.html. Hainan Provincial Department of Education and other eight departments. Implementation plan of comprehensive prevention and control of myopia among children and adolescents in Hainan Province[EB/OL]. (2019-02-21)[2022-12-20]. http://www.moe.gov.cn/jyb_xwfb/xw_zt/moe_357/jyzt_2019n/2019_zt7/zcjj/df/201904/t20190430_380248.html. (in Chinese)