内蒙古地区2019—2022年中小学生脊柱侧弯与近视共患流行趋势及相关因素分析

马鑫悦; 张秀红; 宋逸; 董彦会; 杨田; 马彩霞; 高昇

doi:10.16835/j.cnki.1000-9817.2023.09.003

内蒙古地区2019—2022年中小学生脊柱侧弯与近视共患流行趋势及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2023.09.003

马鑫悦^{1, 2},
张秀红^2, ,,
宋逸³,
董彦会³,
杨田²,
马彩霞¹,
高昇^2, ,

1.
内蒙古医科大学公共卫生学院，呼和浩特 010059
2.
内蒙古自治区综合疾病预防控制中心学校卫生科
3.
北京大学公共卫生学院/北京大学儿童青少年卫生研究所

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:
马鑫悦(1998-)，男，内蒙古鄂尔多斯人，在读硕士，主要研究方向为学校卫生

通讯作者:
张秀红，Email：zxhcdc@163.com

高昇，E-mail：gaosh8899@126.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 R778.1⁺¹ R179
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-13
- 修回日期: 2023-08-21
- 网络出版日期: 2023-09-28
- 刊出日期: 2023-09-25

Prevalence trend and related factors of scoliosis and myopia co-morbidities among primary and middle school students in Inner Mongolia Autonomous Region from 2019 to 2022

MA Xinyue^{1, 2},
ZHANG Xiuhong^{2
, ,},
SONG Yi³,
DONG Yanhui³,
YANG Tian²,
MA Caixia¹,
GAO Sheng^{2
, ,}

1.
School of Public Health, Inner Mongolia Medical University, Hohhot (010059), China

摘要

摘要: 目的分析2019—2022年内蒙古地区中小学生脊柱侧弯与近视共患的流行趋势及共同病因，为制定相关防控措施提供参考。方法采用分层随机整群抽样方法于2019—2022年每年9月在内蒙古12个盟市(103个旗县区)分别抽取181 533，141 552，200 987，190 918名中小学学生，对纳入研究的学生进行脊柱侧弯筛查、视力检查和问卷调查。采用χ²检验对数据进行单因素分析，采用二元多因素Logistic回归模型筛选脊柱侧弯与近视共患的影响因素。结果 2019—2022年内蒙古地区中小学生近视率为55.55%~59.72%；脊柱侧弯率为1.56%~2.81%；脊柱侧弯与近视共患率为1.14%~1.95%，不同年份间差异均有统计学意义(χ²值分别为595.01，775.56，461.84，P值均 < 0.05)。2022年脊柱侧弯和近视共患率女生(1.32%)高于男生(0.97%)，城区(2.57%)高于旗县区(0.62%)，职高和普高学生(3.82%，2.47%)高于初中和小学学生(1.70%，0.42%)，经济发展中好片区(1.21%)高于差片区(0.99%)(χ²值分别为52.19，1 269.82，1 361.52，17.29，P值均 < 0.05)。Logistic回归分析显示，多数或都能做到周末每天至少1 h中高强度运动、每周体育课数量≥3节、课桌椅高度是根据身高调整、在户外课间休息、家长限制视屏时间、严格要求站姿坐姿和脊柱侧弯与近视共患呈负相关(OR=0.65~0.90)；参加补习班、走路或乘车时看书或电子屏幕和脊柱侧弯与近视共患呈正相关(OR值分别为1.27，1.13)(P值均 < 0.05)。结论行为习惯与近视和脊柱侧弯相关。防控脊柱侧弯与近视共患应从学生的行为习惯入手，早筛查、早干预。
- 脊柱侧凸 /
- 近视 /
- 流行病学研究 /
- 回归分析 /
- 学生 /
- 少数民族
Abstract: Objective To analyze the prevalence trend of scoliosis among myopic students in Inner Mongolia Autonomous Region during 2019-2022, to explore the common etiology of myopia and scoliosis co-morbidities, so as to provide a reference for the development of relevant measures. Methods The method of stratified random cluster sampling was used to select 181 533, 141 552, 200 987, 190 918 primary and secondary school students from 12 leagues(103 banners) in Inner Mongolia Atuonomous Region in September each year from 2019 to 2022. And scoliosis screening, vision examination and questionnaire survey were conducted among students in the included studies. The χ² test was used to analyze the data, and the binary multivariate Logistic regression model was used to screen the influencing factors of scoliosis and myopia co-morbidities. Results From 2019 to 2022, the myopia rate of primary and secondary school students in Inner Mongolia Autonomous Region was 55.55%-59.72%, scoliosis rate was 1.56%-2.81% and the rates of scoliosis and myopia co-morbidities were 1.14%-1.95%, and the difference between different years was statistically significant (χ²=595.01, 775.56, 461.84, P < 0.05). In 2022, the co-morbidity rate was higher in girls than in boys(1.32% vs 0.97%), the rate of urban areas was higher than that of rural areas(2.57% vs 0.62%), the rate of students in vocational high school and high school was higher than that in junior high school and primary school (3.82%, 2.47% vs 1.70%, 0.42%), the rate of over-developed areas was higher than that of poor areas (1.21% vs 0.99%)(χ²=52.19, 1 269.82, 1 361.52, 17.29, P < 0.05). Logistic regression analysis showed that at least 1 h of moderate and high-intensity exercise every day on weekends, the number of physical education classes per week was more than 3 sessions, the height of desks and chairs was adjusted according to height, resting outdoors, limiting screen time, and strictly requiring standing and sitting posture were the negative correlated with scoliosis and myopia, and the OR value was 0.65-0.90, reading books or electronic screens while participating in cram classes, walking or riding in the car were positively correlated with comorbid scoliosis and myopia, and the OR values were 1.27 and 1.13 (P < 0.05), respectively. Conclusion Behavioral habits severely affect scoliosis and myopic of students. Prevention and control of scoliosis and myopia co-morbidity should start with students' behavioral habits, early screening and early intervention.
- Scoliosis /
- Myopia /
- Epidemiologic studies /
- 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。

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表 1 不同年份内蒙古中小学生脊柱侧弯与近视及共患检出率比较

Table 1. Comparison of the detection rate of scoliosis and myopia co-morbidities in primary and middle school students in Inner Mongolia Autonomous Region in different years

年份	人数	近视	脊柱侧弯	共患
2019	181 533	100 835(55.55)	5 097(2.81)	3 543(1.95)
2020	141 552	84 541(59.72)	3 489(2.46)	2 541(1.80)
2021	200 987	116 132(57.78)	3 962(1.97)	2 919(1.45)
2022	190 918	110 925(58.10)	2 981(1.56)	2 183(1.14)
χ²值		595.60	775.56	461.84
P值		< 0.01	< 0.01	< 0.01
注：()内数字为检出率/%。

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表 2 2022年不同人口统计学特征内蒙古中小学生脊柱侧弯与近视共患率比较

Table 2. Comparison of demographics characteristics of scoliosis and myopia co-morbidity among primary and secondary school students from Inner Mongolia Autonmous Region in 2022

人口统计学指标		人数	检出人数	χ²值	P值
性别	男	96 708	938(0.97)	52.19	< 0.01
	女	94 210	1 245(1.32)
监测点	城区	51 464	1 323(2.57)	1 269.82	< 0.01
	旗县	139 454	860(0.62)
学段	小学	107 139	447(0.42)	1 361.52	< 0.01
	初中	51 016	867(1.70)
	普高	28 313	699(2.47)
	职高	4 450	170(3.82)
经济片区	中好	135 043	1 632(1.21)	17.29	< 0.01
	差	55 875	551(0.99)
注：()内数字为检出率/%。

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表 3 2022年内蒙古中小学生脊柱侧弯与近视共患的单因素分析

Table 3. Univariate analysis of scoliosis and myopia co-morbidities among primary and secondary school students from Inner Mongolia Autonomous Region in 2022

因素	选项	人数	检出人数	χ²值	P值
周末每天至少1 h中高强度运动	少数做到或几乎做不到	56 524	1 015(1.80)	38.82	< 0.01
	多数或都能做到	78 810	1 081(1.37)
每周体育课节数	≤2	52 745	1 108(2.10)	172.66	< 0.01
	≥3	82 589	988(1.20)
课桌椅高度是否根据身高调整	否	84 736	1 441(1.70)	34.26	< 0.01
	是	50 598	655(1.29)
课间休息活动场所	室内	72 654	1 320(1.82)	73.93	< 0.01
	户外	62 680	776(1.24)
是否因作业或补习减少运动时间	否	91 641	1 373(1.50)	4.75	0.03
	是	43 693	723(1.65)
是否参加补习班	否	79 447	1 104(1.39)	31.96	< 0.01
	是	55 887	992(1.78)
家长是否限制视屏时间	否	53 836	995(1.85)	52.57	< 0.01
	是	81 498	1 101(1.35)
是否胸口离桌超过一拳	否	95 339	1 573(1.65)	21.64	< 0.01
	是	39 995	523(1.31)
是否眼睛离书本超过一尺	否	94 960	1 576(1.66)	25.67	< 0.01
	是	40 374	520(1.29)
是否手指离笔尖一寸左右	否	88 926	1 482(1.67)	23.60	< 0.01
	是	46 408	614(1.32)
老师是否提醒读写姿势	从不或偶尔	62 858	1 067(1.70)	17.03	< 0.01
	经常或总是	72 476	1 029(1.42)
是否躺着或趴着看书或电子屏幕	否	67 874	923(1.36)	31.86	< 0.01
	是	67 460	1 173(1.74)
是否走路或乘车时看书或电子屏幕	否	93 326	1 292(1.38)	53.27	< 0.01
	是	42 008	804(1.91)
对坐姿、站姿的自我要求	无所谓	82 682	1 471(1.78)	73.95	< 0.01
	严格要求	52 652	625(1.19)
注：()内数字为检出率/%。

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表 4 2022年内蒙古中小学生脊柱侧弯与近视共患的多因素Logistic回归分析(n=135 334)

Table 4. Multifactorial Logistic regression analysis of scoliosis and myopia co-morbidities in primary and secondary school students from Inner Mongolia Autonomous Region in 2022 (n=135 334)

自变量	选项	β值	Wald χ²值	P值	OR值(95%CI)
周末每天至少1 h中高强度运动	少数做到或几乎做不到				1.00
	多数或都能做到	-0.10	4.85	0.03	0.90(0.83~0.99)
每周体育课节数	≤2				1.00
	≥3	-0.43	86.64	< 0.01	0.65(0.59~0.71)
课桌椅高度是否根据身高调整	否				1.00
	是	-0.11	4.72	0.03	0.90(0.82~0.99)
课间休息活动场所	室内				1.00
	户外	-0.25	27.49	< 0.01	0.78(0.71~0.86)
是否参加补习班	否				1.00
	是	0.24	28.90	< 0.01	1.27(1.16~1.39)
家长是否限制视屏时间	否				1.00
	是	-0.17	14.14	< 0.01	0.84(0.77~0.92)
是否走路或乘车时看书或电子屏幕	否				1.00
	是	0.12	6.25	0.01	1.13(1.03~1.24)
对坐姿、站姿的自我要求	无所谓				1.00
	严格要求	-0.19	14.01	< 0.01	0.83(0.75~0.91)

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