云南省儿童青少年近视危险因素列线图判别分析

张金娇; 常利涛; 肖洁; 李佩谦; 谢雪妮; 马子雪; 李茜茜; 罗筱; 陈茂森; 黄莹

doi:10.16835/j.cnki.1000-9817.2023.09.024

云南省儿童青少年近视危险因素列线图判别分析

doi: 10.16835/j.cnki.1000-9817.2023.09.024

1.
昆明医科大学公共卫生学院, 云南 650500
2.
云南省疾病预防控制中心学校卫生所

基金项目:

国家自然科学基金项目 81960593

详细信息

作者简介:
张金娇(1995-), 女, 河南洛阳人, 在读硕士, 主要研究方向为社区健康促进

通讯作者:
黄莹, E-mail: huangying02@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
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- HTML全文浏览量: 147
- PDF下载量: 49
- 被引次数: 0
出版历程
- 收稿日期: 2023-05-15
- 修回日期: 2023-07-05
- 网络出版日期: 2023-09-28
- 刊出日期: 2023-09-25

Discriminante analysis of risk factors Nomograms of myopia in children and adolescents in Yunnan Province

1.
School of Public Health, Kunming Medical University, Kunming (650500), China

摘要

摘要: 目的探讨云南省儿童青少年近视的相关因素，并对影响因素进行预测评估，为近视防控提供科学依据。方法 2023年3月9—14日，采用多阶段分层整群随机抽样方法，抽取云南省大理和丽江两个地区6所中小学校的848名学生进行视力检测和近视相关影响因素的问卷调查，使用多因素Logistic回归分析将筛选出的影响因素建立列线图(Nomogram)预测模型。结果调查对象总体近视率为68.3%，男生近视率(63.4%)低于女生(72.9%)，小学生近视率(46.7%)低于初中生(81.1%)，差异有统计学意义(χ²=值分别为8.71，108.07，P值均＜0.05)。每天坚持做眼保健操、课间休息在教学楼外活动、每天睡眠时间7~9和>9 h、父母双方均不近视与云南省儿童青少年近视发生呈负相关(OR值分别为0.64，0.63，0.56，0.28，0.48，P值均＜0.05)；每天放学后读写时间≥3 h、家长不限制玩电子游戏时间与近视发生呈正相关(OR值分别为1.94，1.78，P值均＜0.05)。在影响因素基础上建立Nomogram预测模型定量评价近视风险，结果显示，对于云南省儿童青少年来说发生近视风险较大的3个因素分别是每天睡眠时间、父母近视情况、每天放学后读写时间。结论遗传因素和环境因素与儿童青少年近视发生均相关，列线图预测模型有利于筛查近视高风险因素及采取相应防治措施。
- 近视 /
- 危险因素 /
- 列线图 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To explore the related factors of myopia among children and adolescents in Yunnan Province, and to predict and evaluate the influencing factors, so as to provide a scientific theoretical basis for the prevention and control of myopia. Methods From March 9 to 14, 2023, 848 students from 6 primary and secondary schools in Dali and Lijiang of Yunnan Province were selected by multi-stage stratified random cluster sampling method for visual acuity detection and questionnaire survey on myopia-related factors. Multivariate Logistic regression analysis was used to establish a Nomogram prediction model for the selected influencing factors. Results The overall myopia rate of the respondents was 68.3%, the myopia rate of boys (63.4%) was lower than that of girls (72.9%), and the myopia rate of primary school students (46.7%) was lower than that of junior high school students (81.1%), and the difference was statistically significant(χ²=8.71, 108.07, P < 0.05). Daily eye exercises, activities outside the teaching building during recess, having daily sleep time of 7-9 and >9 h, having both parents without myopia were negatively correlated with the occurrence of myopia in children and adolescents in Yunnan Province (OR=0.64, 0.63, 0.56, 0.28, 0.48, P < 0.05). The reading and writing time after school ≥3 h per day and parents' unrestricted time to play video games were positively correlated with myopia (OR=1.94, 1.78, P < 0.05). Based on the influencing factors, a Nomogram prediction model was established to quantitatively evaluate the risk of myopia. The results showed that greater risk for myopia was associated with sleep duration, parental history of myopia, and the time spent reading and writing after school every day. Conclusion Both genetic factors and environmental factors are related to myopia in children and adolescents. The prediction model of nomogram is beneficial for screening high risk factors of myopia and taking corresponding prevention and treatment measures.
- Myopia /
- Risk factors /
- Nomograms /
- Regression analysis /
- Child /
- Adolescent
注释:

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图 1 预测儿童青少年近视发生风险的列线图模型

Figure 1. A Nomogram predicting model for the risk of myopia among children and adolescents

下载: 全尺寸图片幻灯片

图 2 列线图预测儿童青少年近视风险的验证结果

Figure 2. Validation of the Nomogram model for predicting myopia risk among children and adolescents

下载: 全尺寸图片幻灯片

表 1 儿童青少年近视发生的多因素Logistic回归分析(n=848)

Table 1. Multivariate Logistic regression analysis of myopia occurrence in children and adolescents(n=848)

自变量与常量	β值	P值	OR值(95%CI)
是否每天坚持做眼保健操
否			1.00
是	-0.45	0.03	0.64(0.42~0.95)
按准确的穴位完成眼保健操
否			1.00
是	-0.13	0.53	0.88(0.58~1.32)
课间休息在哪活动
教学楼内			1.00
教学楼外	-0.47	0.01	0.63(0.45~0.88)
每天放学后读写时间/h
＜1			1.00
1~＜2	0.20	0.36	1.22(0.80~1.88)
2~＜3	0.33	0.17	1.39(0.87~2.22)
≥3	0.66	0.04	1.94(1.03~3.64)
家长是否限制玩电子游戏时间
是			1.00
否	0.58	0.01	1.78(1.12~2.82)
平时读写姿势情况
较好			1.00
中等	-0.01	0.96	0.99(0.66~1.49)
较差	-0.13	0.66	0.88(0.49~1.57)
天黑后在昏暗光线下看电子屏幕
经常及以上			1.00
偶尔及以下	0.02	0.94	1.02(0.59~1.78)
躺着或趴着看书或电子屏幕
经常及以上			1.00
偶尔及以下	-0.09	0.75	0.91(0.53~1.58)
每周上体育课次数/节
≤2			1.00
3	-0.39	0.05	0.68(0.47~1.00)
≥4	-0.42	0.18	0.66(0.36~1.20)
每天睡眠时间/h
＜7			1.00
7~9	-0.58	0.04	0.56(0.33~0.96)
＞9	-1.29	＜0.01	0.28(0.15~0.50)
父母近视情况
一方近视			1.00
父母双方均近视	0.04	0.88	1.04(0.59~1.84)
父母双方均不近视	-0.74	＜0.01	0.48(0.33~0.69)
常量	2.46	＜0.01	11.74

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