广东省中小学生筛查性近视现状及相关因素分析

许婵; 李梦; 沈少君; 陈秋霞; 余慧娟; 杨文翰; 曲亚斌

doi:10.16835/j.cnki.1000-9817.2024132

广东省中小学生筛查性近视现状及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2024132

许婵^{1, 2},
李梦¹,
沈少君¹,
陈秋霞¹,
余慧娟^{1, 2},
杨文翰²,
曲亚斌^1, ,

1.
广东省疾病预防控制中心环境与学校卫生所，广州 511430
2.
广东药科大学公共卫生学院儿少卫生学系

基金项目:

广州市科技计划项目 202002030405

广东省医学科学技术研究基金项目 B2019082

广东省医学科学技术研究基金项目 C2019049

详细信息

作者简介:
许婵(1997-)，女，广东湛江人，在读硕士，主要研究方向为儿童青少年心理行为与健康

通讯作者:
曲亚斌，E-mail: gdsjkzx_yabinqu@gd.gov.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R778.1⁺¹ R193
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- HTML全文浏览量: 118
- PDF下载量: 54
- 被引次数: 0
出版历程
- 收稿日期: 2023-10-10
- 修回日期: 2024-03-14
- 网络出版日期: 2024-05-30
- 刊出日期: 2024-05-25

Prevalence and associated factors of screening positive myopia among elementary and middle school students in Guangdong

XU Chan^{1, 2},
LI Meng¹,
SHEN Shaojun¹,
CHEN Qiuxia¹,
YU Huijuan^{1, 2},
YANG Wenhan²,
QU Yabin^{1
, ,}

1.
Department of Environmental and School Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou (511430), Guangdong Province, China

摘要

摘要: 目的了解广东省四至九年级中小学生近视现状及相关因素，为儿童青少年近视干预采取针对性措施提供科学依据。方法于2022年9—10月，采用分层整群随机抽样方法抽取广东省广州、江门和梅州3市29 095名四至九年级中小学生作为研究对象，在非睫状肌麻痹状态下使用台式自动电脑验光仪检测屈光度，开展近视筛查和问卷调查。组间比较采用χ²检验和χ²趋势检验，近视相关因素的分析采用多因素Logistic逐步回归分析。结果中小学生筛查性近视检出率为61.7%，其中四至六年级小学生和七至九年级初中生筛查性近视检出率分别为51.5%，71.9%。多因素Logistic回归分析显示，小学组中，女生(OR=1.39，95%CI=1.30~1.49)、父母一方近视(OR=1.82，95%CI=1.69~1.96)、父母双方近视(OR=2.86，95%CI=2.56~3.18)、每天室内静坐时间>6 h(OR=1.28，95%CI=1.17~1.39)的学生筛查性近视发生风险较高，县区(OR=0.92，95%CI=0.86~0.99)、课间休息活动场所在户外(OR=0.88，95%CI=0.81~0.95)的学生筛查性近视发生风险较低；初中生中，女生(OR=1.84，95%CI=1.69~1.99)、父母一方近视(OR=1.87，95%CI=1.71~2.04)、父母双方近视(OR=3.03，95%CI=2.63~3.50)、每天室内静坐时间>6 h(OR=1.11，95%CI=1.01~1.23)的学生筛查性近视发生风险较高，县区(OR=0.74，95%CI=0.68~0.80)、课间休息活动场所在户外(OR=0.83，95%CI=0.76~0.91)、每天户外活动时间≥2 h(OR=0.87，95%CI=0.80~0.95)的学生筛查性近视发生风险较低(P值均<0.05)。结论广东省中小学生筛查性近视检出率较高，课间休息活动场所、户外活动时间以及室内静坐时间与近视检出率存在关联。应采取针对性的干预措施，适当增加户外活动时间，降低中小学生近视的发生。
- 近视 /
- 患病率 /
- 回归分析 /
- 学生
Abstract: Objective The study aims to analyze the prevalence and associated factors of myopia among 4 to 9 grade students in Guangdong Province in 2022, so as to provide a scientific basis for targeted intervention measures for myopia in children and adolescents. Methods From September to October 2022, stratified cluster random sampling was used to select 29 095 of 4 to 9 grade students from Guangzhou, Jiangmen, and Meizhou in Guangdong Province for myopia screening and questionnaire surveys. The Chi-square test was applied to compare the differences between groups, and multivariable Logistic stepwise regression analysis was used to analyze factors associated with myopia. Results The myopia detection rate of 4 to 9 grade students was 61.7%, with detection rates of 51.5% for 4 to 6 grade primary school students and 71.95% for 7 to 9 grade junior high school students. Multivariable Logistic regression analysis showed that higher myopia rates were detected among girls (OR=1.39, 95%CI=1.30-1.49), students with one (OR=1.82, 95%CI=1.69-1.96) or both parents having myopia (OR=2.86, 95%CI=2.56-3.18), and indoor sedentary time >6 h(OR=1.28, 95%CI=1.17-1.39) in the 4 to 6 grade. Lower myopia rates were detected in the county (OR=0.92, 95%CI=0.86-0.99) and outdoors at recess activities (OR=0.88, 95%CI=0.81-0.95). Meanwhile, higher myopia rates were detected among girls (OR=1.84, 95%CI=1.69-1.99), students with one (OR=1.87, 95%CI=1.71-2.04) or both parents having myopia (OR=3.03, 95%CI=2.63-3.50), and indoor sedentary time >6 h/d (OR=1.11, 95%CI=1.01-1.23) in the 7 to 9 grade. Lower myopia rates were detected in the county (OR=0.74, 95%CI=0.68-0.80), outdoors at recess activities (OR=0.83, 95%CI=0.76-0.91), and outdoor activity time ≥2 h/d(OR=0.87, 95%CI=0.80-0.95)(P<0.05). Conclusions The detection rate of myopia among 4 to 9 grade students in Guangdong Province is relatively high. Place of recess activities, daily outdoor activity and indoor sedentary duration are associated with myopia. Therefore, targeted intervention measures should be adopted, such as appropriately increasing outdoor activity to reduce the occurrence of myopia among primary and middle school students.
- 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。

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表 1 广东省四至九年级学生近视相关行为单因素分析

Table 1. Univariate analysis of screening positive myopia-related behaviors among students in grade 4 to 9, Guangdong Province

相关因素	选项	四至六年级				七至九年级
相关因素	选项	调查人数	筛查性近视人数	χ²/ χ_趋势²值	P值	调查人数	筛查性近视人数	χ²/ χ_趋势²值	P值
性别	男	7 621	3 611(47.4)	107.32	< 0.01	7 687	5 058(65.8)	305.31	< 0.01
	女	6 926	3 877(56.0)			6 861	5 409(78.8)
区域	城区	5 854	3 267(55.8)	73.65	< 0.01	6 107	4 722(77.3)	150.56	< 0.01
	县区	8 693	4 221(48.6)			8 441	5 745(68.1)
父母近视	均不近视	7 360	3 115(42.3)	567.56	< 0.01	7 722	4 978(64.5)	497.06	< 0.01
	一方近视	5 158	2 981(57.8)			4 855	3 797(78.2)
	均近视	2 029	1 392(68.6)			1 971	1 692(85.8)
课间休息活动场所^a	教学楼内	11 144	5 848(52.5)	19.68	< 0.01	11 323	8 321(73.5)	59.95	< 0.01
	户外	3 399	1 636(48.1)			3 222	2 144(66.5)
课后作业时间/h^a	不做作业	33	13(39.4)	21.27	< 0.01	45	24(53.3)	56.79	< 0.01
	<1	4 162	2 058(49.5)			1 802	1 196(66.4)
	1~<3	8 736	4 628(53.0)			9 690	7 002(72.3)
	≥3	1 163	562(48.3)			2 520	1 916(76.0)
经常保持读写作业姿势规范^a	否	8 842	4 510(51.0)	2.01	0.16	9 484	6 872(72.5)	3.52	0.06
	是	5 704	2 978(52.2)			5 064	3 595(71.0)
每天视屏时间/h	无	3 724	1 832(49.2)	10.62	< 0.01	2 647	1 811(68.4)	24.44	< 0.01
	<2	7 862	4 119(52.4)			5 698	4 196(73.6)
	≥2	2 961	1 537(51.9)			6 203	4 460(71.9)
近距离用眼多久休息^a 1次/h	<0.5	7 090	3 555(50.1)	11.36	< 0.01	5 978	4 208(70.4)	12.36	< 0.01
	0.5~<1	3 975	2 123(53.4)			4 179	3 046(72.9)
	≥1	3 482	1 810(52.0)			4 390	3 213(73.2)
每天户外活动时间/h^a	<2	9 584	4 932(51.5)	0.10	0.75	9 564	7 033(73.5)	33.44	< 0.01
	≥2	4 272	2 186(51.2)			4 331	2 979(68.8)
每天睡眠时间是否达标	是	3 125	1 564(50.1)	3.24	0.07	3 319	2 282(68.8)	21.71	< 0.01
	否	11 422	5 924(51.9)			11 229	8 185(72.9)
每天室内静坐时间/h	<2	5 798	2 799(48.3)	58.31	< 0.01	3 787	2 611(69.0)	48.97	< 0.01
	2~6	5 314	2 749(51.8)			4 928	3 479(70.6)
	6	3 435	1 940(56.5)			5 833	4 377(75.0)
注：()内数字为检出率/%；a表示数据有缺失。

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表 2 小学生筛查性近视相关因素多因素Logistic回归分析(n=14 547)

Table 2. Multivariable Logistic regression analysis of factors associated with screening positive myopia in primary school students(n=14 547)

自变量	选项	β值	标准误	Z值	P值	OR值(95%CI)
性别	男					1.00
	女	0.33	0.03	9.65	< 0.01	1.39(1.30~1.49)
区域	城区					1.00
	县区	-0.08	0.04	-2.28	0.02	0.92(0.86~0.99)
父母近视	均不近视					1.00
	一方近视	0.60	0.04	15.95	< 0.01	1.82(1.69~1.96)
	均近视	1.05	0.05	19.13	< 0.01	2.86(2.56~3.18)
课间休息活动场所	教学楼内					1.00
	户外	-0.13	0.04	-3.15	＜0.01	0.88(0.81~0.95)
每天室内静坐时间/h	< 2					1.00
	2~6	0.05	0.04	1.26	0.21	1.05(0.97~1.13)
	> 6	0.24	0.04	5.46	< 0.01	1.28(1.17~1.39)

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表 3 初中生筛查性近视相关因素多因素Logistic回归分析(n=14 548)

Table 3. Multivariable Logistic regression analysis of factors associated with screening positive myopia in secondary school students(n=14 548)

自变量	选项	β值	标准误	Z值	P值	OR值(95%CI)
性别	男					1.00
	女	0.61	0.04	14.67	< 0.01	1.84(1.69~1.99)
区域	城区					1.00
	县区	-0.30	0.04	-7.21	< 0.01	0.74(0.68~0.80)
父母近视	均不近视					1.00
	一方近视	0.63	0.04	13.97	< 0.01	1.87(1.71~2.04)
	均近视	1.11	0.07	15.16	< 0.01	3.03(2.63~3.50)
课间休息活动场所	教学楼内					1.00
	户外	-0.18	0.05	-3.98	< 0.01	0.83(0.76~0.91)
每天户外活动时间/h	<2					1.00
	≥2	-0.14	0.04	-3.28	< 0.01	0.87(0.80~0.95)
每天室内静坐时间/h	< 2					1.00
	2~6	-0.05	0.05	-1.04	0.30	0.95(0.86~1.05)
	> 6	0.11	0.05	2.08	0.04	1.11(1.01~1.23)

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