上海市2021年中小学生常见病共患现状及相关因素

黄生垒; 张凤云; 曲爽笑; 齐文娟; 黄雨婷; 杨妍婷; 杨东玲; 罗春燕

doi:10.16835/j.cnki.1000-9817.2024135

上海市2021年中小学生常见病共患现状及相关因素

doi: 10.16835/j.cnki.1000-9817.2024135

上海市疾病预防控制中心儿童青少年健康所，200336

基金项目:

国家社会科学基金项目 22TYB01870

详细信息

作者简介:
黄生垒(1992-)，男，上海市人，硕士，医师，主要研究方向为儿童青少年生长发育

通讯作者:
杨东玲，E-mail: yangdongling@scdc.sh.cn

罗春燕，E-mail: luochunyan@scdc.sh.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R181.3⁺² R193
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出版历程
- 收稿日期: 2024-01-14
- 修回日期: 2024-03-11
- 网络出版日期: 2024-05-30
- 刊出日期: 2024-05-25

Comorbidity of common illnesses and associated factors among primary and middle school students in Shanghai in 2021

Department of Children and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai(200336), China

摘要

摘要: 目的了解上海市中小学生常见病共患现状及相关因素，为改善致病环境和预防多病共患发生提供参考依据。方法于2021年9—11月采用分层整群抽样的方法，在上海市16个区的每区抽取2所小学、2所初中、2所高中和1所职高，共112所学校的30 331名中小学生，对其健康状况和相关因素进行调查分析。结果上海市中小学生筛查性近视、超重肥胖、血压偏高、脊柱弯曲异常等2种及以上常见病共患检出率为38.91%，其中29.64%的中小学生同时存在2种疾病，9.19%存在3种疾病，0.09%存在4种疾病。共患检出率男生(44.12%)高于女生(33.40%)，初中生(40.40%)高于高中生(38.58%)和小学生(38.01%)，差异均有统计学意义(χ²值分别为366.44，50.33，P值均＜0.01)。多因素Logistic回归分析显示，女生、有时会监督自己和时常会提醒自己的坐姿和站姿与中小学生常见病共患均呈负相关(OR值分别为0.64，0.93，0.90)；初中、每天看电视≥1 h、每天用电脑≥1 h、每天用移动电子设备≥1 h与中小学生常见病共患均呈正相关(OR值分别为1.07，1.10，1.06，1.10)(P值均 < 0.05)。结论上海市中小学生常见病共患检出率情况不容乐观，常见病共患与多种外部环境因素综合作用有关。应采取针对性的干预措施，有效预防学生觉病共患的发生。
- 疾病 /
- 共病现象 /
- 患病率 /
- 回归分析 /
- 学生
Abstract: Objective To understand the current status and associated factors of comorbidity of common illnesses among primary and middle school students in Shanghai, so as to provide a reference for improving the pathogenic environment and preventing the occurrence of comorbidity of common illnesses. Methods From September to November 2021, a stratified cluster sampling method was used to select 30 331 middle school students from 112 schools in 16 districts of Shanghai, each with 2 primary schools, 2 junior high schools, 2 high schools and 1 vocational high school. Elementary school students, their health status and influencing factor questionnaires were analyzed. Results The detection rate of two or more common diseases such as myopia, overweight and obesity, high blood pressure, and abnormal spinal curvature among primary and secondary school students in Shanghai was 38.91%, of which 29.64% of primary and secondary school students had two diseases at the same time, and 9.19% had three diseases, 0.09% had 4 diseases. The detection rate of comorbidity was higher in boys (44.12%) than in girls (33.40%), and higher in junior high school students (40.40%) than in high school students (38.58%) and primary school students (38.01%). The differences were statistically significant (χ²=366.44, 50.33, P < 0.01). Multi-factor Logistic regression analysis showed that girls sometimes supervise themselves and often remind themselves that their sitting and standing postures were negatively correlated with the common comorbidities of primary and secondary school students (OR=0.64, 0.93, 0.90); junior middle school students and watching TV/d ≥1 h, using computers for ≥1 h/d, and using mobile electronic devices for >1 h/d were positively correlated with the comorbidity of common diseases among primary and secondary school students (OR=1.07, 1.10, 1.06, 1.10) (P < 0.05). Conclusions The prevalence of comorbidity of common illnesses among primary and middle school students in Shanghai is not optimistic, which might be associated with combined effects of various external environmental factors. Targeted intervention should be implemented to effectively prevent the occurrence of comorbidities among students.
- Disease /
- Comorbidity /
- Prevalence /
- Regression analysis /
- Students
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表 1 不同组别上海市中小学生常见病共患检出率比较

Table 1. Comparison of prevalence of common comorbidities in different groups among primary and middle school students in Shanghai

变量	选项	人数	2种	3种	4种	总检出数	χ²值	P值
性别	男	15 590	5 240(33.61)	1 624(10.42)	15(0.09)	6 879(44.12)	366.44	＜0.01
	女	14 741	3 750(25.44)	1 162(7.78)	12(0.08)	4 924(33.40)
学段	小学	8 917	2 710(30.39)	675(7.57)	4(0.04)	3 389(38.01)	50.33	＜0.01
	初中	8 377	2 514(30.01)	861(10.28)	9(0.10)	3 384(40.40)
	高中	13 037	3 766(28.89)	1 250(9.59)	14(0.11)	5 030(38.58)
合计		30 331	8 990(29.64)	2 786(9.19)	27(0.09)	11 803(38.91)
注： ()内数字为检出率/%。

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表 2 上海市中小学生常见病共患相关因素的单因素分析

Table 2. Univariate analysis of related factors of common comorbidities among primary and middle school students in Shanghai

变量	选项	人数	共患人数	χ²值	P值	变量	选项	人数	共患人数	χ²值	P值
喝含糖饮料频次/(次·d^-1)	从来不喝	5 377	2 030(37.8)	5.34	0.07	每天使用移动电子设备时间/h	＜1	13 490	5 073(37.6)	17.50	< 0.01
喝含糖饮料频次/(次·d^-1)	＜1	21 335	8 321(39.0)			每天使用移动电子设备时间/h	≥1	16 841	6 730(40.0)
	≥1	3 619	1 452(40.1)			每天户外活动时间/h	＜2	14 570	5 678(39.0)	0.04	0.85
吃油炸食品频次/(次·d^-1)	从来不吃	5 784	2 221(38.4)	0.80	0.67		≥2	15 761	6 125(38.9)
吃油炸食品频次/(次·d^-1)	＜1	23 105	9 019(39.0)			睡眠时间	不足	21 876	8 566(39.2)	1.95	0.16
	≥1	1 442	563(39.0)				充足	8 455	3 237(38.3)
吃新鲜水果频次/(次·d^-1)	从来不吃	855	350(40.9)	13.91	< 0.01	对坐姿和站姿的自我要求	没要求	8 540	3 509(41.1)	24.56	< 0.01
吃新鲜水果频次/(次·d^-1)	＜1	6 957	2 578(37.1)			对坐姿和站姿的自我要求	有时会监督自己	12 725	4 877(38.3)
	≥1	22 519	8 875(39.4)				时常提醒自己	9 066	3 417(37.7)
每天看电视时间/h	＜1	21 303	8 049(37.8)	38.48	< 0.01	班级座位定时调换	从不或仅个别轮换	2 730	1 051(38.5)	13.42	< 0.01
	≥1	9 028	3 754(41.6)				每学期一次	1 979	695(35.1)
每周上体育课节数/节	≤2	5 228	1 976(37.8)	6.17	0.05		≥1次/月	25 622	10 057(39.3)
每周上体育课节数/节	3~4	10 720	4 261(39.7)			每天放学后写作业时间/h	＜1	7 155	2 708(37.8)	4.48	0.03
	≥5	14 383	5 566(38.7)			每天放学后写作业时间/h	≥1	23 176	9 095(39.2)
每天用电脑时间/h	＜1	22 993	8 746(38.0)	30.70	< 0.01	每天静坐时间/h	＜8	17 602	6 876(39.1)	0.40	0.53
	≥1	7 338	3 057(41.7)				≥8	12 729	4 927(38.7)
注： ()内数字为检出率/%。

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表 3 上海市2021年中小学生常见病共患相关因素的多因素Logistic回归分析(n=30 331)

Table 3. Multivariate Logistic regression analysis of related factors of common comorbidities among primary and middle school students in Shanghai in 2021(n=30 331)

自变量	选项	β值	标准误	Wald χ²值	P值	OR值(95%CI)
性别	男					1.00
	女	-0.45	0.02	351.93	< 0.01	0.64(0.61~0.67)
学段	小学					1.00
	初中	0.07	0.03	4.47	0.04	1.07(1.01~1.14)
	高中	-0.02	0.04	0.20	0.65	0.98(0.92~1.06)
吃新鲜水果频次/(次·d^-1)	从来不吃					1.00
	＜1	-0.12	0.08	2.72	0.10	0.88(0.76~1.02)
	≥1	0.02	0.07	0.10	0.75	1.02(0.89~1.18)
每周上体育课	≥5					1.00
节数/节	≤2	-0.06	0.04	2.74	0.10	0.94(0.87~1.01)
	3~4	0.04	0.03	2.08	0.15	1.04(0.99~1.10)
每天看电视时间/h	＜1					1.00
	≥1	0.10	0.03	12.17	< 0.01	1.10(1.04~1.16)
每天用电脑时间/h	＜1					1.00
	≥1	0.06	0.03	4.42	0.04	1.06(1.00~1.13)
每天用移动电子设备时间/h	＜1					1.00
	≥1	0.09	0.03	11.93	< 0.01	1.10(1.04~1.16)
对坐姿和站姿的自我要求	没要求					1.00
	有时会监督自己	-0.07	0.03	6.25	0.01	0.93(0.88~0.98)
	时常提醒自己	-0.11	0.03	10.44	< 0.01	0.90(0.84~0.96)
班级座位定时调换	从不或仅个别人轮换					1.00
	每学期1次	-0.12	0.06	3.82	0.05	0.89(0.78~1.00)
	≥1次/月	0.06	0.04	2.11	0.15	1.06(0.98~1.16)
每天放学后读写作业时间/h	＜1					1.00
	≥1	0.05	0.03	2.76	0.10	1.05(0.99~1.11)

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