中国六省市中小学生电子屏幕使用与近视的关联

高若伊; 许惠玉; 罗慧娟; 张京舒; 李婷; 邝惠宁; 鄂博然; 郭欣

doi:10.16835/j.cnki.1000-9817.2024172

中国六省市中小学生电子屏幕使用与近视的关联

doi: 10.16835/j.cnki.1000-9817.2024172

高若伊^{1, 2},
许惠玉^{1, 3},
罗慧娟^{1, 2},
张京舒²,
李婷²,
邝惠宁^{1, 2},
鄂博然^{1, 2},
郭欣^{1, 2, ,}

1.
首都医科大学公共卫生学院，北京 100069
2.
北京市疾病预防控制中心学校卫生所
3.
北京市通州区疾病预防控制中心学校卫生科

基金项目:

国家重点研发计划项目 2021YFC2702102

北京市卫生健康委员会高层次公共卫生技术人才建设项目领军人才-01-09

详细信息

作者简介:
高若伊(1999-)，女，山东潍坊人，在读硕士，主要研究方向为学校卫生

通讯作者:
郭欣，E-mail: gguoxin2000@126.com

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 F764.6 R193
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- 被引次数: 0
出版历程
- 收稿日期: 2024-01-14
- 修回日期: 2024-01-25
- 网络出版日期: 2024-06-27
- 刊出日期: 2024-06-25

Correlation analysis of electronic screen use and myopia among primary and secondary school students in six provinces and cities of China

GAO Ruoyi^{1, 2},
XU Huiyu^{1, 3},
LUO Huijuan^{1, 2},
ZHANG Jingshu²,
LI Ting²,
KUANG Huining^{1, 2},
E Boran^{1, 2},
GUO Xin^{1, 2
, ,}

1.
School of Public Health, Capital Medical University, Beijing (100069), China

摘要

摘要: 目的探讨中国六省市中小学生电子屏幕使用情况及其与近视的关联，为综合防控中小学生近视提供科学依据。方法于2020年11月至2022年6月，采用分层整群随机抽样与概率抽样相结合的方法，选取中国六省市(北京市、辽宁省、浙江省、河南省、陕西省、重庆市)16 557名中小学生作为研究对象，采用北京市疾病预防控制中心编制的问卷进行电子屏幕使用情况调查，并依据《儿童青少年近视筛查规范》采用质量浓度0.5%的复方托吡卡胺滴眼液麻痹睫状肌后进行裂隙灯验光检查。采用χ²检验比较组间差异，采用二元Logistic回归分析电子屏幕使用与近视的关联。结果有58.3%的中小学生平均每日使用电子屏幕时间≥2 h，有63.4%的中小学生非学习目的一次持续使用电子产品≥15 min。调整混杂因素后，父母不限制使用电子屏幕时间、每日使用电子屏幕时间≥2 h与中小学生近视发生均呈正相关(OR值分别为1.27，1.13，P值均 < 0.05)。按性别分层分析结果显示，每日电子屏幕使用时间≥2 h的男生发生近视的风险较高(OR=1.15，P < 0.05)；按年级分层分析结果显示，在小学低年级学生中，父母不限制电子屏幕使用时间和每日电子屏幕使用时间≥2 h与中小学生近视发生均呈正相关(OR值分别为1.34，1.18)；在小学高年级学生中，非学习目的一次持续使用电子屏幕时间≥15 min与近视发生呈正相关(OR=1.18)(P值均 < 0.05)。电子屏幕使用总时间和一次持续使用电子屏幕时间存在相乘交互作用(OR=1.04，P < 0.05)。结论中国六省市中小学生电子屏幕使用较多，且电子屏幕使用过多与近视相关。学校和家长应当共同限制中小学生电子屏幕的使用，减少中小学生近视的发生。
- 注视，眼 /
- 工具使用行为 /
- 近视 /
- 回归分析 /
- 学生
Abstract: Objective To study the correlation between electronic screen use and myopia among primary and secondary school students in six provinces and cities in China, in order to provide a scientific basis for comprehensive prevention and control of myopia. Methods From November 2020 to June 2022, a total of 16 557 primary and secondary school students from six provinces and cities in China (Beijing City, Liaoning Province, Zhejiang Province, Henan Province, Shaanxi Province, Chongqing City) were selected by stratified cluster random sampling and probability smampling methods, and a questionnaire prepared by Beijing Center for Disease Control and Prevention was used to investigate their electronic screen use. According to Screening Criteria for Myopia in Children and Adolescents, 0.5% mass concentration of compound topicamide eye drops was used to paralyze the ciliary muscle and undergo slit lamp optometry. Chi-square test was used to compare the differences between groups, and binary Logistic regression was used to analyze the association between electronic screen use and myopia. Results About 58.3% of primary and secondary school students used electronic screens for more than two hours a day on average, and 63.4% of primary and secondary school students used continuously electronic products for more than 15 minutes at a time for non-study purposes. After adjusting for confounding factors, parents' unrestricted use of electronic screen time and electronic screen time ≥2 h/d were positively correlated with myopia (OR=1.27, 1.13, P < 0.05). Gender stratified analysis showed that boys who used electronic screen time ≥2 h/d had a higher risk of myopia (OR=1.15, P < 0.05). The results of grade stratification analysis showed that parents' unrestricted electronic screen use time and electronic screen time ≥2 h/d were positively correlated with myopia in the lower grade of primary school students (OR=1.34, 1.18, P < 0.05). Among the higher grade of primary school students, continuous use of electronic screens for non-study purposes for more than 15 minutes at one time was positively correlated with myopia (OR=1.18, P < 0.05). There was a multiplicative interaction between total screen time and one continuous screen time (OR=1.04, P < 0.05). Conclusions Primary and secondary students in six provinces and cities in China reports excessive electronic screen usage which is associated with myopia. Schools and parents should jointly limit the use of electronic screen among primary and secondary students to reduce the occurrence of myopia.
- Fixation, ocular /
- Tool use behavior /
- Myopia /
- 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 不同人口学特征中小学生电子屏幕使用情况构成比较

Table 1. Comparison of composition of electronic screen use among primary and secondary shcool students with different demographic characteristics

人口学指标	选项	人数	每日电子屏幕使用时间				非学习目的一次持续使用电子屏幕时间				父母是否限制孩子使用电子屏幕时间
人口学指标	选项	人数	< 2 h	≥2 h	χ²值	P值	< 15 min	≥15 min	χ²值	P值	是	否	χ²值	P值
学段	小学低年级	8 819	4 196(47.6)	4 623(52.4)	282.86	< 0.01	3 560(40.4)	5 259(59.6)	126.45	< 0.01	6 768(76.7)	2 051(23.3)	709.63	< 0.01
	小学高年级	4 303	1 573(36.6)	2 730(63.4)			1 443(33.5)	2 860(66.5)			3 253(75.6)	1 050(24.4)
	初中	2 016	694(34.4)	1 322(65.6)			641(31.8)	1 375(68.2)			1 294(64.2)	722(35.8)
	高中	1 419	440(31.0)	979(69.0)			412(29.0)	1 007(71.0)			636(44.8)	783(55.2)
性别	男	8 147	3 390(41.6)	4 757(58.4)	0.04	0.83	2 942(36.1)	5 205(63.9)	1.50	0.22	6 025(74.0)	2 122(26.0)	25.10	< 0.01
	女	8 410	3 513(41.8)	4 897(58.2)			3 114(37.0)	5 296(63.0)			5 926(70.5)	2 484(29.5)
是否住校	是	1 759	473(26.9)	1 286(73.1)	177.38	< 0.01	582(33.1)	1 177(66.9)	10.33	< 0.01	643(36.6)	1 116(63.4)	1 243.99	< 0.01
	否	14 798	6 430(43.5)	8 368(56.5)			5 474(37.0)	9 324(63.0)			1 1308(76.4)	3 490(23.6)
地区	东部	8 491	3 444(40.6)	5 047(59.4)	93.06	< 0.01	3 057(36.0)	5 434(64.0)	19.08	< 0.01	6 394(75.3)	2 097(24.7)	307.25	< 0.01
	中部	2 983	1 475(49.4)	1 508(50.6)			1 024(34.3)	1 959(65.7)			2 345(78.6)	638(21.4)
	西部	5 083	1 984(39.0)	3 099(61.0)			1 975(38.9)	3 108(61.1)			3 212(63.2)	1 871(36.8)
注： ()内数字为构成比/%。

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表 2 不同电子屏幕使用情况中小学生近视率和近视程度比较

Table 2. Comparison of myopia rate and myopia degree among primary and secondary shcool students with different electronic screen use

电子屏幕使用情况	选项	人数	近视			近视程度
电子屏幕使用情况	选项	人数	检出人数	χ²值	P值	低度	高度	χ²值	P值
父母是否限制孩子使用电子屏幕时间	是	11 951	5 048(42.2)	211.29	< 0.01	4 780(94.7)	268(5.3)	16.08	< 0.01
	否	4 606	2 524(54.8)			2 331(92.4)	193(7.6)
每日电子屏幕使用时间/h	< 2	6 903	2 800(40.6)	127.55	< 0.01	2 637(94.2)	163(5.8)	0.55	0.46
	≥2	9 654	4 772(49.4)			4 474(93.8)	298(6.2)
非学习目的一次持续使用电子屏幕	<15	6 056	2 531(41.8)	59.72	< 0.01	2 387(94.3)	144(5.7)	1.06	0.30
时间/min	≥15	10 501	5 041(48.0)			4 724(93.7)	317(6.3)
注：近视人数()内数字为检出率/%；近视程度()内数字为构成比/%。

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表 3 中小学生电子屏幕使用与近视情况关联分层分析(n=16 557)

Table 3. Stratified analysis of electronic screen use among students and its association with myopia(n=16 557)

分层变量	选项	父母不限制孩子使用电子屏幕时间^a		每日电子屏幕使用时间≥2 h^b		非学习目的一次持续使用电子屏幕时间≥15 min^c
分层变量	选项	OR值(95%CI)	P值	OR值(95%CI)	P值	OR值(95%CI)	P值
性别	男	1.39(1.21~1.58)	< 0.01	1.15(1.03~1.29)	0.01	1.08(0.97~1.21)	0.17
	女	1.18(1.04~1.34)	0.01	1.10(0.99~1.23)	0.09	1.04(0.93~1.16)	0.49
年级	小学低年级	1.34(1.17~1.53)	< 0.01	1.18(1.06~1.32)	< 0.01	1.00(0.90~1.11)	0.93
	小学高年级	1.15(0.98~1.34)	0.09	1.10(0.89~1.16)	0.86	1.18(1.03~1.36)	0.02
	初中	1.26(0.95~1.68)	0.11	1.18(0.91~1.54)	0.21	1.06(0.81~1.39)	0.68
	高中	1.15(0.78~1.69)	0.47	1.08(0.71~1.65)	0.73	0.83(0.54~1.28)	0.39
注： a、b、c分别表示与父母限制使用电子屏幕时间、每日电子屏幕使用时间 < 2 h、非学习目的一次持续使用电子屏幕时间 < 15 min相比。

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