Co-morbidity of screening myopia and scoliosis among primary and secondary school students in Beijing and associated factors
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摘要:
目的 探讨2019—2022年北京市中小学生筛查性近视与脊柱侧弯共患情况及相关因素，以期为综合防控儿童青少年近视和脊柱侧弯提供新的思路。 方法 2019—2022年，使用分层整群随机抽样方法从北京市分别抽取34 923，34 321，36 008，35 598名中小学生进行视力、脊柱侧弯检查和问卷调查。中小学生筛查性近视与脊柱侧弯共患率的组间差异采用χ2检验进行分析，筛查性近视与脊柱侧弯共患的相关因素采用多因素Logistic回归进行分析。 结果 2019—2022年，中小学生筛查性近视患病率逐年上升，脊柱侧弯患病率逐年下降，共患率2022年(0.69%)较2019年(2.31%)下降了1.62百分点。2022年筛查性近视与脊柱侧弯共患率城区(0.98%)高于郊区(0.50%)，不同学段共患率依次为普通高中生(1.65%)>职业高中生(1.21%)>初中生(0.76%)>小学生(0.22%)，差异均有统计学意义(χ2值分别为28.97，153.55，P值均 < 0.01)。多因素Logistic回归分析结果显示，睡眠时间不充足、家长不限制电子屏幕的使用时间与筛查性近视和脊柱侧弯共患均呈正相关[OR值(95%CI)分别为1.59(1.20~ 2.12)，1.34(1.02~1.76)]；老师经常或总是提醒读写姿势、每日进行≥1 h中高强度体力活动与筛查性近视和脊柱侧弯共患均呈负相关[OR值(95%CI)分别为0.70(0.52~0.96)，0.56(0.34~0.92)](P值均 < 0.05)。 结论 北京市中小学生近视与脊柱侧弯共患现状不容乐观。应关注儿童青少年的读写姿势和相关行为习惯，保证中小学生充足的睡眠时间，进而预防近视和脊柱侧弯共患的发生发展。 Abstract:Objective To investigate the co-morbidity of screening myopia and scoliosis among primary and secondary school students in Beijing from 2019 to 2022 and its influencing factors, in order to provide new ideas for comprehensive prevention and control of myopia and scoliosis in children and adolescents. Methods From 2019 to 2022, 34 923, 34 321, 36 008 and 35 598 primary and secondary school students in Beijing were selected by stratified cluster random sampling method, and visual acuity examination, scoliosis examination and questionnaire survey were conducted on them. Chi-square test was used to analyze the inter-group differences between screening myopia and scoliosis among primary and secondary school students, and the correlation factors between screening myopia and scoliosis were analyzed by multivariate Logistic regression. Results From 2019 to 2022, the prevalence of screening myopia increased by year, while scoliosis decreased by year, and the comorbidity rate in 2022 (0.69%) decreased by 1.62% compared with 2019 (2.31%). In 2022, screening myopia with scoliosis rates (0.98%) than urban suburbs (0.50%), high school students (1.65%) >professional high school students (1.21%) >junior middle school students (0.76%) >primary school students (0.22%) (χ2=28.97, 153.55, P < 0.01). The results of multivariate Logistic analysis found that insufficient sleep time and parents did not limit the use of electronic screen time were the risk factors for screening myopia and scoliosis [OR(95%CI)=1.59(1.20-2.12), 1.34(1.02-1.76), P < 0.05]. Teachers often or always remind that reading and writing posture and one hour or more of moderate-intensity physical activity every day were protective factors for screening myopia and scoliosis [OR(95%CI)=0.70(0.52-0.96), 0.56(0.34-0.92), P < 0.05]. Conclusions The co-morbidity of acadmic screening myopia and scdiosis is not optimistic in Beijing. Attention should be paid to the reading and writing posture and related behavioral habits of children and adolescents, and ensure that children in each school section have sufficient sleep time, so as to prevent the occurrence and development of screening myopia and scoliosis. -
Key words:
- Myopia /
- Scoliosis /
- Prevalence /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。2) 高若伊与孙冰洁为共同第一作者。 -
表 1 北京市2019—2022年中小学生脊柱侧弯、筛查性近视及共患率比较
Table 1. Comparison of the rates of scoliosis, screening myopia and co-morbidity among primary and secondary school students in Beijing, 2019-2022
年份 人数 筛查性近视 脊柱侧弯 共患 2019 34 923 19 791(56.67) 1 208(3.46) 806(2.31) 2020 34 321 19 936(58.09) 742(2.16) 545(1.59) 2021 36 008 21 209(58.90) 769(2.14) 588(1.63) 2022 35 598 21 110(59.30) 335(0.94) 246(0.69) χ2值 58.65 527.22 305.28 P值 < 0.01 < 0.01 < 0.01 注： ()内数字为患病率/%。 
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表 2 北京市不同组别中小学生2022年筛查性近视与脊柱侧弯共患率比较
Table 2. Comparison of the co-morbidity rates of screening myopia and scoliosis among primary and secondary school students in Beijing in 2022
组别 选项 人数 共患人数 χ2值 P值 性别 男 18 349 115(0.63) 2.28 0.07 女 17 249 131(0.76) 地区 城区 14 021 138(0.98) 28.97 < 0.01 郊区 21 577 108(0.50) 学段 小学 17 481 38(0.22) 153.55 < 0.01 初中 8 528 65(0.76) 普高 6 187 102(1.65) 职高 3 402 41(1.21) 注： ()内数字为患病率/%。
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表 3 北京市中小学生2022年筛查性近视与脊柱侧弯共患的单因素分析
Table 3. Single factor analysis of co-morbidity of screening myopia and scoliosis among primary and middle school students in Beijing in 2022
变量 选项 人数 共患人数 χ2值 P值 每日是否进行≥1 h中高强度体力活动 是 2 871 17(0.59) 5.09 0.03 否 20 582 213(1.03) 放学回家后读书写字时间/h < 1 6 146 44(0.72) 24.49 < 0.01 1~ < 2 8 407 63(0.75) ≥2 8 172 115(1.41) 不知道 728 8(1.10) 是否参加课外培训班 是 16 800 181(1.08) 5.70 0.02 否 6 653 49(0.74) 家长是否限制电子屏幕使用时间 是 12 712 100(0.79) 10.76 < 0.01 否 10 741 130(1.21) 读写时胸离书桌超过一拳 从不或偶尔 10 987 118(0.95) 1.85 0.17 经常或总是 12 466 112(0.90) 读写时眼离书本超过一尺 从不或偶尔 10 340 117(1.13) 4.33 0.04 经常或总是 13 113 113(0.86) 读写时手离笔尖一寸左右 从不或偶尔 9 192 110(1.20) 7.26 < 0.01 经常或总是 14 261 120(0.84) 老师提醒注意读写姿势 从不或偶尔 15 220 173(1.14) 10.86 < 0.01 经常或总是 8 233 57(0.69) 平均每日看电脑时间/h ＜1 16 746 147(0.88) 6.38 0.01 ≥1 6 707 83(1.24) 睡眠时间 充足 12 905 87(0.67) 27.76 < 0.01 不充足 10 548 143(1.36) 注： ()内数字为患病率/%。
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表 4 北京市中小学生2022年筛查性近视与脊柱侧弯共患的多因素Logistic回归分析(n=23 453)
Table 4. Multivariate Logistic regression analysis of comorbidity of myopia and scoliosis among primary and secondary school students in Beijing in 2022(n=23 453)
自变量 选项 β值 OR值(95%CI) P值 每日是否进行≥1 h中高强度体力活动 否 1.00 是 -0.58 0.56(0.34~0.92) 0.02 睡眠时间 充足 1.00 不充足 0.47 1.59(1.20~2.12) < 0.01 老师提醒注意读写姿势 从不或偶尔 1.00 经常或总是 -0.35 0.70(0.52~0.96) 0.02 家长是否限制电子屏幕使用时间 是 1.00 否 0.29 1.34(1.02~1.76) 0.04
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