近视儿童青少年角膜塑形镜配戴依从性纵向轨迹分析

白国欣; 曹明聪; 李海月; 王健; 王玉荷; 徐晓腾; 陈忠飞

doi:10.16835/j.cnki.1000-9817.2025148

近视儿童青少年角膜塑形镜配戴依从性纵向轨迹分析

doi: 10.16835/j.cnki.1000-9817.2025148

1.
河北省沧州市中心医院眼科医学中心，061000
2.
沧州市眼科医院小儿斜弱视二科

基金项目:

沧州市科技计划自筹经费项目 23244102098

详细信息

作者简介:
白国欣(1979-)，女，河北沧州人，硕士，副主任护师，主要研究方向为眼科护理与近视防控管理

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 R778.3
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出版历程
- 收稿日期: 2025-03-07
- 修回日期: 2025-03-28
- 网络出版日期: 2025-06-07
- 刊出日期: 2025-05-25

Longitudinal trajectory analysis of orthokeratology lens wearing adherence in myopic children and adolescents

1.
Eye Medicine Center of Cangzhou Central Hospital, Cangzhou (061000), Hebei Province, China

摘要

摘要: 目的分析近视儿童青少年角膜塑形镜(OK镜)配戴依从性轨迹的潜在类别及影响因素，为近视儿童青少年OK镜配戴依从性的动态精准干预提供依据。方法 2024年1—6月，采用方便抽样方法选取沧州市中心医院眼科医学中心配戴OK镜的310名近视儿童青少年为研究对象。采用一般资料调查表、OK镜配戴者依从性调查问卷、执行功能行为评定量表自评版(BRIEF-SR)、家庭支持量表以及自制近视控制态度问卷于患者配镜时(T0)，戴镜后2周(T1)、1个月(T2)、3个月(T3)及6个月(T4)进行资料收集。采用增长混合模型识别近视儿童青少年OK镜配戴依从性轨迹类别，采用多元Logistic回归分析其影响因素。结果近视儿童青少年OK镜配戴依从性大致可以分为4种类别发展轨迹：C1典范坚守型(58例，18.71%)、C2循序渐进型(130例，41.94%)、C3起伏不定型(85例，27.42%)以及C4顽固低从型(37例11.94%)。多元Logistic回归分析结果显示，以C1组为参照，年龄(C3, OR=0.74)、父母受教育程度(C4, OR=0.67)、执行功能(C2, OR=0.69；C4, OR=0.44)、家庭支持(C3, OR=0.75)与近视控制态度(C2, OR=0.39)均是OK镜配戴依从性轨迹类别的影响因素；以C2组为参照，年龄(C3, OR=0.55)、父母受教育程度(C3, OR=0.34；C4, OR=0.64)、执行功能(C3, OR=0.77)、家庭支持(C4, OR=0.58)均是OK镜配戴依从性轨迹类别的影响因素；以C3组为参照，年龄(C4, OR=0.68)、近视控制态度(C4, OR=0.44)均是OK镜配戴依从性轨迹类别的影响因素(P值均 < 0.05)。结论近视儿童青少年OK镜配戴依从性可大致分为4种变化轨迹，存在群体异质性。应基于不同轨迹及影响因素，给予动态、精准的配戴依从性干预策略。
- 近视 /
- 角膜塑性术 /
- 病人依从 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To analyze the potential categories and influencing factors of the compliance trajectory of orthokeratology lenses (OK lens) in myopic children and adolescents, so as to provide a basis for dynamic and accurate intervention of OK lens compliance in myopic children and adolescents. Methods From January to June 2024, 310 myopic children and adolescents wearing OK lens were selected as research subjects from the Ophthalmology Medical Center of Cangzhou Central Hospital using a convenient sampling method. Data were collected at four time points: when the glasses were first fitted (T0), 2 weeks after fitting (T1), 1 month later (T2), 3 months later (T3), and 6 months later (T4). The data collection methods included general information questionnaires, compliance surveys for OK lens wearers, the Behavior Rating Inventory of Executive Function-Self-report Version (BRIEF-SR), family support scales, and a self-made questionnaire on myopia control attitudes. A growth mixed model was used to identify the trajectory categories of compliance with OK lens wearing among myopic children and adolescents, and multiple Logistic regression analysis was employed to examine the influencing factors. Results The compliance with OK lens among myopic children and adolescents were roughly divided into four developmental trajectories: C1 exemplary adherent (58 cases, 18.71%), C2 gradual progressor (130 cases, 41.94%), C3 fluctuating (85 cases, 27.42%), and C4 stubborn low follower (37 cases, 11.94%). Multivariate Logistic regression analysis showed that, with C1 group as the reference, age (C3, OR=0.74), parental education level (C4, OR=0.67), executive function (C2, OR=0.69; C4, OR=0.44), family support (C3, OR=0.75) and myopia control attitude (C2, OR=0.39) were all influencing factors for the compliance trajectory of OK lens; with C2 group as the reference, age (C3, OR=0.55), parental education level (C3, OR=0.34; C4, OR=0.64), executive function (C3, OR=0.77), and family support (C4, OR=0.58) were all influencing factors for the compliance trajectory of OK lens; with C3 group as the reference, age (C4, OR=0.68), and myopia control attitude (C4, OR=0.44) were both influencing factors for the compliance trajectory of OK lens (P < 0.05). Conclusions The compliance of wearing OK lens in children and adolescents with myopia can be roughly divided into four trajectories, and there is group heterogeneity. Dynamic and precise compliance intervention strategies should be given based on different trajectories and influencing factors.
- Myopia /
- Orthokeratologic procedures /
- Patient compliance /
- Regression analysis /
- Child /
- Adolescent
注释:

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图 1 近视儿童青少年OK镜配戴依从性的潜在类别发展轨迹

Figure 1. Potential developmental trajectory of OK lens wearing adherence in myopic children and adolescents

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表 1 近视儿童青少年OK镜配戴依从性得分的增长混合模型拟合分析

Table 1. Growth mixed model fitting analysis of OK lens wearing adherence scores for myopic children and adolescents

模型	AIC值	BIC值	aBIC值	Entropy值	P_LMR-LRT值	P_BLRT值	类别概率
1	4 872.38	4 924.18	4 880.84	-	-	-	1
2	4 429.12	4 486.30	4 434.28	0.73	< 0.01	< 0.01	0.78/0.22
3	4 189.67	4 218.37	4 196.33	0.87	< 0.01	< 0.01	0.26/0.58/0.16
4	4 073.17	4 136.77	4 109.75	0.93	< 0.01	< 0.01	0.19/0.42/0.27/0.12
5	4 002.11	4 064.17	4 018.35	0.88	0.07	0.03	0.13/0.37/0.24/0.16/0.10

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表 2 近视儿童青少年OK镜配戴依从性轨迹类别的单因素分析

Table 2. Univariate analysis of trajectory categories for OK lens wearing adherence in myopic children and adolescents

类别	人数	性别		年龄/岁			居住地		家庭月收入/万元			父母受教育程度
类别	人数	男	女	7~10	>10~12	>12~18	农村	城镇	< 1	1~2	>2	高中及以下	大专/本科	研究生及以上
C1	58	26(44.83)	32(55.17)	15(25.86)	19(32.76)	24(41.38)	22(37.93)	36(62.07)	15(25.86)	30(51.72)	13(22.41)	11(18.97)	28(48.28)	19(32.76)
C2	130	62(47.69)	68(52.31)	41(31.54)	68(52.31)	21(16.15)	66(50.77)	64(49.23)	25(19.23)	79(60.77)	26(20.00)	25(19.23)	88(67.69)	17(13.08)
C3	85	43(50.59)	42(49.41)	44(51.76)	17(20.00)	24(28.24)	27(31.76)	58(68.24)	22(25.88)	42(49.41)	21(24.71)	39(45.88)	32(37.64)	14(16.47)
C4	37	22(59.46)	15(40.54)	10(27.03)	9(24.32)	18(48.65)	16(43.24)	21(56.76)	9(24.32)	20(54.05)	8(21.62)	22(59.46)	10(27.03)	5(13.51)
χ²值		1.38		6.28			1.20		1.12			8.13
P值		0.10		0.02			0.19		0.39			0.01
注：()内数字为构成比/%。

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