中国儿童1987与2006年视力残疾分析

Visual disability among children in China between 1987 and 2006

目的分析1987和2006年中国儿童视力残疾患病率、分布特征、影响因素和致残原因。方法利用1987和2006年2次全国残疾人抽样调查数据,以0~14岁儿童为研究对象,χ2检验分析不同儿童视力残疾分布的差异,非条件logistic回归分析儿童视力残疾的影响因素。结果 1987—2006年,中国儿童视力残疾标化现患率从86.37/10万升至108.38/10万,提高了25.49%,但盲和低视力的变化方向不同,盲的标化现患率下降了10.21%,低视力标化现患率则提高了56.06%。多因素分析表明,1987年,不同性别、年龄儿童视力残疾发生率差异有统计学意义;2006年,不同年龄、民族、家族规模、区域的儿童视力残疾发生率差异有统计学意义。1987和2006年前2位致残原因均分别是遗传或先天异常、屈光不正或弱视,分别共占66.24%和70.91%,与1987年相比,2006年遗传或先天异常致残占比下降,屈光不正或弱视占比上升。结论 1987—2006年20年间,中国儿童视力残疾现患率上升,但盲与低视力现患率的变化不同;相对于1987年,2006年社会经济因素成为影响中国儿童视力残疾的重要因素;致残原因构成的变化可能是儿童视力残疾构成变化的原因之一。

Objective To analyze the prevalence rate, distribution, determinants and causes of visual disability among children in China between 1987 and 2006. Methods Data for the children aged 0 - 14 years were derived from two waves of National Sample Survey on Disability in China during 1987 and 2006. Chi-square test and unconditioned binary logistic regression were utilized to explore the distribution characteristics and determinants of visual disability. Results Among the children surveyed, the age-standardized prevalence rate of overall visual disability increased by 25.49%, from 86. 37 in 1987 to 108.38 per 100 000 children in 2006,with a decrease of 10. 21% in the age-standardized prevalence rate of blind and an increase of 56.06% in the age-standardized prevalence rate of low vision from 1987 to 2006. Logistic regression analyses showed that gender and age were significantly associated with visual disability among children in 1987; while significant associations of age, ethnicity, family size, and place of residence with visual disability were observed in 2006. For the causes of visual disability in the children, both birth defects and ametropia or amblyopia were most important factors, totally accounting for 66. 24% and 70. 91% of all visual disability in 1987 and in 2006. However,compared with in 1987 ,the proportion of visual disability caused by birth defects decreased but that caused by ametropia or amblyopia increased in 2006. Conclusion The prevalence rate of overall visual disability in Chinese chil- dren increased from 1987 to 2006 ,but the prevalence rate of blind and low vision changed differently possibly because of the variations in causes of visual disability. In comparison with 1987, socioeconomic factors became significant in deter- mining the prevalence of visual disability in the children.