杭州市6～15岁儿童散光现况

Prevalence of astigmatism in Hangzhou children aged 6-15

目的了解杭州市6～15岁儿童散光的患病情况,为防治儿童散光提供依据。方法整群抽取杭州市某区5所小学及2所中学在校学生6 643名,在非睫状肌麻痹状态下用自动验光仪测量双眼屈光状况。结果 6 643名儿童检出散光≤-0.50 D者4 809名,检出率为72.39%;散光≤-0.75 D者2 175名,检出率为32.74%;散光≤-1.00 D者1 773名,检出率为17.66%。散光度≤2.00 D者占绝大多数,构成比为90.39%,各年龄组散光度分布差异无统计学意义(χ2=29.062,P=0.358)。顺规散光是6～15岁儿童散光的主要类型,占82.87%;逆规散光和斜轴散光各占13.26%和3.88%,各年龄组轴向分布差异无统计学意义(χ2=14.420,P=0.701)。6～15岁儿童以复合近视散光为主(77.83%),单纯近视性散光、单纯远视性散光、复合远视性散光及混合散光的构成比分别为5.74%,1.86%,4.11%,10.47%。随着散光程度的加深,顺规散光所占比例呈上升趋势,逆规散光逐渐减少;复合近视性散光所占比例越低,混合散光越高。结论 6～15岁儿童散光检出率较高;顺规散光和复合近视散光是主要类型;散光程度越高,顺规散光越高。应加强儿童散光的早期屈光筛查及矫正。

Objective To exam the prevalence of astigmatism in Hangzhou children aged 6 - 15, and to explore the distribution rule and main type. Methods A cluster sampling method was used to select 5 elementary schools and 2 junior high schools in Hangzhou. Noncycloplegic autorefraction was conducted on the right and left eye of each children. Results A total of 6 643 students were examined. Defining astigmatism as worse than or equal to 0. 50D ,0.75D, and 1.00D cylinder in one eye, the prevalence of astigmatism was 72.39% （ 4 809 ） ,32.74% （ 2 175 ）, and 17.66% （ 1 773 ）. The rate of astigmatism increased with grades, which had a significant difference（ P 〈 0.01） , and there was a significant increase at 10-years-old. But no different between genders （ P 〉 0.05 ）. The low astigmatism were the main groups accounting for 90.39%. And the distribution of degree among each age group had no significant difference （χ2 = 29. 062, P = 0. 358 ）. With-the-rule astigmatism was most common （ 82.87% ） than against-the-rule astigmatism, and the majority of astigmatism was compound myopia astigmatism（77.83% ）. The rate of with-therule astigmatism increased with degree. In contrast, the rate of against-the-rule astigmatism decreased with degree. In addition, the rate of mixed astigmatism increased and compound myopia astigmatism decreased with degree. Conclusion The prevalence of astigmatism is high. In Hangzhou, most astigmatism is myopic with-the-rule astigmatism. The higher degree of astigmatism, the more with-the-rule. The screening and correcting as early in children need to be improved.