杭州市五所小学学生近视相关因素调查

Investigation of the associated factors leading to myopia in five primary school students in Hangzhou

目的调查杭州地区小学生近视发生的相关因素。方法横断面研究。采用整群抽样的方法，凋查杭州市朝晖区5所小学1~6年级学生近视的情况，选取右眼数据，检查数据包括球镜度、散光度、眼轴长度、角膜曲率。收集信息包括父母近视情况，课后及周末写作业时间，课后及周末户外活动时间。采用单因素方差分析。结果近视组与非近视组的性别、家族史、近距离作业及户外活动时间差异有统计学意义。女生近视患病率高于男生（63．7％掘67．4％）。父母近视（F=10．559，P〈0．05）、周末（F=7．555，P〈0．05）及课后（F=2．492，P〈0．05）写作业时间过长为近视的危险因素，课后（F=11．351，P〈0．05）及周末（F=6．387，P〈0．05）户外活动具有保护作用。结论近视与性别、家族史、近距离工作及户外活动有关。环境与基因因素均与小学生近视密切相关，其中环境因素中近距离阅读对近视的作用具有很强的时间依赖性，户外活动中紫外线的作用值得关注。

Objective To investigate the associated factors leading to myopia in primary school students in a relatively developed region in Hangzhou. Methods This was a cross-sectional study. By cluster sampling, primary students from 5 schools （grades 1-6） in Zhaohui District, Hangzhou, were recruited for this investigation. The right eye was examined and data were collected on spherical refraction, cylinder refraction, axial length and corneal curvature. Information was also obtained on family history, time spent on near reading after school and on weekends, and time spent on outdoor activities both after school and on weekends. A one-way ANOVA was used for analysis. Results There were significant differences in gender, family history, time spent on near reading and outdoor activity between myopic and non-myopic groups. Females were more likely to be myopic than males （63.7% vs. 67.4%）. The students with myopic parents （F=10.559, P〈0.05） or those who spent more time on near reading on weekends （F=7.555, P〈0.05） and after school （F=2.492, P〈0.05） were more likely to be myopic. On the other hand, outdoor activities both after school （F=11.351, P〈0.05） and during weekends （F=6.387, P〈0.05） reduced the prevalence of myopia. Conclusion Myopia in primary school students is associated with gender, family history, near reading and outdoor activity. So both genetic and environmental factors contribute to the development of myopia. The effect of environmental factors, especially near reading, is time-dependent, and ultraviolet exposure during outdoor activity plays a significant role.