山东省冠县4～18岁学生屈光不正横断面研究

A cross-sectional survey on refractive errors in students 4-18 years old in Guanxian county,Shandong province

目的 调查山东省冠县4～18岁在校（园）学生屈光不正患病状况.方法 横断面调查研究.通过随机整群抽样从冠县幼儿园、小学、初中和高中随机抽取学生进行屈光不正现况调查.所有学生接受裸眼视力、矫正视力、散瞳验光、眼内压、眼前节、眼后节等检查.屈光不正与性别、年龄的关系采用二元Logistic回归模型进行分析.结果 共3 112例4～18岁在校（园）学生接受检查,其中完成散瞳验光检查3 111例,完成视力检查3 094例.近视患病率为31.3％ （95％CI：29.7％～33.0％）,年龄较大[OR：1.49 （95％CI：1.45～1.54）,P＜0.01]、女性[OR：1.31 （95％CI：1.09～1.57）,P＜0.01]和城镇学生[OR：2.54（95％CI：2.11～3.07）,P＜0.01]的近视患病率较高.高度近视总体患病率为1.4％ （95％CI：1.0％～1.8％）,散光的总体患病率为32.4％（95％CI：30.8％～34.0％）,屈光参差的总体患病率为6.2％（95％CI：5.4％～7.1％）,高度近视、散光和屈光参差患病率均呈现随年龄增长而上升的趋势（P＜0.01）,其中散光和屈光参差的患病率与居住地有关（P＜0.01）,但均与性别无关（P＞0.05）;远视患病率为8.2％（95％CI：7.2％～9.2％）,并随年龄增加而下降[OR：0.72（95％CI：0.68～0.76）;P＜0.01].较好眼裸眼视力≤20/40和≤20/200者分别有675例（21.8％）和85例（2.7％）.单眼或双眼裸眼视力≤20/40的880人中,837人（95.1％）是由于屈光不正导致的.结论 山东省冠县4～18岁在校（园）学生的视力损害主要由以近视为主的屈光不正导致,且呈现出随随年龄增加而上升的趋势.

Objective To examine the prevalence of refractive errors among preschool children and schoolchildren in Guanxian county,Shandong province.Methods Using a random cluster sampling in a cross-sectional school-based study design,children ranging in age from 4 to 18 years were selected from kindergartens,primary schools,and junior and senior high schools in Guanxian county.All children underwent a complete ocular examination including measurement of uncorrected （UCVA） and best corrected visual acuity （BCVA）,auto-refractometry under cycloplegia and ophthalmic examination.The prevalence rates of refractive error and its association with age and gender were analyzed by a bivariate regression model.Results Of 3 112 eligible children,cycloplegic refraction was completed on 3 111 and the visual acuity of 3 094 was successfully tested.The overall prevalence of myopia was 31.3％（95％CI：29.7％-33.0％）.Myopia was associated with older children [OR：1.45 （95％CI：1.41-1.50）; P＜0.01],female gender [OR：1.45（95％CI：1.41-1.50）; P＜0.01] and children in urban areas [OR：2.54 （95％CI：2.11-3.07） ; P＜0.01].The prevalence of high myopia,astigmatism and anisometropia was 1.4％ （95％CI：1.0％-1.8％）,32.4％ （95％CI：30.8％-34.0％） and 6.2％ （95％CI：5.4％-7.1％）,respectively.All prevalences were associated with older children （P＜0.01） but not gender （P＞0.05）.The prevalence of astigmatism and anisometropia was also associated with children in urban areas （P＜0.01）.The overall prevalence of hyperopia was 8.2％（95％CI：7.2％-9.2％）,and the trend decreased with age [OR：0.72（95％CI：0.68-0.76）; P＜0.01].UCVA was 20/40 or worse in the better eye in 675（21.8％） children,and 20/200 or worse in the better eye in 85（2.7％） children.UCVA≤20/40 in one or both eyes was found in 880（28.4％） children,with undercorrected refractive error as the cause in 837（95.1％） children.Conclusion Visual impairment in students 4-18 years of age in Guanxian county was mainly attributed to refractive errors,especially myopia.The prevalence of refractive errors increased with age.