北京市2017—2018学年中小学生视力不良及影响因素分析

Prevalence of visual acuity impairment and associated factors among primary and middle school students in Beijing during 2017-2018

目的了解北京市2017-2018学年中小学生视力不良现况及其影响因素,为制定近视防控策略提供科学依据。方法对2017-2018学年北京市学生常见病及健康危险因素监测的20 225名中小学生基本信息及相关危险行为进行问卷调查,采用5m标准对数视力表进行双裸眼视力检查。结果北京市2017-2018学年中小学生总视力不良检出率为71.9%(小学一到三年级除外),由高到低依次为城市女生(79.1%)、城市男生(73.1%)、郊区女生(71.7%)和郊区男生(65.8%),差异有统计学意义(χ^2=72.7,P<0.01);重度视力不良检出率为47.5%,其中城区(50.8%)高于郊区(44.6%),女生(51.0%)高于男生(44.1%),差异均有统计学意义(P值均<0.05)。视力不良检出率及重度视力不良率由高到低均为普通高中(88.6%,70.7%)、初中(78.1%,53.5%)、职业高中(75.0%,52.1%)和小学高年级学生(54.2%,25.4%),差异有统计学意义(χ^2值分别为35.5,41.4,P值均<0.01)。城市学生(OR=1.23)、女生(OR=1.27)、每天户外活动时间<1h(0R=1.19)、不正确的读写姿势(OR=1.50)、在家做作业时不正确灯光类型(OR=1.29)、放学后在家写作业时间≥1h(OR=1.43)、每天使用电子产品等视屏时间≥1h(OR=1.24)、每天睡眠时间<8h(OR=1.15)等均与视力不良的发生呈正性相关(P值均<0.05)。结论北京市中小学生的视力不良防控形势十分严峻,建议采取整体与个体干预相结合的方式,打造医院一学校一家庭一学生的防控网络,改善学生视力不良流行状况。

Objective To analyze the prevalence of reduced visual acuity(VA)impaired and associated risk factors among primary and middle school students in the 2017-2018 academic year in Beijing.Methods Demographic information and health related behaviors were collected through questionnaire survey.VA was measured by using 5-meter standard logarithmic visual acuity chart among 20225students.Results The overall prevalence of VA impairment for students in Beijing was 71.9%,highest in urban girls(79.1%),followed by urban boys(73.1%),suburban girls(71.7%)and suburban boys(65.8%)with statistically significant differences(χ^2=72.7,P<0.01).The prevalence of serve myopia was 44.7%,with urban students(50.8%)higher than suburban students(44.6%),girls(51.0%)higher than boys(44.1%).Urban students,girls,poor posture,the inappropriate lamplight for homework,homework duration.≥1h per day,screen time duration≥1h per day were associated with higher risk of VA impairment,while physical activity duration ≥1h per day and sleep duration ≥8h per day were negatively associated with risk of VA impairment(P<0.05).Conclusion Visual acuity impairment is becoming a major public health problem in primary and middle school students in Beijing.This paper calls for a mix of myopia prevention and intervention strategies that involvement of hospital, school,family and individuals,a framework integrating specific and general intervention approaches.