西安市中小学生脊柱侧凸的流行病学调查

Epidemiological investigation of scoliosis in primary and secondary school students in Xi'an

目的：调查西安市中小学生脊柱侧凸的患病情况,提高脊柱侧凸防治水平。方法：2013年9月至2014年4月随机在西安市选取31所中小学,选择其中7-18岁的学生进行调查,依次对所有受检者进行体格检查、脊柱侧凸测量尺检查及X线检查,X线检查脊柱侧凸Cobb’s角≥10°者诊断为脊柱侧凸。结果：此次调查共涉及30 742名学生,男15 898名,女14 844名。体格检查阳性者1121例,阳性率3.65%;脊柱侧凸测量尺检查阳性者789例,阳性率2.57%;X线检查阳性者393例,阳性率1.28%。最终诊断为脊柱侧凸者393例,男160例,女233例,女生患病率高于男生（χ^2=19.296,P=0.000）。Cobb’s角10°-19°者329例,Cobb’s角20°-39°者56例,Cobb’s角≥40°者8例。胸腰段侧凸157例,其中向左侧凸101例、向右侧凸56例;胸段侧凸123例,其中向左侧凸43例、向右侧凸80例;腰段侧凸80例,其中向左侧凸56例、向右侧凸24例;胸腰双弯33例。将调查对象按年龄分为3组（7-9岁组、10-15岁组和16-18岁组）,3组患病率比较,差异有统计学意义（χ^2=43.927,P=0.000）;两两比较（α＇=0.017）,7-9岁组患病率低于10-15岁组和16-18岁组（χ^2=42.459,P=0.000;χ^2=43.149,P=0.000）;10-15岁组和16-18岁组患病率比较,差异无统计学意义（χ^2=0.278,P=0.000）。7-9岁组和16-18岁组男女患病率比较,差异均无统计学意义（χ^2=0.036,P=0.849;χ^2=0.025,P=0.847）;10-15岁组男生患病率低于女生（χ^2=24.738,P=0.000）。结论：西安市中小学10岁以上学生的脊柱侧凸患病率较高,10-15岁年龄段的女生患病率高于男生,应引起足够重视。

Objective：To investigate the prevalence of scoliosis in primary and secondary school students in Xi’an so as to improve the prevention and treatment level of scoliosis.Methods：From September 2013 to April 2014,31 primary and secondary schools in Xi’an were randomly selected,in which students of 7 -18 years old were investigated by physical examination,scoliosis measuring scale measurement and X-ray examination successively.The subjects with scoliosis Cobb’s angle of ≥10° in X-ray examination were diagnosed as scoliosis. Results：A total of 30 742 students（15 898 males and 14 844 females）were involved in this survey.The physical examination results were positive in 1121 cases（positive rate 3.65%）,and scoliosis measuring scale measurement results were positive in 789 cases（positive rate 2.57%）,and X-ray examination results were positive in 393 cases（positive rate 1.28%）.Ultimately,393 cases（160 males and 233 fe-males）were diagnosed as scoliosis and the prevalence rate was higher in females compared to males（χ^2 =19.296,P =0.000）.Cobb’s an-gle of 10 -19 degrees was found in 329 cases,while Cobb’s angle of 20 -39 degrees was found in 56 cases and Cobb’s angle of ≥40° was found in 8 cases.The thoracolumbar lateral curvature was found in 157 cases（bend to the left in 101 cases and to the right in 56 cases）;123 patients suffered from thoracic lateral curvature（bend to the left in 43 cases and to the right in 80 cases）;80 cases belonged to lumbar lateral curvature（bend to the left in 56 cases and to the right in 24 cases）;and lateral curvature was found in thoracic and lumbar spine in 33 cases.Respondents were divided into 3 groups according to age（7 -9-years-old group,10 -15-years-old group and 16 -18-years-old group）.There was statistical difference in the prevalence rate of scoliosis between the three groups（χ^2 =43.927,P =0.000）.Further pair-wise comparison（α′=0.017）showed that the prevalence rate was lower in 7 -9-years-old group compared to the other two groups（χ^2 =42.459,P =0.000;χ^2 =43.149,P =0.000）.No statistical difference was found between 10 -15-years-old group and 16 -18-years-old group（χ^2 =0.278,P =0.000）.There was no statistical difference in the prevalence rate between males and females in 7 -9-years-old group and 16 -18-years-old group（χ^2 =0.036,P =0.849;χ^2 =0.025,P =0.847）,and the prevalence rate was lower in male studentscompare to female students in 10 -15-years-old group（χ^2 =24.738,P =0.000）.Conclusion：The prevalence rate of scoliosis is high in students more than 10 years old in primary and secondary schools in Xi’an and females have a relative higher prevalence rate compared to males in 10 -15-years-old students,which should be paid enough attention.