青少年儿童人群眼轴增长的相关因素

An analysis of relevant factors affecting axial length growth in teenagers and children

目的 通过对青少年儿童人群的眼轴增长的相关因素分析,探讨近视发生发展的规律,为预防和控制近视提供依据.方法 前瞻性研究.分层随机抽样选取上海市徐汇区和虹口区2个区12所中小学,6～13岁的学生4 651例（取右眼数据）,进行屈光相关检查（包括裸眼远视力、屈光度、眼轴、角膜曲率等）,测身高、体质量,对性别、年龄、家族史等进行问卷调查,完成2年3次（初查,每隔1年复查）的数据收集.SAS 9.3建立混合模型（mixed model）,对眼轴增长相关因素进行统计分析.结果 眼轴随时间变量而增加,第1年和第2年的系数估计分别为0.247、0.491 （P＜0.01）;性别、体质指数、等效球镜度（SE）、平均角膜曲率等变量的系数估计分别为-0.307、0.006、-0.303、-0.297（P＜0.01）;在年龄变量中,相对于6岁年龄组,7～13岁各组变量的系数估计分别为0.115、0.392、0.471、0.600、0.816、0.865、0.909（P＜0.01）;在家族史变量中,相对于父母双方均无近视组,一人中低度数组、一人高度数组、双方均中低度数组、一人高度一人中低度数组、双方均高度数组的系数估计分别为0.122、0.257、0.238、0.429、0.429（P＜0.01）.右眼2年眼轴变化值与2年SE变化值呈负相关（r=-0.462,P＜0.01）.结论 在青少年儿童人群中,眼轴随时间增长,并且与年龄、体质指数、家族史、平均角膜曲率相关.眼轴随年龄逐步增长;体质指数越高,增长越快;父母近视程度越高,增长越快;平均角膜曲率越高,增长越慢.SE为正值时,数值越高,眼轴增长越慢;SE为负值时,数值越高,眼轴增长越快.

Objective To investigate the principles influencing the occurrence and development of myopia by analyzing factors relevant to axial length growth in teenagers and children;to provide a basis for prevention and control of myopia.Methods In a prospective study,a stratified random sampling was used to select 12 middle schools and primary schools in the Shanghai Xuhui and Hongkou districts.The study enrolled 4 651 students,ranging in age from 6 to 13 years.Visual acuity,refractive error,axial length,and corneal curvature were tested and height and weight were recorded.A survey questionnaire that included information about the students＆#39; age,gender,family history,etc.,was completed and follow-up surveys were repeated 2 times over a 2-year period.Census data were analyzed with a mixed model using SAS 9.3 software.Results Axial length increased as a function of time.The coefficient estimate was 0.247,0.491 （P〈0.01）.Variables such as gender,body mass index （BMI）,spherical equivalent （SE）,and an estimation of the average corneal curvature coefficient were-0.307,0.006,-0.303,-0.297,respectively （P〈0.01）.For the age variable,the 6-year-old group was compared to the 7-to 13-year-old groups and the variable coefficient estimates were 0.115,0.392,0.471,0.600,0.816,0.865,0.909 （P〈0.01）.For family history variables,parents were grouped as follows：neither parent was myopic,one was in the low or middle myopia group,one was in the high myopia group,both were in the low or middle myopia group,one was in the low or middle and one was in the high myopia group,both were in the high myopia group,coefficient estimates were 0.122,0.257,0.238,0.429,0.429,the differences were statistically significant （P〈0.01）.The change in 2 years of axial length of right eye shows negative relation with the change in 2 years of SE.Conclusion In this population of teenagers and children,relevant findings revealed that axial length increases with time,age,BMI,family history,spherical equivalent,and average corneal curvature.Axial length increased gradually as age increased.The higher the BMI was,the faster the growth.The higher the degree of myopia in parents,the faster the growth.The higher the average corneal curvature was,the slower the axial length growth was.When the spherical equivalent was positive,a higher number corresponded with a slower growth in axial length.When the spherical equivalent was negative,a higher number corresponded with a faster growth in axial length.