杭州市小学二～四年级学生视力不良现况及影响因素分析

Prevalence and associated factors of poor vision among primary school students

目的了解小学二~四年级学生视力不良流行趋势和影响因素,为有针对性地开展视力保护工作提供依据。方法分层整群抽取杭州市具有城乡代表性的6所小学二~四年级小学生共2 691人进行流行病学调查,通过单因素和多因素非条件Logistic回归分析,了解相关意识、行为、环境因素对视力的影响。结果学生视力不良率为38.6%,其中二~四年级学生视力不良率分别为32.6%,33.8%和50.4%,随着年级的升高而升高（χ2=71.62,P〈0.01）。多因素非条件Logistic回归分析显示,主观认为近视能预防（OR=0.774）、经常注意保护视力（OR=0.608）是保护因素;与近距离用眼休息间隔超过1 h的学生相比较,休息间隔〈30 min（OR=0.693）或在30~45 min（OR=0.689）的学生视力不良发生率低;周末户外活动时间为30~60 min的学生视力不良发生率高于户外活动时间〉1 h的学生（OR=1.301）;而认为戴眼镜酷、近视与否无所谓、父亲近视、母亲近视、小时候一直开夜灯睡觉等是危险因素（OR值分别为2.743,1.854,1.324,1.308,1.430,P值均〈0.05）。结论小学生视力保护干预应及早开展,尤其应加强对小学生近视认知、视力保护意识、视力保护行为等方面的宣传教育,提高视力自我保护意识,培养学生良好的读写行为、眼放松习惯等。

Objective To assess the prevalence and associated factors of poor vision among pupils,in order to offer evidence for effective and preventive strategies against myopia.Methods A stratified cluster sampling survey was conducted among2 691 pupils from grade 2 to grade 4 in 6 primary schools in Hangzhou.Univariate and bivariate conditional logistic regressions were recruited to examine whether attitudinal,behavioral,environmental factors had impacts on vision.Results Overall prevalence of poor vision was 38.6%,with significant increasing trend with grade（32.6%,33.8% and 50.4% in grade 2,grade 3 and grade 4）（χ2= 71.62,P〈0.01）.Beliefs in myopia prevention（OR = 0.774）,paying attention to eye health（OR = 0.608）were protective factors of poor vision.The prevalence of poor vision was higher among students who reported average break time less than 30 min（OR= 0.693）or 30-45 min（OR = 0.689）than those had more than 1 hours.Students with 30-45 min outdoor activities on weekend had higher suspected poor vision rate than those with 1 h outdoor activities（OR = 1.301）.Overlooked benefits of wearing glasses（OR =2.743）,indifferent attitude towards myopia（OR = 1.854）,myopic father（OR = 1.324）,myopic mother（OR = 1.308）and sleep with nightlight in childhood（OR = 1.430）were risk factors for myopia.Conclusion The relevant departments should pay sufficient attention to the prevention and control as soon as possible to enhance myopia-related knowledge,beliefs,attitudes and behaviors.