西部农村小学生视力不良影响因素分析

Prevalence of poor vision and its influencing factors among rural primary school students in western China

目的探讨西部农村小学生视力不良发生率和配镜率与个体及学校间的关系,为制定有效干预措施提供依据。方法在西部陕西省A市和甘肃省B市农村随机抽样251所小学,对学校的校长和19 803名4~5年级小学生进行标准化问卷调查,并用ETDRS视力表对学生进行视力筛查。结果 4~5年级学生视力不良发生率为24.16%,视力不良学生配镜率为16.85%,其中女生、5年级、家庭富裕、学校每年组织视力筛查、每天播放眼保健操和榆林市的学生视力不良发生率相对更高,差异均有统计学意义（均P〈0.05）;5年级、家庭富裕、学校每年组织视力筛查、学校开展了视力保护宣传活动和榆林市的视力不良学生配镜率相对更高,差异均有统计学意义（均P〈0.05）;多因素logistic回归分析结果表明,视力不良发生率男生更低（OR=0.791）,5年级（OR=1.432）、富裕家庭（OR=1.155）和A市（OR=1.960）发生率更高,5年级（OR=1.401）、富裕家庭（OR=1.459）和学校开展了视力保护宣传活动（OR=1.469）的视力不良学生配镜率更高。结论西部农村4~5年级学生视力不良发生率高,配镜率低;性别、年级、家庭经济状况是影响学生视力不良发生率和配镜率的主要因素;2项主要的学校眼保健活动（视力筛查和眼保健操）与学生视力不良发生率和配镜率无关。

Objective To explore the relationship between individual and school factors and poor vision and glasses wearing among primary school students in rural areas of western China and to provide evidences for effective intervention on poor vision in the students. Methods Totally 251 rural primary schools were randomly selected from two municipalities in Shaanxi and Gansu province in western China; all the principals and 19 803 grade 4 and 5 students of the schools selected were surveyed with a structured questionnaire. Early Treatment Diabetic Retinopathy Study（ ETDRS） chart was used to screen poor vision in the students. Results The overall prevalence of poor vision was 24. 16% among the students and of the students with poor vision only 16. 85% wore glasses for vision correction. The girl students and the students in grade 5,from rich families,with yearly school vision screening,doing eye exercise every day at school,and from one of the two municipalities had a significantly higher prevalence of poor vision（ all P〈0. 05）. Among students with poor vision,those in grade 5,from rich families,with yearly school vision screening,with dissemination of vision care knowledge in school,and from one of the two municipalities had a significantly higher ratio of wearing glasses for vision correction（ all P〈0. 05）. The results of logistic regression showed that boy students had a lower risk of poor vison（ odds ratio[OR]= 0. 791）,the students in grade 5（ OR = 1. 432）,from rich families（ OR = 1. 155）,and from one of the two municipalities（ OR = 1. 960） had higher risk of poor vision. Among students with poor vision,those in grade 5（ OR =1. 401）,from rich families（ OR = 1. 459）,and with dissemination of vision care knowledge in school（ OR = 1. 469） were more likely to ware glasses for vision correction. Conclusion The prevalence of poor vision is high among rural primary students in western China. However,the rate of wearing glasses for vision correction is lowamong the students with poor vision. The influencing factors of poor vision and wearing glasses for vision correction include gender,grade,and familial economic status.