汕头市中小学生隐性斜视现况横断面研究

Cross-sectional study of heterophoria among primary,middle and high school students in Shantou District,China

目的:了解汕头地区城乡中小学生隐性斜视的患病现况,为防治斜视提供依据。方法:横断面研究,随机整群抽样调查。在汕头地区调查9所城乡中小学校,共7 537人。眼位检查采用33 cm角膜映光法,视远视近遮盖去遮盖与交替遮盖法;记录检查结果并按年级、城乡、不同类型眼位等特征进行归类,统计学方法分析总结。结果:完成调查人数共7 464人,其中男女分别为3 928和3 536人,平均年龄11岁;本调查人群内、外隐斜视患病率分别为3.08%和60.65%,小学生内隐斜视率高于初中、高中学生内隐斜视率(P<0.001);高中学生外隐斜视率高于小学、初中学生外隐斜视率(P<0.001),特别是以高三年级学生外斜视率最高;农村学生的内、外隐斜视率均高于城市学生(P<0.05);logistic回归模型显示隐斜视率与年龄、性别无明显相关性。结论:首次报道了国内学生中隐性斜视的分布特点,即内隐性斜视以小学生多,外隐斜视以高中生多,农村学生的隐斜率高于城市学生,可能与中国学生的屈光发育状态有关。

Objective： To investigate the prevalence of heterophoria among urban and rural students in Shantou City of Guangdong Province, China. Methods： Cluster sampling was used in randomly selecting 7 537 students from 9 schools in Shantou City. Ocular alignment was assessed by using the Hirschberg light reflex and cover test. Cover testing was performed by using fixation targets at both distance （6 m） and near （30 cm）. Statistical analyses were performed using SPSS statistical software to investigate the association of age, grades and schools and different types of strabismus. Results： A total of 7 464 students were examined （participation rate was 99.03%）, including 3 928 boys and 3 536 girls, mean age 11 years. The prevalence of esophoria and exophoria were3.08% and 60.65%. Esophoria prevalence of primary school students have the significant difference （P〈0.001） contrast with middle school students and high school students. And prevalence of exophoria was highest in high school students and significantly higher than middle and primary school students respectively （P〈0.001）. Heterophoria was more prevalent in rural school students than urban school students（P〈0.05）. Multivariate logistic regression model indicated that the prevalence of heterophoria had no significant correlation with grades and ages. Conclusion： This survey first reported the prevalence ofheterophoria in China. The prevalence of esophoria appears to be higher in primary students and exophoria was highest in high school students; Prevalence of Heterophoria in the population of this survey generally showed higher in rural school students than urban areas. These may be associated with refraction in Chinese students.