成都市龙泉驿区高三学生近视的流行病学特征

Epidemiological characteristics of myopia in high school students in Longquanyi District, Chengdu

目的:了解2014—2016年成都市龙泉驿区高三学生近视现状。方法:2014—2016年在成都市龙泉驿区随机整群抽样调查5所高级中学,对其高三学生进行医学验光及问卷调查。结果:共调查在校高三学生16 796人,排除不合格204人,列入研究者共16 592人,其中2014年5 438人,2015年5 213人,2 0 1 6年59 4 1人。调查结果表明:重点高中近视率明显高于普通高中(χ2=3 2 2. 0 6 5, P <0. 0 1),且重点高中学生的近视程度(度数)普遍高于普通高中(χ2=8.102,P<0.05);2016年近视率较2014及2015年明显增加(P<0.01);学习时间≥1h/次(P<0.01)、看电视时间≥2h/d(P<0.05)是近视的危险因素;睡眠时间≥8 h/d(P<0.01)、体育锻炼≥1 h/d(P<0.01)、经常做眼保健操(P<0.05)为保护因素;学习时间是否大于1 h(χ2=3.330)、看电视时间是否大于2h(χ2=0.176)、体育锻炼时间是否小于1h(χ2=0.904)对近视程度的影响并不明显(P>0.05);配镜不准确很可能会导致轻度近视向中度近视发展(χ2=108.218,P<0.01);睡眠时间<8h/d(χ2=7.644)、不经常做眼保健操(χ2=6.396)均会导致近视程度的加深。结论:成都市龙泉驿区重点高中近视率及近视程度均高于普通高中。青少年的近视率的上升与学习压力大、学习时间过长、缺乏休息与户外运动等有密切关系,近视程度的加深与配镜不准确(家长不重视)关系显著。因此,改善学生的学习环境、提高心理素质、减轻学习压力,鼓励劳逸结合,并加强家长与学生本人对近视的认识和建立长期的医患随访关系,对降低成都市龙泉驿区近视率及近视发展具有重要意义。

Objective： To study the current status of myopia among high school students from 2014 to 2016 in Longquanyi District, Chengdu. Methods： Random cluster sampling of five senior high schools in Longquanyi District of Chengdu was conducted for three consecutive years. Medical optometry and questionnaire surveys were conducted for high school students. Results： A total of 16 796 high school students were investigated, 204 unqualified individuals were excluded, and a total of 16 592 students were included in the study, including 5 438 in 2014, 5 213 in 2015 and 5 941 in 2016. The survey results showed that the rate of myopia in key high schools was significantly higher than that in ordinary high schools（P〈0.01）, and the degree of myopia of students in key high schools was significantly higher than that in ordinary high schools（P〈0.05）; the rate of myopia was increased significantly in 2016 compared with those in 2014 and 2015（both P〈0.01）; learning time ≥1 h/time（P〈0.01） and watching TV time ≥2 h/d（P〈0.05） risk factors for myopia; sleep time ≥8 h/d（P〈0.01）, sports exercise ≥1 h/d（P〈0.01） and frequent eye exercises（P〈0.05） were considered as protective factors. Whether the study time was longer than 1 h, whether the time of watching TV was longer than 2 h, and whether the physical exercise time was shorter than 1 h did not affect the degree of myopia significantly（P〈0.05）; inaccurate glasses had a significant impact on the degree of myopia（P〈0.01）; sleep time 8 h/d and infrequent eye exercises all resulted in a higher degree of myopia. Conclusion： The rate and degree of myopia in key high schools in Longquanyi District of Chengdu are higher than those in ordinary high schools. The increase in myopia among adolescents is closely correlated with the pressure of study, long learning time, lack of rest and outdoor sports, etc. The aggravation of myopia is significantly correlated with the inaccuracy of glasses. Therefore, there is an urgent need to improve students＇ learning environment, improve their psychological quality, reduce learning pressure, encourage the coordination between work and leisure, strengthen parents＇ and students＇ understanding of myopia and establish a long-term follow-up relationship between doctors and patients, thereby reducing the risk and progression of myopia.