幼儿屈光不正的家庭养育环境因素分析

Family rearing environment factors for ametropia in infants

目的探讨家庭养育环境对幼儿屈光不正的影响因素,为预防滁州市幼儿屈光不正提供科学指导。方法2017年7月~8月,采取整群抽样的方法选取滁州市2所儿童保健相关的医院门诊462名1~3岁儿童为筛查对象,采用视力筛查仪筛查屈光状态,并根据相应标准将其分为屈光正常及屈光不正儿童,同时对其抚养人进行问卷调查,主要内容包括家庭人文和家庭环境因素。结果本次共筛选出343名屈光正常与119名屈光不正幼儿。与屈光正常幼儿相比,屈光不正组母亲大专及以上文化程度(64.7%vs.52.8%)、幼儿被动吸烟(38.7%vs.25.1%)、晚上开灯睡觉(21.0%vs.11.4%)、经常哭闹(24.4%vs.15.2%)、喜欢看亮的灯(59.7%vs.48.1%)的比例较高,差异均有统计学意义(χ^2=5.105、7.987、7.081、5.182、4.724,均P<0.05),而家庭采光较好(76.5%vs.87.5%)、每天户外活动不少于0.5h(92.4%vs.97.4%)比例较低,差异均有统计学意义(χ^2=8.209、4.513,均P<0.05)。多因素Logistic回归分析结果显示:家庭采光好(OR=0.445,95%CI:0.254~0.780)、每天大于0.5h的户外活动(OR=0.257,95%CI:0.097~0.685)是屈光不正的保护因素,而其母亲大专及以上文化程度(OR=1.354,95%CI:1.074~1.708)、幼儿喜欢看亮的灯(OR=1.580,95%CI:1.004~2.485),被动吸烟(OR=1.638,95%CI:1.025~2.618)是屈光不正的危险因素。结论幼儿母亲学历、家庭采光、户外活动、看亮的灯、被动吸烟是其屈光不正的重要影响因素,应加大视力保护宣传,提高抚养人保护幼儿视力的知识知晓和能力。

Objective To explore the family rearing environment factors for ametropia among infants so as to provide scientific guidance for preventing ametropia among infants in Chuzhou City.Methods A cluster sampling method was used to select 462 infants aged 1-3 years from outpatients of 2 children health care hospitals in Chuzhou City from July to August in 2017. Their refractive status was screened and diagnosed by Welch Allyn Sure Sight Vision Screener. The infants were divided into the emmetropia group and the ametropia group according to the related standard;meanwhile, a questionnaire survey on family culture and environmental factors was conducted among guardians.Results There were 343 infants with emmetropia and 119 ones with ametropia. The proportions of mothers with college degree education background and above (64.7% vs. 52.8%), infants with passive smoking (38.7% vs. 25.1%), sleeping with a night light (21.0% vs. 11.4%), often crying (24.4% vs. 15.2%) and enjoying watching bright lights (59.7% vs. 48.1%) were higher in the ametropia group than in the emmetropia group, showing statistically significant differences (χ^2=5.105,χ^2=7.987,χ^2=7.081,χ^2=5.182,χ^2=4.724, all P<0.05). But the proportions of infants with better daylighting in the house (76.5% vs. 87.5%) and outdoor activities over half an hour(92.4% vs. 97.4%)were lower in the ametropia group than in the emmetropia group, showing statistically significant differences (χ^2=8.209,χ^2=4.513, both P<0.05). Multivariate logistic analysis revealed that better daylighting in the house (OR=0.445, 95%CI:0.254-0.780) and outdoor activities over half an hour (OR=0.257, 95%CI:0.097-0.685) were the protective factors for ametropia, while mothers with college degree education background and above (OR=1.354, 95%CI:1.074-1.708), infants in favor of watching bright lights (OR=1.580, 95%CI:1.004-2.485) and infants with passive smoking (OR=1.638, 95%CI:1.025-2.618) were the risk factors for ametropia.Conclusions Mothers’ education background, daylighting in the house, outdoor activities, watching bright lights and passive smoking are important factors affecting the infants’ refractive error;and hence, it is necessary to give more publicity to eyesight protection and improve the guardians’ knowledge and ability of infant eyesight protection.