云南芒市民族聚居区中小学生近视及裸眼视力损伤现状

Epidemiology of myopia and unaided visual impairment of primary and secondary school students of Han and minorities in Mangshi City in Yunnan

目的了解云南省少数民族聚居区中小学生裸眼视力损伤及近视的流行状况,为学校卫生资源的合理分配提供科学依据。方法 2014年3-8月对云南省芒市7 681名中小学生进行视力检查、眼前段检查、屈光检查、眼球运动和眼底检查等眼科检查和问卷调查,以等效球镜小于-0.5 D作为近视的标准,裸眼视力损伤以较好眼和较差眼分别为基准进行分析。结果中小学生近视率为39.1%,高度近视率为0.6%。基于较差眼裸眼视力损伤率为11.4%,其中屈光不正占87.3%。女生近视率高于男生(χ^2=29.74,P<0.01),但高度近视率的性别差异无统计学意义(P=0.19);且两者均随年龄增长而增加(χ^2值分别为351.23,22.56,P值均<0.01);近视率中以傣族最高(63.7%),彝族最低(36.6%)(χ^2=78. 14,P <0.01),而各民族高度近视人数较少,差异较小。对性别、年龄和民族校正后,与近视发生呈正相关的因素有身高(OR=1.02,95%CI=1.01~1.03)、使用电脑(OR=1.17,95%CI=1.03~1.32)、父亲近视(OR=1.56,95%CI=1.24~1.94)、母亲近视(OR=1.33,95%CI=1.08~1.63)和阅读时间增多(OR=1.18,95%CI=1.09~1.28);与高度近视发生呈正相关的因素有父亲近视(OR=3.98,95%CI=1.72~9.22)和使用电脑(OR=2.31,95%CI=1.17~4.57)。结论云南农村地区在校中小学生近视及裸眼视力损伤率处于我国相对较低水平,但仍较为普遍。应重视有关初级眼保健政策制定和投入。

Objective To investigate the prevalence and associated factors of unaided visual impairment and myopia among primary and secondary school students in Yunnan Province,and to provide scientific basis for myopia prevention. Methods The study was conducted among primary and secondary school students in Mangshi,Yunnan Province from March to August,2014. All the 7 681 subjects underwent detailed eye examinations and a questionnaire survey. Myopia was defined as spherical equivalent value of less than-0.5 diopters. Unaided visual impairment was analyzed on the basis of the better and the worse-seeing eye,respectively. Results The prevalence of myopia and high myopia were 39.1% and 0.6%. The prevalence of unaided visual impairment was 11.4% based on the worse-seeing eye. Refractive errors accounted for 87.3% of the participants with unaided visual impairment.Prevalence of myopia was higher in girls than in boys( χ^2= 29.74,P<0.01),but there was no gender difference in high myopia( P= 0.19). The prevalence of myopia and high myopia increased significantly with increasing age( χ^2= 351.23,22.56,P<0.01). Besides,prevalence of myopia was 63.7% in Dai nationality students and 36.6% in Yi nationality students( χ^2= 78.14,P< 0.01),which was higher than other ethnic minorities. After adjusting for the effects of sex,age and ethnicity,the presence of myopia was associated with increasing height( OR = 1.02,95%CI = 1.01-1.03),computer use( OR = 1.17,95% CI = 1.03-1.32),having a myopic father( OR = 1.56,95%CI = 1.24-1.94),having a myopic mother( OR = 1.33,95%CI = 1.08-1.63) and more time reading( OR = 1.18,95%CI = 1.09-1.28). High myopia was found to be more prevalent in children who had a myopic father( OR = 3.98,95%CI = 1.72-9.22) and using computers( OR = 2.31,95% CI = 1.17-4.57). Conclusion Myopia and unaided visual impairment is prevalent in school students in rural China( Yunnan),though the prevalence is relatively lower compared with other areas in China. Attention should be paid to the formulation and input of primary eye care policies.