学龄前儿童高度近视的影响因素分析

Risk Factors for High Myopia in Preschool Children

目的探讨学龄前儿童高度近视的影响因素。方法回顾性分析南昌大学第二附属医院2015—2019收治的学龄前高度近视患儿129例129眼(右眼)的临床资料,对高度近视发病因素进行统计分析。将129眼按等效球镜度数大小分为3组:A组(<-6.00~-8.00 D)76例、B组(<-8.00~-10.00 D)33例、C组(≤-10.00 D)20例,比较3组眼轴长度和眼压;129眼中77眼按随访时间分为3组:2年组25例、3年组30例、4年组22例,比较3组平均每年近视增长度数。结果129例患儿父母近视者占89.2%,居住城市者占68.2%,每天户外活动小于2 h者占75.2%,使用电子产品大于2 h者占65.1%,发现近视后戴镜矫正者仅41.9%。A、B、C 3组眼轴长度逐渐增大,差异有统计学意义(F=105.027,P<0.001);A、B、C 3组间眼压比较,差异无统计学意义(F=1.033,P=0.359)。2年组、3年组、4年组每年平均近视增长度数逐渐增大,3组间比较差异有统计学意义(F=11.687,P<0.001)。结论学龄前儿童高度近视受遗传因素和环境因素共同影响,优生优育和改善相应的环境因素是降低高度近视发病率的关键。

Objective To explore the risk factors for high myopia in preschool children.MethodsClinical data of 129 preschool children with high myopia(129 right eyes)admitted to the Second Affiliated Hospital of Nanchang University between 2015-2019 were analyzed retrospectively.The pathogenic factors were analyzed statistically.The 129 eyes were divided into three groups according to the spherical equivalent refraction:group A(76 eyes,-6.00--8.00 D),group B(33 eyes,<-8.00--10.00 D),and group C(20 eyes,<-10.00 D).Axial length and intraocular pressure were compared among the three groups.Of the 129 eyes,77 were divided into three groups according to the follow-up time:2-year group(25 eyes),3-year group(30 eyes),and 4-year group(22 eyes).The increased degree of myopia per year was compared among the three groups.ResultsAmong the 129 children,89.2%of their parents suffered from myopia,68.2%lived in the city,75.2%had outdoor activities less than 2 hours per day,65.1%used electronic products for more than 2 hours,and only 41.9%wore glasses for correcting myopia.The axial length in group B was longer than that in group A,and that in group C was longer than that in group B(F=105.027,P<0.001).There were no significant differences in the intraocular pressure among the three groups(F=1.033,P=0.359).The increased degree of myopia per year in 3-year group was greater than that in 2-year group,and that in 4-year group was greater than that in 4-year group(F=11.687,P<0.001).Conclusion High myopia are affected by both genetic and environmental factors in preschool children.Prenatal and postnatal care and environmental improvement are keys to reduce the prevalence of high myopia.