2020年无锡市滨湖区中小学生近视筛查现状分析

Prevalence of myopia of primary and middle school students in Binhu district of Wuxi City

目的了解无锡市滨湖区中小学生近视现状,为有效开展近视防控工作提供参考。方法通过分层整群抽样,2020年在无锡市滨湖区小学、初中和高中各抽取1所学校,收集3所学校在校学生的视力检查结果、非睫状肌麻痹状态下屈光检测数据,采用SPSS 25.0软件进行χ^(2)检验和χ^(2)趋势检验,以比较不同特征学生的近视率并分析年级、学段等与近视率之间的关系,以P<0.05为差异具有统计学意义。结果共收集6 441名中小学生视力及屈光检查结果,其中小学生3 645人,初中生2 012人,高中生784人;女生2 931人,男生3 510人。2020年无锡市滨湖区中小学生近视患病率为51.22%(3 299/6441),其中小学生、初中生、高中生近视患病率分别为40.82%(1 488/3 645)、64.17%(1 291/2 012)、66.33%(520/784)。不同学习阶段学生近视率差异有统计学意义(χ^(2)=512.807,P<0.001),近视患病率随着学段升高而增高(χ^(2)=380.925,P<0.001)。男、女生近视率分别为23.54%、27.68%,差异无统计学意义(χ^(2)=0.547,P=0.459)。进一步分析发现,不同年级学生近视率差异有统计学意义(χ^(2)=733.346,P<0.001),随着年级升高近视率总体呈上升趋势(χ^(2)=505.399,P<0.001);且从四年级开始,随着年级上升,轻度近视者所占比例总体呈逐渐降低趋势,而中、高度近视者所占比例总体呈逐渐升高趋势(χ^(2)=196.277,P<0.001)。结论无锡市滨湖区中小学生近视患病率相对较高,呈低龄高发趋势,且随着学段上升中高度近视率逐步增高。为缓解医院临床眼科繁重的防治负担,建议可构建以健康体检管理中心眼科为主,医院、学校、社区、家庭和个人等多方联动的三级近视防控康联体模式,实施"预防为主、分类施策、综合干预"的近视防控策略。

Objective To understand the current status of myopia among primary and middle school students in Binhu District of Wuxi city,to provide reference for effective prevention and control of myopia. Methods Through using a stratified cluster sampling method, a primary school, a junior middle school and a senior high school were selected in Binhu District of Wuxi City in 2020. The results of visual acuity examination and refractive tests of students in the selected schools were analyzed to estimate the myopia prevalence and the degree of myopia. Results Visual acuity and refractive examination results of 6441 primary and middle school students were collected,including3 645 primary school students, 2 012 middle school students and 784 high school students. There are 2 931 females and 3 510 males. In 2020,the myopia prevalence of primary and middle school students in Binhu District of Wuxi City was 51.22%(3 299/6 441);the prevalence of myopia in primary,middle school and high school students was 40.82%(1 488/3 645),64.17%(1 291/2 012)and 66.33%(520/784), respectively. There was a significant difference among the prevalence of myopia among students at different school stages (χ^(2)=512.807, P<0.001), and the myopia prevalence increased with the school stages (χ^(2)=380.925,P<0.001). The prevalence of myopia of males and females were 23.54% and 27.68%,respectively,with no significant difference (χ^(2)=0.547,P=0.459). Further analysis showed that there was a significant difference in prevalence of myopia among students of different grades (χ^(2)=733.346, P<0.001);the prevalence of myopia increased with grade (χ^(2)=505.399, P<0.001). From the fourth grade, the proportion of mild myopia showed a gradual downward trend with the increase of grade,whilst the proportion of middle and high myopia showed a gradual upward trend with the increase of grade (χ^(2)=196.277,P<0.001).Conclusions The myopia prevalence of primary and middle school students is relatively high in Binhu District of Wuxi City, showing a trend of high incidence at a young age. The myopia prevalence increases gradually with the rise of the grade. To relieve the heavy prevention and treatment burden of clinical ophthalmology in hospitals, it is suggested to build a three-level myopia prevention and control conjoint mode based on the ophthalmology of health examination management center and interconnected with hospitals, schools, communities, families and individuals. The prevention and control strategy of “prevention first, classified measures and comprehensive intervention”should be implemented.