甘肃省8872名小学生近视现状及其影响因素分析

Analysis of myopia status and influencing factors of 8872 primary school students in Gansu Province

目的了解2019年甘肃省8872名四至六年级学生近视的流行现状及其影响因素,为儿童青少年近视的预防与控制提供科学依据。方法采用多阶段整群随机抽样法抽取甘肃省6个市区的8872名四至六年级小学生,进行远视力检查、屈光检查和问卷调查,组间率的比较采用χ^(2)检验、趋势χ^(2)检验,等级资料采用秩和检验,影响近视的多因素分析采用二元logistic回归。结果本次近视检出4500人,近视检出率为50.7%,其中男生、女生近视率均为50.7%,差异无统计学意义(χ^(2)=0.002,P>0.05);四至六年级学生近视率分别为47.3%、48.6%、56.5%,近视率随年级呈升高趋势(χ^(2)趋势=58.985,P<0.001)。logistics回归分析结果显示:每天课后作业/读写时长≥1 h是近视的危险因素(P<0.001);班级座位每周调整1次(OR=0.578,P<0.001)、一学期调整一次课桌椅高度(OR=0.852,P=0.009)、每天做眼保健操的次数超过3次以上(OR=0.671,P=0.026)、每天户外的活动时间≥1 h(OR=0.641,P<0.001)是近视的保护因素。结论甘肃省8872名小学生近视问题不容乐观,应及时采取有效干预措施,改善用眼环境,改变近距离用眼习惯,注意正确的读写姿势,合理安排户外活动时间和课后读写时间等,从而预防近视的发生。

Objective To investigate the prevalence and influencing factors of myopia among 8872 grade 4-6 primary school students in Gansu Province in 2019,so as to provide scientific evidence for the prevention and control of myopia in children and adolescents.Methods A multi-stage cluster random sampling method was used to select 8872 primary school students of grades 4-6 in 6 urban areas of Gansu Province for distance vision examination,refractive examination,and questionnaire survey.Theχ^(2)test and trendχ^(2)test were used for the comparison among groups in detected rates,the rank sum test was used for grade data,and binary logistic regression was used for multivariate analysis of myopia.Results There were 4500 persons with myopia detected at this time,and the detection rate of myopia was 50.7%,among which the myopia rates of boys and girls were both 50.7%,and of course,the difference was not statistically significant(χ^(2)=0.002,P>0.05).The rates of myopia among 4-6 grade students were 47.3%,48.6%,and 56.5%respectively,and the rate of myopia increased with grade(χ^(2)trend=58.985,P<0.001).The results of the logistic regression analysis showed that homework every day/read and writing duration≥1 h was the risk factor for myopia(P<0.001).Class seating being adjusted weekly 1 time(OR=0.578,P<0.001),desk and chair height adjustment 1 time during one semester(OR=0.852,P=0.009),doing eye exercises more than 3 times 1 day or more(OR=0.671,P=0.026),and outdoor activity time≥1 h every day(OR=0.641,P<0.001)were protective factors for myopia.Conclusion The myopia problem of 8872 primary school students in Gansu Province is not optimistic,and effective interventions should be taken in time,including adjustment of the eye environment,changing the habit of using the eyes at close range,paying attention to the correct reading and writing posture,reasonably arranging outdoor activity time and after-school reading and writing time,etc.,so as to prevent the occurrence of myopia.