四川省中小学生脊柱弯曲异常现状及影响因素分析

Abnormal spinal curvature and associated factors among primary and secondary school students in Sichuan Province

目的了解四川省中小学生脊柱弯曲异常现状及其影响因素,为科学开展防控工作提供依据。方法采用分层整群随机抽样的方法,于2022年9—11月抽取四川省21个市(州)小学四年级至高中三年级210713名学生进行脊柱弯曲异常筛查和问卷调查。采用χ^(2)检验、多因素Logistic回归分析脊柱弯曲异常的影响因素。结果四川省中小学生脊柱弯曲异常检出率为3.42%,城区(4.54%)高于郊县(2.57%),女生(3.86%)高于男生(2.98%),高中生(4.70%)高于初中生(3.80%)和小学生(2.21%),差异均有统计学意义(χ^(2)值分别为606.96,123.81,645.24,P值均<0.01)。多因素Logistic回归分析结果显示,城区、学段(初中、高中)、女生、平时单肩背书包、每学年课桌椅高度根据身高进行调整次数≤1次、每周至少进行1 h中高强度运动0 d、每天室内静坐时长≥10 h与脊柱弯曲异常呈正相关(OR值分别为1.72,1.75,1.87,1.26,1.09,1.07,1.10,1.25,P值均<0.05)。结论四川省中小学生脊柱弯曲异常检出率可能受地区、学段、性别等因素影响。应重点关注城市中学女生,制定有针对性的防控策略,降低中小学生脊柱弯曲异常发生率。

Objective To investigate abnormal spinal curvature among primary and secondary school students in Sichuan Province,so as to provide evidence for scientific prevention.Methods Using a stratified cluster random sampling method,a total of 210713 students of grade 4 to grade 12 from 21 cities(prefectures)in Sichuan Province were selected for spinal curvature screening and questionnaire survey from September to November 2022.Chi-square test and multivariate Logistic regression model were used to analyze the influencing factors of abnormal spinal curvature.Results The detection rate of abnormal spinal curvature was 3.42%,with urban areas(4.54%)higher than that in suburban areas(2.57%),girls(3.86%)higher than that in boys(2.98%),high school students(4.70%)higher than that in middle school students(3.80%)and elementary school students(2.21%),the differences were statistically significant(χ^(2)=606.96,123.81,645.24,P<0.01).Multivariate Logistic regression analysis showed that urban area,junior and senior high school,girl,carrying backpack on one shoulder,desks and chairs adjusted for student height less than≤1 time every school year,moderate-to-vigorous physical activity less than 1 h per week,and indoors sedentary time more than 10 h/d were positively associated with abnormal spinal curvature(OR=1.72,1.75,1.87,1.26,1.09,1.07,1.10,1.25,P<0.05).Conclusion The detection rate of abnormal spinal curvature of primary and secondary school students may be affected by the urbanicity,educational stage as well as gender in Sichuan Province.More attention should be paid to urban high school girls,and targeted strategies should be explored to reduce the incidence of abnormal spinal curvature.