6~36月龄幼儿屈光发育状况及影响因素分析

Analysis of Refractive Development and Its Influencing Factors in Children Aged 6~36 Months

目的调查6~36月龄幼儿屈光发育的基本状况,并分析相关影响因素。方法挑选6~36月龄562名儿童,采用手持式全自动视力筛查仪对双眼进行非睫状肌麻痹下屈光度检测,获得并比较各年龄段的屈光度及屈光异常患病率。根据问卷调查表用Logistic回归分析屈光发育的影响因素。结果平均SE为0.38(0,0.63)D,DS为0.75(0.5,1.13)D,DC为0.75(0.5,1.28)D。其中SE、DS、DC男孩女孩之间,差异均无统计学意义(P>0.05),DS、DC在左右眼差异有统计学意义(P<0.05),而SE左右眼差异无统计学意义(P>0.05)。6~36月龄幼儿屈光状态以远视为主,其中屈光正常者占38.97%,屈光异常者占61.03%(近视前期占42.70%,散光占20.64%,远视占3.91%,近视占1.25%)。不同年龄段的屈光度、屈光异常率比较,差异无统计学意义(P>0.05)。Logistic回归分析早产是屈光异常的危险因素(P=0.012,OR=2.68,95%CI:1.24~5.79),户外活动是避免发生屈光异常的保护性因素(P=0.008,OR=0.83,95%CI:0.72~0.95),而其他因素并不构成屈光度的影响因素(P>0.05)。结论6~36月龄幼儿屈光状态以远视为主,散光是主要的屈光异常类型,早产和户外活动是屈光发育的影响因素,屈光发育总体受遗传和环境因素影响较小。近视前期人群要警惕近视低龄化的发生。

Objective To investigate the basic status of refractive development in children aged 6~36 months and analyze the related influencing factors.Methods A total of 562 children aged 6~36 months were selected to detect the diopter of both eyes without ciliary paralysis using a hand-held automatic vision screening instrument.The diopter and the prevalence rate of abnormal refraction in different age groups were obtained and compared.Logistic regression was used to analyze the influencing factors of refractive development.Results The mean SE was 0.38(0,0.63)D,DS was 0.75(0.5,1.13)D,and DC was 0.75(0.5,1.28)D.There was no statistical significance in SE,DS and DC between boys and girls(P>0.05);there was statistical significance in DS and DC between left and right eyes(P<0.05),but there was no statistical significance in SE between right and right eyes(P>0.05).Hyperopia was the main refractive state in children aged 6~36 months,of which 38.97%were normal refractive,61.03%were abnormal refractive(42.70%were premyopia,20.64%astigmatism,3.91%were hypertropia,1.25%were myopia).There were no significant differences in refractive power and refractive abnormality rate among different age groups(P>0.05).Logistic regression analysis showed that preterm birth was a risk factor for refractive abnormalities(P=0.012,OR=2.68,95%CI:1.24~5.79),and outdoor activity was a protective factor against refractive abnormalities(P=0.008,OR=0.83,95%CI:0.72~0.95).Other factors do not contribute to the influence of diopter(P>0.05).Conclusion Hypermetropia is the dominant refractive state in children aged 6 to 36 months,and astigmatism is the main type of refractive abnormalities.The refractive status of children aged 6~36 months is mainly farsightedness,astigmatism is the main type of refractive abnormalities,preterm birth and outdoor activities are the influencing factors of refractive development,and the overall influence of genetic and environmental factors is small.People in the early stage of myopia should be vigilant about the occurrence of myopia young age.