河南省中小学生2019—2020年近视队列研究结果

Analysis of a cohort study on myopia among primary and secondary school students in Henan Province,2019-2020

目的追踪调查新型冠状病毒感染疫情期间河南省中小学生的视力变化情况,为近视的防控提供理论依据。方法基于队列研究设计,于2019年9月采用多阶段随机整群抽样,对河南省郑州、新乡、周口和平顶山4座城市2222名小学至高中学生进行视力检测,并在2020年6月对其进行随访,现场开展视力检测和问卷调查。采用Wilcoxon和Kruskal-Wallis秩和检验、χ^(2)检验、单因素方差分析、多重线性回归分析河南省中小学生2019-2020年的视力变化及其影响因素。结果相比2019年,2020年学生总体近视率有所增长,差异有统计学意义(55.7%,64.9%,χ^(2)=1035.91,P<0.01),轻、中、重度近视率2年差异均有统计学意义(2019年:32.4%,18.8%,4.4%;2020年:36.7%,22.5%,5.7%,χ^(2)值分别为8.43,9.23,3.94,P值均<0.05);2020年中小学生近视发病率为28.3%。多重线性回归分析显示,初中、小学四至六年级、小学一至三年级、地区经济水平低、使用电视上网课、休息时不看远方、晴天时学习桌桌面的亮度一般、晚上学习时只使用屋顶灯与学生近视进展有关(B值分别为-0.16,-0.18,-0.20,-0.06,-0.21,-0.13,-0.11,-0.40,P值均<0.05)。结论河南省2019-2020年中小学生视力向近视方向进展,且近视进展受教育阶段、经济水平、用眼习惯、用眼环境等因素综合影响。应积极干预并强化近视防控,改善中小学生用眼环境,以减缓近视发展。

Objective To track and investigate the changes in visual acuity of primary and secondary school students in Henan Province during the COVID-19 pandemic home confinement,so as to provide theoretical basis for the prevention and control of myopia.Methods A cohort study design was employed for this research.In September 2019,visual acuity tests were conducted among 2222 primary and secondary school students by Multi-stage random cluster sampling method from four cities in Henan Province,including Zhengzhou,Xinxiang,Zhoukou,and Pingdingshan.A follow-up study was conducted in June 2020,with on-site visual acuity tests and questionnaire surveys.Wilcoxon rank sum test,Kruskal-Wallis rank sum test,Chi-square test,one-way analysis of variance,and multiple linear regression model were used to analyze the changes in visual acuity of primary and secondary school students and the influencing factors from 2019 to 2020.Results Compared with 2019,the overall myopia rate of students increased in 2020,and the difference was statistically significant(55.7%,64.9%,χ^(2)=1035.91,P<0.01),and the difference between mild,moderate and severe myopia rates occurred at 2 years(2019:32.4%,18.8%,4.4%,2020:36.7%,22.5%,5.7%,χ^(2)=8.43,9.23,3.94,P<0.05).The myopia incidence rate of primary and secondary school students in 2020 was 28.3%.As presented in multiple linear regression analysis,middle school,grade 4th-6th and grade 1st-3rd of primary school,low economic level,using television for online classes,the study desk being not bright on sunny days,without looking far away during breaks,the brightness of the study desk and desktop which was average on sunny days,and using roof lamp only when studying at night were associated with myopia progression among students(B=-0.16,-0.18,-0.20,-0.06,-0.21,-0.13,-0.11,-0.40,P<0.05).Conclusions During 2019-2020,primary and secondary school students in Henan Province experience a progression towards myopia,which is comprehensively influenced by education stage,economic level,the habit of using eyes,and visual environment.Myopia prevention and control should be actively intervened and strengthened to improve the eye environment for primary and secondary school students,in order to slow down the development of myopia.