开封市部分城区7~12岁儿童弱视的流行病学特征及预防保健措施研究

Epidemiological Characteristics and Preventive Measures of Amblyopia Among Children Aged 7-12 years in Some Urban Areas of Kaifeng City

目的 分析开封市部分城区7~12岁儿童弱视的流行病学特征并对其预防保健措施进行探讨。方法 以分层随机整群抽样法,抽取开封市部分城区5所小学的34690例儿童作为本次研究调查对象。均进行裸眼视力的检查,对裸眼视力<0.7的儿童进一步开展散瞳验光和眼底检查,依据《弱视诊断专家共识(2011年)》确诊弱视。统计弱视儿童不同年龄、性别、弱视类型的患病情况,通过单因素和多因素logistic回归分析弱视发生的影响因素。结果 本次调查的开封市部分城区的34690例儿童中,弱视298例,其患病率为0.84%,其中男性和女性的弱视患病率分别为0.86%、0.85%;7~8岁、9~10岁、11~12岁年龄段儿童的弱视患病率依次为0.75%、0.82%、1.02%;屈光不正性、屈光参差性、斜视性、形觉剥夺性弱视的占比依次为45.97%、34.22%、12.75%、7.04%;单因素分析结果显示,两组在斜视、弱视家族史、早产史占比方面比较差异有统计学意义(P<0.05);经Logistic回归模型多因素分析,斜视(P=0.020,OR=4.170)、弱视家族史(P=0.018,OR=3.550)、早产史(P=0.007,OR=2.399)是弱视发生的独立影响因素。结论 开封市部分城区7~12岁儿童弱视的患病率为0.84%,其中屈光因素是造成弱视发生的主要原因。且斜视、弱视家族史、早产史是弱视发生的独立影响因素,应对相关因素予以有效控制,施以有针对性的弱视防治措施以此来降低开封市城区的弱视患病率。

Objective To analyze the epidemiological characteristics of amblyopia in children aged 7-12 years old in some urban areas of Kaifeng City,and to explore the preventive measures.Methods Stratified random cluster sampling method was used to select 34690 children from 5 primary schools in part of Kaifeng City.All the children with uncorrected visual acuity were examined.Mydriasis optometry and fundus examination were further carried out for children with uncorrect-ed visual acuity<0.7,and amblyopia was diagnosed according to the"amblyopia diagnosis expert consensus(2011)".The prevalence of amblyopia children with different ages,genders and types of amblyopia was statistically analyzed.The influencing factors of amblyopia were analyzed by univariate and multivariate logistic regression.Results Among 34690 children in Kaifeng City,298 cases were amblyopia,and the prevalence rate was 0.84%.The prevalence of amblyopia in male and female was 0.86%and 0.85%,respectively;The prevalence of amblyopia was 0.75%,0.82%and 1.02%in 7-8 years old,9-10 years old and 11-12 years old;The percentages of ametropia,anisometropia,strabismus and form deprivation amblyopia were 45.97%,34.22%,12.75%and 7.04%,respectively;Univariate analysis showed that there were significant differences in the proportion of strabismus,amblyopia family history and premature birth history between the two groups(P<0.05);Multivariate logistic regression analysis showed that strabismus(P=0.020,or=4.170),family history of amblyopia(P=0.018,or=3.550)and preterm birth history(P-0.007,or=2.399)were the independent influencing factors of amblyopia.Conclusion The prevalence of amblyopia in children aged 7-12 years old in some urban areas of Kaifeng City is 0.84%,and refractive factors are the main causes of amblyopia.And strabismus,amblyopia family history,premature birth history are the independent influencing factors of amblyopia.We should effectively control the relevant factors and implement targeted amblyopia prevention measures to reduce the prevalence of amblyopia in Kaifeng City.