天津中小学生近视与脊柱侧弯共患现状及学校环境风险因素分析

Comorbidity of myopia and scoliosis in primary and secondary school students and analysis of risk factors in school environment in Tianjin

目的了解天津市中小学生近视与脊柱侧弯的共患现状,并分析学校环境中可能的风险因素,为制定更有效的预防措施提供依据。方法2023年9—10月,采用分层整群随机抽样方法从天津市16个区抽取41654名中小学生开展近视和脊柱侧弯筛查。采用χ^(2)检验对数据进行单因素分析,采用二元多因素Logistic回归模型及累积效应分析探索二者共患的相关因素。结果2023年天津市中小学生筛查性近视与脊柱侧弯共患检出率为2.65%,郊区(3.26%)高于城区(2.02%),女生(3.81%)高于男生(1.59%),高中生(6.17%)高于初中生(4.19%)、小学生(0.44%),组间差异均有统计学意义(χ^(2)值分别为62.23,198.69,953.19,P值均<0.01)。二元多因素Logistic回归分析显示,每周体育课节数≥3节,每天在校做眼保健操次数≥2次,课间开展户外休息或活动,老师提醒注意读写姿势,对坐姿、站姿严格要求与筛查性近视和脊柱侧弯共患均呈负相关(OR值分别为0.66,0.77,0.71,0.78,0.74);躺着或趴着看书或电子屏幕与筛查性近视和脊柱侧弯共患呈正相关(OR=1.77)(P值均<0.05)。累积效应分析显示,累积得分(“4~7”“7~9”“≥10”)与筛查性近视和脊柱侧弯共患均呈负相关(OR值分别为0.65,0.55,0.52,P值均<0.05)。结论学校的环境支持及学生个人在校行为习惯与筛查性近视和脊柱侧弯共患相关。防控近视与脊柱侧弯共患应改善学生校内健康相关的环境因素。

Objective To investigate the comorbidity of myopia and scoliosis among primary and secondary school students in Tianjin,and to analyze the school environment risk factors contributing to these health issues,so as to provide a scientific basis for development effective prevention measures.Methods A total of 41654 primary and secondary school students from 16 districts of Tianjin were selected by stratified random cluster sampling from September to October 2023 to screen for myopia and scoliosis.Univariate analysis was performed to examine the data,followed by a bivariate multivariate Logistic regression model and cumulative effect analysis to explore the influencing factors of their comorbidity.Results In 2023,the prevalence of comorbidity of screening positive myopia and scoliosis among primary and secondary school students in Tianjin was 2.65%.The prevalence was higher in suburban areas(3.26%)compared to urban areas(2.02%),higher among females(3.81%)compared to males(1.59%),and highest in high school students(6.17%)compared to middle school(4.19%)and primary school students(0.44%)(χ^(2)=62.23,198.69,953.19,P<0.01).Logistic regression analysis showed that the number of physical education classes≥3 per week,the number of eye health exercises at school≥2 per day,outdoor activities between classes,teachers'reminding to pay attention to reading and writing posture and strict eye standing posture were negatively correlated with the comorbidity of screening positive myopia and scoliosis(OR=0.66,0.77,0.71,0.78,0.74,P<0.05).Reading or electronic screen while lying or lying on the stomach was positively associated with the comorbidity of screening positive myopia and scoliosis(OR=1.77,P<0.05).Cumulative effect analysis showed that the cumulative score(4-7,7-9,≥10)was negatively correlated with the comorbidity of screening positive of myopia and scoliosis(OR=0.65,0.55,0.52,P<0.05).Conclusions The school environment support and students'personal behavior habits in school are related to the comorbidity of comorbidity of screening positive myopia and scoliosis.Prevention and control of myopia and scoliosis should improve the environmental factors related to students'health in school.