2022年甘孜州藏汉彝族高中阶段学生屈光不正现状分析

Analysis on current ametropia of tibetan,Han and Yi high school students in Ganzi Prefecture in 2022

目的 调查甘孜州高中阶段学生屈光不正及屈光参差现状特点,为防控提供理论依据。方法 2022年10月,采用整群抽取方法抽取能覆盖甘孜州18个县的普通中学和中等职业学校高中阶段学生,由专业人员进行远视力、非睫状肌麻痹下电脑验光检查。采用χ^(2)检验比较城乡、性别、民族间的近视、远视、散光、各型屈光参差和近视程度与散光程度的构成患病检出率的差异,以P<0.05为差异有统计学意义。结果 共调查1 592名高中阶段学生,其中男生769人、女生823人,城市587人、农村1 005人,藏族1 119人、汉族367人、彝族106人,检出近视率64.45%、远视率13.07%、散光率63.57%、远视参差率1.88%、近视参差率9.23%、散光参差率15.64%、异种参差率4.59%。近视率及近视性散光率:女生(70.84%,54.53%)高于男生(57.61%,42.52%)(χ^(2)值分别为30.37、22.58,P均<0.05)、城市学生(73.91%,53.66%)高于农村(59.50%,45.77%)(χ^(2)值分别为29.09、9.24,P均<0.05),汉族近视率(70.03%)高于藏族(64.34%)和彝族(45.27%)(χ^(2)=20.35,P<0.001)、藏族近视性散光率(51.12%)高于汉族(44.68%)和彝族(36.79%)(χ^(2)=8.62,P=0.013),女生及城市学生的近视检出率(70.84%,73.91%)均高于散光检出率(65.85%,65.93%)(χ^(2)值分别为4.72、6.75,P均<0.05)。不同特征人群的散光参差检出率均高于近视参差检出率(χ^(2)值分别为412.16、432.26、288.06、557.24、568.52和202.34,P均<0.05);不同特征人群的近视程度均以重度最高、中度较高、轻度最低(χ^(2)值分别为170.19、198.59、147.29、222.16、134.86、78.55和9.86,P均<0.05);散光程度在城市和汉族学生中是:中度最高、轻度较高、重度最低(χ^(2)值分别为82.97、47.96,P均<0.05),男生、女生、农村、藏族、汉族、彝族的散光程度与近视程度刚相反,(χ^(2)值分别为53.01、40.38、82.97、128.74、164.2、47.96和33.07,P均<0.05)。远视与各型屈光参差检出率差异均无统计意义(P均>0.05)。结论 甘孜州高中阶段学生的屈光不正状况除近视检出率较高外,散光、远视、各型屈光参差患病检出率也较高。对甘孜州学生的屈光不正的防控需重视,应针对致病因素采取科学有效的干预措施。

Objective To investigate the current characteristics of refractive errors and anisometropia among high school students in Ganzi Prefecture,and to provide theoretical basis for prevention and control.Methods In October 2022,the cluster sampling method was used to select high school and secondary vocational school students covering 18 counties in Ganzi Prefecture,and computer optometry with remote vision and non-ciliary paralysis was performed by professionals.Chi-square test was used to compare the difference in the detection rate of myopia,farsightedness,astigmatism,anisometropia,myopia degree and astigmatism degree between urban and rural areas,gender and ethnic groups,and P<0.05 was considered statistically significant.Results A total of 1592 senior high school students were investigated,including 769 boys and 823 girls.There were 587 urban students and 1005 rural students;1119 Tibetan students,367 Han students and 106 Yi students.The detection rate of myopia was 64.45%.The rate of farsightedness was 13.07%.The rate of astigmatism was 63.57%.The deviation rate of farsightedness was 1.88%.The deviation rate of myopia was 9.23%.The deviation rate of astigmatism was 15.64%.And the rate of heterogeneity was 4.59%.In terms of myopia rate and myopia astigmatism rate:the rates of girls(70.84%,54.53%)were higher than those of boys(57.61%,42.52%)(x^(2)=30.37,22.58,respectively,all P<0.05);and the rates of urban students(73.91%,53.66%)were higher than those of rural students(59.50%,45.77%)(x^(2)=29.09,9.24,respectively all P<0.05).The myopia rate of Han students(70.03%)was higher than those of Tibetan(64.34%)and Yi students(45.27%)(x^(2)=20.35,P<0.001).The myopia astigmatism rate of Tibetan students(51.12%)was higher than those of Han(44.68%)and Yi students(36.79)(x^(2)=8.62,P=0.013).The detection rates of myopia of girls(70.84%)and urban students(73.91%)were higher than their detection rates of astigmatism(65.85%,65.93%)(x^(2)=4.72,6.75,respectively all P=0.009).The difference detection rates of astigmatism of different populations were higher than those of myopia(x^(2)=412.16,432.26,288.06,557.24,568.52 and 202.34,respectively,all P<0.05).The degree of myopia was the highest in the population with severe prevalence composition,higher in the population with moderate prevalence composition,and the lowest in the population with mild prevalence composition(x^(2)=170.19,198.59,147.29,222.16,134.86,78.55 and 9.86,respectively,all P<0.05).The degree of astigmatism was the highest in urban and Han students with moderate prevalence composition,higher in students with mild prevalence composition,and the lowest in the students with severe prevalence composition(x^(2)=82.97,47.96,all P<0.05).The degrees of astigmatism in boys,girls,rural,Tibetan,Han and Yi students were just opposite to the degrees of myopia(x^(2)=53.01,40.38,82.97,128.74,164.2,47.96 and 33.07,all P<0.05).There was no statistical significance in the detection rates of hypermetropia and anisometropia(all P>0.05).Conclusions In addition to the high detection rate of myopia,the detection rates of astigmatism,farsightedness and anisometropia among high school students in Ganzi Prefecture were also high.The prevention and control of refractive errors among students in Ganzi Prefecture should pay attention to their differences,and scientific and effective intervention measures should be taken against the pathogenic factors.