中国六省市中小学生电子屏幕使用与近视的关联

Correlation analysis of electronic screen use and myopia among primary and secondary school students in six provinces and cities of China

目的探讨中国六省市中小学生电子屏幕使用情况及其与近视的关联,为综合防控中小学生近视提供科学依据。方法于2020年11月至2022年6月,采用分层整群随机抽样与概率抽样相结合的方法,选取中国六省市(北京市、辽宁省、浙江省、河南省、陕西省、重庆市)16557名中小学生作为研究对象,采用北京市疾病预防控制中心编制的问卷进行电子屏幕使用情况调查,并依据《儿童青少年近视筛查规范》采用质量浓度0.5%的复方托吡卡胺滴眼液麻痹睫状肌后进行裂隙灯验光检查。采用χ^(2)检验比较组间差异,采用二元Logistic回归分析电子屏幕使用与近视的关联。结果有58.3%的中小学生平均每日使用电子屏幕时间≥2 h,有63.4%的中小学生非学习目的一次持续使用电子产品≥15 min。调整混杂因素后,父母不限制使用电子屏幕时间、每日使用电子屏幕时间≥2 h与中小学生近视发生均呈正相关(OR值分别为1.27,1.13,P值均<0.05)。按性别分层分析结果显示,每日电子屏幕使用时间≥2 h的男生发生近视的风险较高(OR=1.15,P<0.05);按年级分层分析结果显示,在小学低年级学生中,父母不限制电子屏幕使用时间和每日电子屏幕使用时间≥2 h与中小学生近视发生均呈正相关(OR值分别为1.34,1.18);在小学高年级学生中,非学习目的一次持续使用电子屏幕时间≥15 min与近视发生呈正相关(OR=1.18)(P值均<0.05)。电子屏幕使用总时间和一次持续使用电子屏幕时间存在相乘交互作用(OR=1.04,P<0.05)。结论中国六省市中小学生电子屏幕使用较多,且电子屏幕使用过多与近视相关。学校和家长应当共同限制中小学生电子屏幕的使用,减少中小学生近视的发生。

Objective To study the correlation between electronic screen use and myopia among primary and secondary school students in six provinces and cities in China,in order to provide a scientific basis for comprehensive prevention and control of myopia.Methods From November 2020 to June 2022,a total of 16557 primary and secondary school students from six provinces and cities in China(Beijing City,Liaoning Province,Zhejiang Province,Henan Province,Shaanxi Province,Chongqing City)were selected by stratified cluster random sampling and probability smampling methods,and a questionnaire prepared by Beijing Center for Disease Control and Prevention was used to investigate their electronic screen use.According to Screening Criteria for Myopia in Children and Adolescents,0.5%mass concentration of compound topicamide eye drops was used to paralyze the ciliary muscle and undergo slit lamp optometry.Chi-square test was used to compare the differences between groups,and binary Logistic regression was used to analyze the association between electronic screen use and myopia.Results About 58.3%of primary and secondary school students used electronic screens for more than two hours a day on average,and 63.4%of primary and secondary school students used continuously electronic products for more than 15 minutes at a time for non-study purposes.After adjusting for confounding factors,parents'unrestricted use of electronic screen time and electronic screen time≥2 h/d were positively correlated with myopia(OR=1.27,1.13,P<0.05).Gender stratified analysis showed that boys who used electronic screen time≥2 h/d had a higher risk of myopia(OR=1.15,P<0.05).The results of grade stratification analysis showed that parents'unrestricted electronic screen use time and electronic screen time≥2 h/d were positively correlated with myopia in the lower grade of primary school students(OR=1.34,1.18,P<0.05).Among the higher grade of primary school students,continuous use of electronic screens for non-study purposes for more than 15 minutes at one time was positively correlated with myopia(OR=1.18,P<0.05).There was a multiplicative interaction between total screen time and one continuous screen time(OR=1.04,P<0.05).Conclusions Primary and secondary students in six provinces and cities in China reports excessive electronic screen usage which is associated with myopia.Schools and parents should jointly limit the use of electronic screen among primary and secondary students to reduce the occurrence of myopia.