北京市中小学生筛查性近视与脊柱侧弯共患情况及相关因素分析

Comorbidity of screening myopia and scoliosis among primary and secondary school students in Beijing and associated factors

目的探讨2019—2022年北京市中小学生筛查性近视与脊柱侧弯共患情况及相关因素,以期为综合防控儿童青少年近视和脊柱侧弯提供新的思路。方法2019—2022年,使用分层整群随机抽样方法从北京市分别抽取34923,34321,36008,35598名中小学生进行视力、脊柱侧弯检查和问卷调查。中小学生筛查性近视与脊柱侧弯共患率的组间差异采用χ^(2)检验进行分析,筛查性近视与脊柱侧弯共患的相关因素采用多因素Logistic回归进行分析。结果2019—2022年,中小学生筛查性近视患病率逐年上升,脊柱侧弯患病率逐年下降,共患率2022年(0.69%)较2019年(2.31%)下降了1.62百分点。2022年筛查性近视与脊柱侧弯共患率城区(0.98%)高于郊区(0.50%),不同学段共患率依次为普通高中生(1.65%)>职业高中生(1.21%)>初中生(0.76%)>小学生(0.22%),差异均有统计学意义(χ^(2)值分别为28.97,153.55,P值均<0.01)。多因素Logistic回归分析结果显示,睡眠时间不充足、家长不限制电子屏幕的使用时间与筛查性近视和脊柱侧弯共患均呈正相关[OR值(95%CI)分别为1.59(1.20~2.12),1.34(1.02~1.76)];老师经常或总是提醒读写姿势、每日进行≥1 h中高强度体力活动与筛查性近视和脊柱侧弯共患均呈负相关[OR值(95%CI)分别为0.70(0.52~0.96),0.56(0.34~0.92)](P值均<0.05)。结论北京市中小学生近视与脊柱侧弯共患现状不容乐观。应关注儿童青少年的读写姿势和相关行为习惯,保证中小学生充足的睡眠时间,进而预防近视和脊柱侧弯共患的发生发展。

Objective To investigate the comorbidity of screening myopia and scoliosis among primary and secondary school students in Beijing from 2019 to 2022 and its influencing factors,in order to provide new ideas for comprehensive prevention and control of myopia and scoliosis in children and adolescents.Methods From 2019 to 2022,34923,34321,36008 and 35598 primary and secondary school students in Beijing were selected by stratified cluster random sampling method,and visual acuity examination,scoliosis examination and questionnaire survey were conducted on them.Chisquare test was used to analyze the intergroup differences between screening myopia and scoliosis among primary and secondary school students,and the correlation factors between screening myopia and scoliosis were analyzed by multivariate Logistic regression.Results From 2019 to 2022,the prevalence of screening myopia increased by year,while scoliosis decreased by year,and the comorbidity rate in 2022(0.69%)decreased by 1.62%compared with 2019(2.31%).In 2022,screening myopia with scoliosis rates(0.98%)than urban suburbs(0.50%),high school students(1.65%)>professional high school students(1.21%)>junior middle school students(0.76%)>primary school students(0.22%)(χ^(2)=28.97,153.55,P<0.01).The results of multivariate Logistic analysis found that insufficient sleep time and parents did not limit the use of electronic screen time were the risk factors for screening myopia and scoliosis[OR(95%CI)=1.59(1.20-2.12),1.34(1.02-1.76),P<0.05].Teachers often or always remind that reading and writing posture and one hour or more of moderateintensity physical activity every day were protective factors for screening myopia and scoliosis[OR(95%CI)=0.70(0.52-0.96),0.56(0.34-0.92),P<0.05].Conclusions The comorbidity of acadmic screening myopia and scdiosis is not optimistic in Beijing.Attention should be paid to the reading and writing posture and related behavioral habits of children and adolescents,and ensure that children in each school section have sufficient sleep time,so as to prevent the occurrence and development of screening myopia and scoliosis.