中国四年级学生近视检出情况及其相关因素

Prevalence of myopia and associated factors among fourth-grade students in China

目的 分析中国四年级学生近视检出情况,探讨影响学生近视的因素。方法 从2018年中国教育追踪调查(China education panel survey, CEPS)小学队列中选取符合条件的四年级学生作为研究对象,共26 373人。采用χ^(2)检验比较不同特征学生近视检出率差异,并利用多水平logistic回归分析模型分析影响近视检出率的因素。结果 小学四年级学生筛查性近视检出率为52.11%,女生的近视检出率(56.38%)高于男生(48.20%)(χ^(2)=176.597,P<0.001);城镇户籍学生的近视检出率为55.71%,比农村户籍学生(48.59%)高7.12%(χ^(2)=133.790,P<0.001)。多水平logistic回归分析模型分析显示城乡学生近视检出率影响因素不同,是否参加体育兴趣班(OR=0.83, 95%CI:0.74~0.93,P=0.001)、与父母同住情况(OR=1.21,95%CI:1.07~1.38,P=0.002)对农村学生近视检出率的作用显著;年龄(OR=0.91,95%CI:0.84~0.98,P=0.014)、是否为独生子女(OR=1.09, 95%CI:1.01~1.18,P=0.030)、认知水平(OR=1.09,95%CI:1.01~1.18,P=0.032)、家庭经济条件(OR=1.23, 95%CI:1.03~1.47,P=0.020)对城镇学生近视检出率作用显著。结论 科学控制学生近视风险需要根据学生自身、家庭及其生活环境,因地制宜,结合城乡差异采取合理的干预措施。

Objective To analyze the screening nearsightedness of the fourth grade students in China and discuss the factors affecting the students′myopia.Methods A total of 26373 students were selected from the fourth grade primary school cohort of China education panel survey(CEPS)in 2018.χ^(2) test was used to compare the prevalence of myopia among students with different characteristics,and multi-level logistic regression model was used to analyze the factors affecting the detection rate of myopia.Results The prevalence rate of screening myopia was 52.11%,with girls(56.38%)higher than boys(48.20%)(χ^(2)=176.597,P<0.001).The myopia rate of urban registered students was 55.71%,which is 7.12%higher than that of rural registered students(48.59%)(χ^(2)=133.790,P<0.001).Multilevel logistic regression analysis showed that there were different factors affecting the risk of myopia among urban and rural students.Whether they participated in sports interest classes(OR=0.83,95%CI:0.74-0.93,P=0.001)and living with parents(OR=1.21,95%CI:1.07-1.38,P=0.002)had a significant effect on the risk of myopia among rural students.Age(OR=0.91,95%CI:0.84-0.98,P=0.014),only child or not(OR=1.09,95%CI:1.01-1.18,P=0.030),cognitive level or not(OR=1.09,95%CI:1.01-1.18,P=0.032),family economic conditions(OR=1.23,95%CI:1.03-1.47,P=0.020)had significant effect on myopia risk of urban students.Conclusions It is necessary to take reasonable intervention measures according to local conditions and the difference between urban and rural areas to control the prevalence of myopia in students scientifically.