中小学生5757名近视化的演变过程及近视防控的临床意义  

The evolution on natural course of myopization in 5757 schoolchildren and its clinical significance

作　　者：高作书[1] 杜晓琨[2] 石一宁[3] 陈研明[4] 方思捷[5] 

机构地区：[1]陕西省第二人民医院,陕西西安710005 [2]西安市中心医院 [3]陕西省人民医院 [4]西安交通大学 [5]天津医科大学

出　　处：《中国实用眼科杂志》2013年第7期927-932,共6页Chinese Journal of Practical Ophthalmology

基　　金：陕西省科技厅科技研究发展项目（2009K17-02）;安徽省科技厅科技研究发展项目（20088086）;西安市科技局社会发展基金资助项目（GG2006156）

摘　　要：目的通过对在校中小学生包括小学1年级至高中3年级的12个年级近视患病率及程度构成比的变化趋势进行调查，观察在校学生近视化形成的自然病程。方法采用自动验光仪（NIKONSPEEDY—K）对中小学生5757人（男生2978人，占51．7％，女生2779人，占48．3％。）动态眼屈光状态等指标进行采集，输入编辑的专项应用程序，用SPSS11．0软件行统计分析。结果正视眼不断近视化，近视程度由轻度逐渐发展到中度。7岁进入近视化-0．78D，高中三年时的平均-3．57D达到中度近视水平。7～18岁12年间年近视化幅度为-0．22D。学生的近视化年增长在13岁和16岁有2个缓进，在10岁、15岁和18岁有3个递增。女生先进入近视化，男生随之，最终在18岁趋于一致。右眼先进入近视化，左眼随之，最终在18岁趋于一致。结论在校期间7～18岁的-3．0D眼球近视化是正常青少年发育过程中眼球从22mm到23mm的1mm增长结果，并不因为近距离阅读而增加。中国的过度近视化关键是青少年丧失了对其正常的缓冲补偿能力，即3。6岁问的＋3．0D远视缓冲和22．5mm以内的眼轴程度控制。故而提出近视防控策略：（1）过度过早的眼球正视化指导近视的预测性，学龄前充足的远视缓冲可以减少近视形成。（2）儿童青少年近视的发育性、进行性的临床意义在于树立学龄期的12年持续对近视控制的观念，并提出儿童青少年屈光度的分类建议。（3）提出眼球屈光发育的“预测公式”和近视防控的“关键年龄点”。Objective To observe the course of myopization during 12 years schooldays. Meth- ods A total of 5757 students in 4 primary schools and middle schools were examined. The collect- ed data included object ophthalmic examinations, which were non-cycloplegic objective refraction, vi- sual acuity, intraocular pressure, fundus evaluation, weight, height, and the special designed question- naire investigation. The special designed inventory scale was filled in and input special computer pro- gram, then the data were statistically analyzed with SPSSll.0. Results The emmetropization shifted to myopization gradually during 12 years＇ schooldays, and from low myopia to moderate myopia continually. Myopization began at 7 years old and progressed to moderate degree at 18 years old with the -0.22D average increase per year. There were 2 slow-down periods at 13- and 16-year-old and 3 speed-up periods at 10-, 15-, 18-year-old. Conclusions Early onset myopization or over-em- metropization may guide our prediction of myopia, that is, enough hyperopia may buffer the myopicshift to reduce the myopic development. The schoolchildren implicate us to set up a concept schoolchildren＇ classification of refractive error control ocular features of development and progression in of persistent control. For this purpose, we suggest a and set a predict formula and key point of myopiacontrol.

关 键 词：近视化 远视缓冲 近视防控 

分 类 号：R776.106[医药卫生—眼科]