223例高中学生3年间眼屈光状况的纵断面变化  

Three years longitudinal study of refractive errors in 223 senior high school students

作　　者：宋国玲[1] 杜晓琨[1] 石一宁[2] 陈研明[1] 方严 

机构地区：[1]西安市中心医院,710003 [2]陕西省人民医院 [3]安徽眼科研究所

出　　处：《临床眼科杂志》2013年第6期493-499,共7页Journal of Clinical Ophthalmology

基　　金：西安市科技局社会发展基金资助项目(编号GG2006156);陕西省科技厅科技研究发展项目(编号2009K17-02);安徽省科技厅科技研究发展项目(编号2008B86)

摘　　要：目的 观察高中学生3年间眼屈光状况及相关参数的变化.方法 对2007届高中学生追踪观察,全年级共完成3次完整记录和检查者223例,其中,男性115例（51.6%）,女性108例（48.4%）.采用NIKON SPEEDY-K自动验光仪、在非睫状肌麻痹情况下进行动态眼屈光指标进行采集;检查项目包括：（1）客观眼部检测;（2）问卷调查.结果 ①进入16岁的高中阶段,学生的眼屈光度平均为-3.00D以上的中度近视;与初三年级的屈光度相比,高一、高二年级学生眼近视化过程呈现近视减缓（暂称为＆quot;回退现象＆quot;）,并在高二、高三年级学生眼近视化过程呈现近视加重（暂称为＆quot;递增现象＆quot;）;高一、高二球镜回退时,柱镜呈进展趋势,早于高二、高三的近视加速.在高中3年间,左眼的近视加重速度高于右眼、男生的近视加重速度高于女生,近视屈光度的眼别的差异和性别的差异在高三消失.身高、体重、眼压等参数随屈光改变发生相应的变化.②高中3年期间,男生身高增加1 cm,女生仅0.35 cm;体重男生增加1.62 kg,女生1.06 kg.到高3时,男生平均身高174.83 cm,女生162.39 cm;男生平均体重64.88 kg,女生52.51 kg.③高中3年期间,眼压呈降低趋势,右眼降低幅度大于左眼,女生眼压降低幅度大于男生,男生右眼降低0.7 mm Hg、左眼0.45 mm Hg,女生右眼降低1.46 mm Hg、左眼1.51 mm Hg.高一时女生、右眼眼压偏高,到高三时左右眼、男女生眼压趋于一致,男生平均眼压右眼16.73 mm Hg、左眼16.76 mm Hg,女生右眼16.68 mm Hg、左眼16.65 mm Hg.结论 进入高中阶段,持续医源性干预可以有效的控制近视的发展,有可能将近视度数控制在较为安全的单纯性的低度近视范围,具体措施包括有效的矫正散光,关注身体发育速度,检测和控制眼压在正常平均值以下,同时控制的关键点是青春发育期的13～15岁,应将近视的医源性干预工作重点放在近视�Objective To observe the changes of the refractive errors and the relative bioparameters in the senior high school students in three years. Methods We collected the complete records of 223 senior high school students of class of 2007. The data included object ophthalmic examination, non-cycloplegic objective refractions visual acuity, intraocular pressure （IOP）, fundns evaluation, weight and height, and a specially designed questionnaire investigation. Results 1. The average refractive error at the baseline was moderate myopia up to - 3.0 D. Compared with that of junior 3rd year students, myopic progression slowed down in 1st senior year and speed up in the 2nd and 3rd years. Interestingly, progres- sion of sphere errors changed in an opposite way to cylinder errors. The differences of refractive errors between genders and between the right and left eyes diminished and disappeared eventually in the 3rd senior year. 2. Other bioparameters, such as height, weight and intraocular pressure, also increased in the 3 years. Average height increased 1 cm in boys and 0.35 cm in girls, while average weight increased 1.62 kg in boys and 1.06 kg in girls. 3. The intraocular pressure tended to decrease generally, and IOP was lower in girls than in boys or lower in right eyes than in left eyes. Conclusion Constant prophylactic and iatrogeuic intervention during age 16 - 18 could slow the progression and control the myopia to a less severe level, or correct astigmatism completely, and monitor the IOP level as well general growth. However, the critical peri- ed for best myopic control may be earlier from 13 - 15 years of age.

关 键 词：近视控制 眼压 散光 医源性干预 

分 类 号：R778[医药卫生—眼科]