6～11岁儿童眼球生物学参数的分布及对屈光状态的影响  

Distribution of ocular biological parameters and their correlation with refractive status in 6 ～ 11 years old children

作　　者：廖梦霏 宋胜仿[1] 刘世纯[1] 宋叶飞 罗杰 李凤 蔡血芹 周文君[1] 吕莎[1] 徐霁[1] 苏杨[1] 唐冲 张瑶 李华[1] LIAO Mengfei;SONG Shengfang;LIU Shichun;SONG Yefei;LUO Jie;LI Feng;CAI Xueqin;ZHOU Wenjun;LYU Sha;XU Ji;SU Yang;TANG Chong;ZHANG Yao;LI Hua(Department of Ophthalmology,Yongehuan Hospital, Chongqing Medical University,Chongqing,402160,China)

机构地区：[1]重庆医科大学附属永川医院眼科,重庆402160

出　　处：《第三军医大学学报》2019年第3期252-258,共7页Journal of Third Military Medical University

基　　金：重庆市社会事业与民生保障科技创新专项(CSTC2016shmszx130070);永川区科技计划项目(YCSTC2015bf5001);重庆医科大学附属永川医院研究生创新基金(YJSCX201709)~~

摘　　要：目的了解学龄儿童眼轴长度(axial length,AL)、角膜曲率半径(corneal radius of curvature,CR)等眼球参数分布情况,探讨屈光状态的影响因素,并评估眼球生物学参数对屈光发育的监测作用。方法纳入重庆市永川区6～11岁学龄儿童共1 768例,采用AL-Scan测量AL、角膜曲率(corneal curvature,K),角膜白到白(white-to-white,WTW),中央角膜厚度(central corneal thickness,CCT),使用1%环喷托酯散瞳验光后,所有右眼根据等效球镜度数(spherical equivalent,SE)分为远视、正视、近视3组,分析不同年龄、不同屈光组之间各参数的关系以及眼部参数对屈光状态的影响。结果1 768名学生的AL、K、AL/CR、WTW、CCT、SE分别为(23. 17±0. 86) mm、(43. 22±1. 41) D、2. 97±0. 10、(11. 92±0. 42) mm、(558. 27±31. 86)μm、(0. 26±1. 26) D。与女生比较,男生的AL增长(0. 49 mm),AL/CR比值增大(0. 1),WTW增长(0. 18 mm),CCT增厚(6. 31μm),K值降低(0. 71D),差异均有统计学意义(P <0. 001)。AL、CR、AL/CR在不同屈光状态组间差异均有统计学意义(P <0. 01),近视组AL、AL/CR最大,且AL/CR均值大于3;近视组CR最小。AL与CR呈正相关(r=0. 571,P <0. 001),SE与AL/CR、AL、CR的相关系数分别为-0. 802、-0. 609和0. 106 (P <0. 001)。在不同年龄组中,SE与AL、AL/CR的相关性随年龄增加呈增强趋势。在不同屈光状态组中,SE与AL、AL/CR的相关性在近视组最强。多元线性回归显示:AL/CR、AL以及性别均对SE有影响(P <0. 05)。结论重庆市永川区6～11岁学龄儿童眼球生长发育过程中AL变化较明显,不同性别儿童眼球发育存在差异; SE与AL、AL/CR、性别均存在相关性,其中AL/CR对屈光改变影响最大,对近视发生、发展的监测具有一定的临床意义。Objective To investigate the distribution of axial length( AL),corneal radius of curvature( CR) and other ocular biological parameters in 6 ~ 11-year-old school-age children,and to explore the influencing factors for refractive status and evaluate the monitoring effect of above parameters on refractive development. Methods A total of 1 768 children aged 6 to 11 years,resident in Yongchuan District,Chongqing were enrolled in this study. Their AL,corneal curvature( K),white to white( WTW),and central corneal thickness( CCT) were measured by AL-Scan. After pupillary dilatation with 1%cyclopentanlol,cycloplegic retinoscopy was performed for refractive status. According to the spherical equivalent( SE), all right eyes were divided into myopia, hyperopia and emmetropia groups. The relationships of above parameters among different age groups and among different refractive groups and their effect on refractive status were analyzed. Results The mean AL,K,AL/CR,WTW,CCT and SE were23. 17 ± 0. 86 mm,43. 22 ± 1. 41 D,2. 97 ± 0. 10,11. 92 ± 0. 42 mm,558. 27 ± 31. 86 μm,and 0. 26 ±1. 26 D,respectively in the 1 768 students. Compared with the girls,the boys had significantly longer AL( 0. 49 mm),greater AL/CR( 0. 1),larger WTW( 0. 18 mm),thicker CCT( 6. 31 μm),and smaller K( 0. 71 D)( P < 0. 001). There were statistically differences in AL,CR,AL/CR among different refractive status groups( P < 0. 01). The myopia group had the largest AL and AL/CR,and mean AL/CR greater than3;but smallest CR. AL was positively correlated with CR( r = 0. 571,P < 0. 001),and the correlation coefficients of SE with AL/CR ratio,AL and CR were-0. 802,-0. 609 and 0. 106( P < 0. 001),respectively. In different age groups,the correlation coefficients of SE with AL and AL/CR ratio were increased with age. In the different refractive statuses,the correlation of SE with AL and AL/CR was the strongest in the myopia group. Multiple linear regression analysis showed that AL/CR,AL,and gender all had effect on SE( P < 0. 05). Conclusion Significant alter

关 键 词：学龄儿童 屈光状态 眼球生物学参数 眼轴长度/角膜曲率半径比值 

分 类 号：R195.2[医药卫生—卫生统计学] R339.14[医药卫生—卫生事业管理]