大理白族自治州中小学生疑似脊柱侧凸检出率及影响因素分析  

Detection rate and influencing factors of suspected scoliosis among primary and middle school students in Dali Bai Autonomous Prefecture

作　　者：蒲光鸿 王晓雯[2] 赵智[1] 卢江 李彩红[1] 晏自祥 王意文 张立 王迎松[1] Pu Guanghong;Wang Xiaowen;Zhao Zhi;Lu Jiang;Li Caihong;Yan Zixiang;Wang Yiwen;Zhang Li;Wang Yingsong(Department of Orthopaedics,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China;Yunnan Center for Disease Control and Prevention,Kunming 650100,China;Department of Medical,Fuwai Yunnan Cardiovascular Hospital,Kunming 650102,China)

机构地区：[1]昆明医科大学第二附属医院骨科,昆明650101 [2]云南省疾病预防控制中心,昆明650100 [3]云南省阜外心血管病医院医务科,昆明650102

出　　处：《中华骨科杂志》2022年第21期1433-1440,共8页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金(81860403、81960413);云南省科技人才与平台计划(202205AF150009)。

摘　　要：目的调查大理白族自治州中小学生疑似脊柱侧凸检出率及其影响因素。方法以学校为筛查地点, 采用目测法、Adams前屈试验结合躯干旋转测量仪测量躯干旋转角度, 于2021年9至11月对大理8县380所中小学共176 729名6~18岁学生进行脊柱健康普查, 将躯干旋转角≥5°或目测法复测阳性作为阳性标准筛查出疑似脊柱侧凸人群。收集筛查人群的姓名、性别、年龄、民族等人口学资料, 记录筛查地区社区或乡村委员会所在地海拔高度, 采用二元logistic回归分析筛选脊柱侧凸的影响因素。结果计划完成筛查人数为176 729名, 实际完成人数为140 026名, 完成率79.23%;共检出疑似脊柱侧凸阳性3 190名, 检出率为2.28%;女性检出率2.52%, 高于男性的2.03%(χ^(2)=37.18, P<0.001);10~18岁人群检出率2.90%, 高于6~9岁人群的0.70%(χ^(2)=620.79, P<0.001);6岁至18岁各年龄段受检人群检出率差异有统计学意义(χ^(2)=1 451.00, P<0.001)。汉族检出率2.67%, 高于非汉族人群的2.15%(χ^(2)=31.06, P<0.001);在非汉族人群中, 白族人群检出率2.07%, 低于非白族人群的2.26%(χ^(2)=4.02, P=0.045)。趋势χ^(2)检验显示, 在海拔高度<1 500 m、1 500~1 599 m、1 600~1 699 m、1 700~1 799 m、1 800~1 899 m、1 900~1 999 m、2 000~2 099 m、2 100~2 199 m、2 200~2 299m和≥2 300 m各组间, 总体人群、10~18岁人群和6~9岁脊柱侧凸检出率的差异有统计学意义(χ^(2)=249.02、195.64、24.46, P<0.05)。二分类变量logistic回归分析显示, 男性发生脊柱侧凸的风险较低(OR=0.82, P<0.001);10~18岁相对于6~9岁人群, 发生脊柱侧凸的风险增加(OR=0.12, P<0.001);白族相对于汉族发生脊柱侧凸的风险较低(OR=0.75, P<0.001)。海拔高度≥2 000 m是发生脊柱侧凸的危险因素(OR=1.52, P<0.001)。结论大理白族自治州中小学生疑似脊柱侧凸的检出率为2.28%, 女性、10~18岁、汉族、海拔≥ 2 000 m的群体可能面临更高的脊柱侧凸患病的风�Objective To investigate the epidemiological characteristics and influencing factors of scoliosis among primary and middle school students in Dali Bai autonomous prefecture.Methods A total of 176,729 students aged 6-18 years from 380 primary and secondary schools in eight counties of Dali Bai Autonomous Prefecture were screened for spinal health by visual method,Adams forward bend test and scoliometer measuring the angle of trunk rotation from September to November 2021.The angle of trunk rotation≥5°or visual method retest positive was used as a positive standard to confirm suspected scoliosis population.Demographic data of the screening population including name,gender,age and ethnicity were collected.The average altitude of the community or village committee in the screening area was recorded.Binary logistic regression analysis was used to screen the influencing factors of scoliosis.Results There were 176,729 people planned to complete the screening.A total of 140,026 people were actually completed screening with completion rate 79.23%.A total of 3,190(2.28%)suspected scoliosis positive people were detected.The detection rate of female was 2.52%,which was higher than that of male 2.03%(χ^(2)=37.18,P<0.001).The detection rate of 10-18 years old group was 2.90%,which was higher than that of 6-9 years old group 0.70%(χ^(2)=620.79,P<0.001).There was a significant difference in the detection rate among different age groups from 6 to 18 years old(χ^(2)=1,451.00,P<0.001).The detection rate of Han population was 2.67%,which was higher than that of non-Han population 2.15%(χ^(2)=31.06,P<0.001).In non-Han population,the detection rate of Bai population was 2.07%,which was lower than that of non-Bai population 2.26%(χ^(2)=4.02,P=0.045).Trend chi-square test showed significant difference in the detection rate of scoliosis among the general population,10-18 years old population and 6-9 years old population in the altitude<1,500 m,1,500-1,599 m,1,600-1,699 m,1,700-1,799 m,1,800-1,899 m,1,900-1,999 m,2,000-2,099 m,2,1

关 键 词：脊柱侧凸 普查 学生 高海拔 人种群 

分 类 号：R726.8[医药卫生—儿科]