上海市中小学生脊柱侧弯筛查及影响因素分析  

Screening for scoliosis and associated factors among primary and middle school students in Shanghai

作　　者：储莉婷 张凤云 齐文娟 祁月 杨军林 王丽敏[3] 杨东玲[1] 罗春燕[1] CHU Liting;ZHANG Fengyun;QI Wenjuan;QI Yue;YANG Junlin;WANG Limin;YANG Dongling;LUO Chunyan(Institute of Child and Adolescent Health,Shanghai Municipal Center for Disease Control and Prevention,Shanghai(200336),China;不详)

机构地区：[1]上海市疾病预防控制中心儿童青少年健康所,200336 [2]上海交通大学医学院附属新华医院脊柱中心 [3]中国疾病预防控制中心慢性非传染性疾病预防控制中心监测室

出　　处：《中国学校卫生》2023年第8期1134-1139,共6页Chinese Journal of School Health

基　　金：中国儿童青少年脊柱侧弯流行病学调查项目。

摘　　要：目的了解上海市中小学生脊柱侧弯的发生情况及影响因素,为制定儿童青少年脊柱侧弯防控策略和措施提供数据支持。方法于2021年9—12月,采用多阶段分层整群抽样方法抽取上海市4个区16所中小学4531名四年级至初三年级学生,开展脊柱侧弯筛查和问卷调查。采用独立样本t检验、χ^(2)检验、Fisher确切概率法和非参数Mann-Whitney U检验进行统计学分析,使用多因素Logistic回归分析脊柱侧弯的影响因素。结果脊柱侧弯的现场检出率为7.4%,患病率为2.2%,侧弯部位胸腰段占比最高(60.4%),侧弯角度10°~<20°占比最高(88.1%)。男生脊柱侧弯检出率为1.6%,女生为3.3%,差异有统计学意义(χ^(2)=11.84,P<0.01);脊柱侧弯学生与初筛阴性学生体重、体质量指数(BMI)差异均有统计学意义(t值分别为-3.77,-5.30,P值均<0.01);不同班级座位调换频率中小学生脊柱侧弯检出率差异有统计学意义(Z=2.02,P<0.05)。多因素Logistic回归分析结果显示,女生发生脊柱侧弯的风险高于男生(OR=1.87,95%CI=1.21~2.88),BMI、班级座位调换均与脊柱侧弯呈负相关[OR值(95%CI)分别为0.89(0.83~0.95),0.49(0.25~0.93)];男生班级座位调换与脊柱侧弯呈负相关(OR=0.26,95%CI=0.10~0.67);女生学段与脊柱侧弯呈正相关(OR=2.35,95%CI=1.26~4.41),BMI与脊柱侧弯呈负相关(OR=0.86,95%CI=0.79~0.94)(P值均<0.05)。结论脊柱侧弯定期筛查是有效的早期发现方法,初中、低BMI的女生可作为密切关注对象。根据脊柱侧弯的发生情况和影响因素,可开展基于家庭、学校、社会等多方面的综合防控。Objective To understand the prevalence and influencing factors of scoliosis among primary and middle school students in Shanghai,so as to provide reference for the prevention and control strategies of scoliosis in children and adolescents.Methods From September to December 2021,a total of 4531 students from grade four of primary school to grade three of junior high school from 16 primary and middle schools in 4 districts of Shanghai were selected by multi-stage stratified cluster sampling to carry out scoliosis screening and questionnaire survey.Independent sample t-test,Chi-squared test,Fisher's exact probability method and nonparametric Mann Whitney U-test were used for statistical analysis,and multivariate Logistic regression was used to analyze the influencing factors of scoliosis.Results The on-the-spot detection rate of scoliosis abnormality was 7.4%and the prevalence was 2.2%,mainly for thoracolumbar scoliosis(60.4%)and the scoliosis angle of 10°-<20°(88.1%).The results showed that the detection rate of scoliosis in boys was 1.6%and in girls was 3.3%,with a statistically significant difference(χ^(2)=11.84,P<0.01).There were significant differences in weight and BMI between scoliosis students and students with negative initial screening(t=-3.77,-5.30,P<0.01).And there was a statistically significant difference in the detection rate of scoliosis with different frequency of classroom seating arrangements(Z=2.02,P<0.05).The results of multivariate Logistic regression showed that the risk of scoliosis in girls was higher than that in boys(OR=1.87,95%CI=1.21-2.88).BMI(OR=0.89,95%CI=0.83-0.95)and frequency of classroom seating arrangements(OR=0.49,95%CI=0.25-0.93)were correlated with lower rate of scoliosis.After stratification by sex,the frequency of classroom seating arrangements(OR=0.26,95%CI=0.10-0.67)in boys and the educational stage(OR=2.35,95%CI=1.26-4.41)in girls(P<0.05)was correlated with higher rate of scoliosis,while BMI(OR=0.86,95%CI=0.79-0.94)in girls were correlated with lower rate of scoliosis.C

关 键 词：脊柱侧凸 问卷调查 患病率 回归分析 学生 

分 类 号：R682.3[医药卫生—骨科学] R179[医药卫生—外科学] R726.8[医药卫生—临床医学]