中小学生读写姿势与近视关联的多水平模型分析  

A multilevel model analysis of the association between reading and writing posture with myopia in primary and secondary school students

作　　者：许惠玉 秦冉 张京舒 王路[2] 王艳 罗慧娟 郭欣[1,2] XU Huiyu;QIN Ran;ZHANG Jingshu;WANG Lu;WANG Yan;LUO Huijuan;GUO Xin(School of Public Health,Capital Medical University,Beijing(100069),China;不详)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]北京市疾病预防控制中心学校卫生所

出　　处：《中国学校卫生》2023年第12期1878-1882,共5页Chinese Journal of School Health

基　　金：北京市卫生健康委员会高层次公共卫生技术人才建设项目(领军人才-01-09);国家重点研发计划项目(2021YFC2702102)。

摘　　要：目的探讨中国儿童青少年读写姿势与近视的关联,为减少中小学生近视的发生提供参考。方法于2020年11月—2022年6月采用多阶段分层整群概率抽样方法选取北京市、浙江省、重庆市、陕西省、辽宁省、河南省6个省(市)的中小学生为研究对象,收取完成按照《儿童青少年近视筛查规范》进行睫状肌麻痹验光检查及问卷调查的16782名学生数据,分析中小学生读写姿势与近视之间的关联。结果中小学生近视总体检出率为45.7%,其中小学生35.0%,初中生84.1%,高中生90.4%;73.6%的中小学生存在读写姿势不良。调整性别、学段、区域、每天白天户外活动时间、父母是否近视等混杂因素,多水平Logistic回归结果显示,读写姿势不良(OR=1.17,95%CI=1.07~1.28)、从不/偶尔在读写时眼睛距离书本超过一尺(OR=1.28,95%CI=1.08~1.53;OR=1.23,95%CI=1.08~1.40)、老师偶尔提醒孩子注意读写姿势(OR=1.13,95%CI=1.01~1.25)、经常/总是趴着读书写字或脸放在手臂上(OR=1.15,95%CI=1.01~1.32;OR=1.46,95%CI=1.17~1.82)、总是用手托着头读书写字(OR=1.56,95%CI=1.20~2.01)与近视呈正相关,父母偶尔提醒孩子注意读写姿势(OR=0.85,95%CI=0.76~0.96)与近视呈负相关(P值均<0.05)。结论读写姿势不良是中小学生近视患病的风险因素。需加强读写姿势的干预,以减少中小学生近视的发生。Objective To explore the association between reading and writing posture with the occurrence of myopia in Chinese children and adolescents,so as to provide a reference for reducing its prevalence among primary and secondary school students.Methods Using data from the 2020 survey on the current status of hyperopia reserve in primary and secondary school students from six provinces/cities,namely Beijing,Zhejiang,Chongqing,Shaanxi,Liaoning,and Henan selected by multi-stage stratified cluster probability sampling method during November 2020 to June 2022.A total 16782 students who completed the optometry examination of cycloplegia according to the Children and Adolescents Myopia Screening Standard and questionnaire survey were included for analyzing analyze the association between reading and writing posture with myopia.Results The overall detection rate of myopia among primary and secondary school students was 45.7%,of which 35.0%were primary school students,84.1%junior high school students,and 90.4%senior high school students.Poor reading and writing posture was found in 73.6%of primary and secondary school students.Adjusting for confounding factors such as gender,school period,region,outdoor time every day,and whether parents were myopic,the results of the multilevel Logistic regression showed that the following factors were positively correlated with myopia:poor reading and writing posture(OR=1.17,95%CI=1.07-1.28),never/occasionally reading and writing with a reading distance which was more than one foot away between the eyes and book(OR=1.28,95%CI=1.08-1.53,OR=1.23,95%CI=1.08-1.40),teachers occasionally reminding the child of their reading and writing posture(OR=1.13,95%CI=1.01-1.25),and often/always reading and writing while lying down or with the face on the arm(OR=1.15,95%CI=1.01-1.32,OR=1.46,95%CI=1.17-1.82),always reading and writing with the head in the hand(OR=1.56,95%CI=1.20-2.01).Further,a negative correlation was detected between myopia and parents occasionally reminding their children of their reading

关 键 词：阅读 书写 近视 回归分析 学生 

分 类 号：R778.11[医药卫生—眼科] R179[医药卫生—临床医学] R193