苏州市小学生1年屈光度进展及影响因素分析  

Refractive progression based on one-year follow-up and its influencing factors among primary school students in Suzhou City

作　　者：王越红[1] 吕慧玲 包新宇 张俪叶 沈蕙[1,2,3] 胡佳 WANG Yuehong;LYU Huiling;BAO Xinyu;ZHANG Liye;SHEN Hui;HU Jia(Suzhou Municipal Center for Disease Control and Prevention,Suzhou,Jiangsu 215004,China;School of Public Health,Nanjing Medical University,Nanjing,Jiangsu 211166,China;Suzhou Institute for Advanced Study on Public Health,Gusu School,Nanjing Medical University,Suzhou,Jiangsu 215006,China)

机构地区：[1]苏州市疾病预防控制中心,江苏苏州215004 [2]南京医科大学公共卫生学院,江苏南京211166 [3]南京医科大学姑苏学院苏州市公共卫生高等研究院,江苏苏州215006

出　　处：《实用预防医学》2024年第5期518-522,共5页Practical Preventive Medicine

基　　金：江苏省卫生健康委面上项目(M2022029);苏州市科技发展计划(医疗卫生科技创新)项目(SKY2022067)。

摘　　要：目的 分析苏州市小学生1年屈光度变化及其影响因素,为近视精准防控提供依据。方法 基于2020年苏州市儿童青少年健康监测项目随机选取了30所小学,收集26 003名具有2020和2021年视力建档学生的数据,视力建档包括5 m标准对数视力表下的裸眼远视力检查和非睫状肌麻痹下的电脑验光,分析近视、裸眼远视力和等效球镜度数的1年进展,多因素logistics回归分析屈光度变化的主要影响因素。结果 纳入26 003名学生,男生13 856人(占53.29%),城市13 356人(占51.36%)。随访1年,小学生总体近视率由40.35%增长至54.76%。右眼的等效球镜度数年均变化(-0.55±0.65)D,不同年级、性别、地区和基线屈光状态组变化差异均有统计学意义(P<0.05);右眼裸眼视力变化(-0.08±0.16),不同年级、性别、体质指数分组和基线屈光状态组变化差异均有统计学意义(P<0.05)。多因素logistic回归分析屈光中快速进展影响因素显示,近视前期、低度近视、乡村和六年级(OR值分别为0.388、0.666、0.862和0.856,P均<0.05)是屈光中快速进展的保护因素,女生、三~四年级(OR值分别为1.129、1.035和1.127,P均<0.05)是屈光中快速进展的危险因素。结论 苏州小学生1年随访后屈光度向近视化方向发展,年级、基线屈光状态、性别和地区是屈光度进展的影响因素,应开展重点人群的预防和控制。Objective To analyze the changes in refractive status and its affecting factors among pupils in Suzhou City,and to provide a basis for targeted prevention and control of myopia.Methods Based on the Health Promotion Program for Children and Adolescents in Suzhou City in 2020,30 primary schools were randomly selected to collect the data about 26,003 pupils with 2020 and 2021 eyesight records.And the eyesight records included uncorrected visual acuity based on reading the standard logarithmic visual acuity chart at the distance of 5m and non-cycloplegic refraction measured with an autorefractor.We analyzed the progression of myopia,naked-eye distant vision and spherical equivalent refraction(SER)based on one-year follow-up.Multivariate logistic regression analysis was performed to explore the factors influencing refraction progression.Results A total of 26,003 pupils were enrolled into this study,including 13,856 male pupils(accounting for 53.29%)and 13,356 urban ones(accounting for 51.36%).The results of one-year following up displayed that the overall myopia rate of the pupils increased from 40.35%to 54.76%.The average annual change in SER of the right eye was(-0.55±0.65)D,and there were statistically significant differences in the change of SER among different grades,genders,areas and baseline refractive state groups(all P<0.05).The change in uncorrected visual acuity of the right eye was(-0.08±0.16),and there were statistically significant differences in the changes among different grades,genders,body mass indexes and baseline refractive state groups(all P<0.05).Multivariate logistic regression analysis on the factors affecting medium and rapid progression of refraction revealed that prophase of myopia,low myopia,rural area and Grade VI were protective factors for medium and rapid progression of refraction(OR=0.388,OR=0.666,OR=0.862,OR=0.856,all P<0.05).Female students and Grades III&IV were risk factors for medium and rapid progression of refraction(OR=1.129,OR=1.035,OR=1.127,all P<0.05).Conclusion The result

关 键 词：近视 小学生 屈光 

分 类 号：R179[医药卫生—妇幼卫生保健] R778.1[医药卫生—公共卫生与预防医学]