西藏林芝市3~6年级学生屈光状态及参数相关性研究  

Analysis of refractive status and parameter correlations among three to six grade students in Nyingchi,Tibet

作　　者：李宁凤 任国梁 江瑜 陈丹娜 高宗银 冷云霞 LI Ningfeng;REN Guoliang;JIANG Yu;CHEN Danna;GAO Zongyin;LENG Yunxia(Department of Ophthalmology,the Second Affiliated Hospital of South China University of Technology,Guangzhou First People’s Hospital,Guangzhou 510180,China;Guangzhou Geriatric Hospital,Guangzhou 510900,China)

机构地区：[1]华南理工大学附属第二医院(广州市第一人民医院)眼科,广东广州510180 [2]广州市老年医院,广东广州510900

出　　处：《广州医药》2025年第1期32-41,共10页Guangzhou Medical Journal

基　　金：广州市临床高新技术项目(2023C-GX03);广州市科技计划项目(2024B03J1255,2023A04J0619)。

摘　　要：目的分析高原地区3~6年级学生屈光状态及屈光参数之间的关系。方法2023年9月,采用随机抽样方法选取林芝市波密县某两所小学3~6年级535名学生进行校园筛查。计算并记录裸眼远视力(UCVA),非睫状肌麻痹电脑验光下散光及其轴位、等效球镜(SE)、眼轴(AL)、角膜曲率半径(CR)和眼轴/角膜曲率半径轴率比(AL/CR)。采用SPSS 22.00统计软件分析数据。结果3~6年级学生AL和AL/CR大体趋势为随年级升高而增长,SE随年级升高而降低。3~6年级学生总体筛查性近视患病率为29.91%,且3~6年级筛查性近视患病率分别为20.35%、25.53%、30.53%和51.38%。总体散光患病率为51.59%,其中顺规散光、逆规散光及斜轴散光分别占90.22%、7.61%及2.17%。视力不良者约40.37%。以非睫状肌麻痹验光SE≤-0.50 D同时UCVA<5.0作为筛查性近视的诊断,AL/CR诊断筛查性近视的灵敏度为0.656、特异度为0.887和Youden指数为0.534,曲线下面积(AUC)为0.802,优于AL评估(AUC=0.764)。结论高原地区3~6年级学生的筛查性近视患病率随年级升高而快速增长,且散光患病率较高,视力不良者较多。AL/CR值对筛查性近视监测具有一定的临床意义。Objective To analyze the relationship between refractive status and refractive parameters of students in grades three-six in plateau area.Methods In September,2023,a random sampling method was used to select 535 students from grades three-six of two primary schools in Bomi County,Nyingchi City,for school screening.Distance uncorrected visual acuity(UCVA),astigmatism and its axis position,equivalent spherical(SE),axial length(AL),corneal radius(CR),and axial length/corneal radius ratio(AL/CR)were calculated and recorded.The data was analyzed using the statistical software SPSS 22.00.Results The general trend of AL and AL/CR for grade three-six students was increased with grade increasing,while SE decreased with grade increasing.The overall prevalence of screening myopia was 29.91%,and the prevalence of screening myopia in grades three to six was 20.35%,25.53%,30.53%and 51.38%,respectively.The overall prevalence rate of astigmatism was 51.59%,including 90.22%,7.61%and 2.17%for astigmatism with the rule,astigmatism against the rule and oblique astigmatism,respectively.About 40.37%of the students had poor vision.Screening myopia was diagnosed using non-cycloplegic optometry with SE≤-0.50 D combined with UCVA<5.0.The sensitivity and specificity of AL/CR for screening myopia were 0.656 and 0.887,respectively,with a Youden index of 0.534 and an area under the curve(AUC)of 0.802.This was superior to the AL evaluation,which had an AUC of 0.764.Conclusions The prevalence of screening myopia increased rapidly with the increase of grade in grade 3 to 6 in plateau area.And there were high prevalence of astigmatism and more poor vision.AL/CR value has a certain clinical significance in the monitoring of screening myopia.

关 键 词：高原地区 筛查性近视 散光 患病率 眼轴轴长/角膜曲率半径比 

分 类 号：R778.1[医药卫生—眼科]