上海市3~16岁儿童屈光进展的时间与空间差异研究  

A study on the temporal and spatial differences in refractive progression among children aged 3-16 in Shanghai

作　　者：邵洁[1] 黄蛟灵 陈金枝 高梓天 黄倩[1] 张怡[1] 王玉林 SHAO Jie;HUANG Jiaoling;CHEN Jinzhi;GAO Zitian;HUANG Qian;ZHANG Yi;WANG Yulin(Preventive Health Department,Pudong New Area Weifang Community Health Center,Shanghai 200122,China;不详)

机构地区：[1]上海市浦东新区潍坊社区卫生服务中心预防保健科,上海200122 [2]上海交通大学医学院公共卫生学院,上海200025 [3]上海市浦东新区沪东社区卫生服务中心预防保健科,上海200120

出　　处：《中华全科医学》2025年第1期89-93,共5页Chinese Journal of General Practice

基　　金：上海市浦东新区卫健委资助项目(PW2021A-62);上海市浦东新区优秀青年项目(PWRq2021-32);国家自然科学基金面上项目(72274122);上海市“沪眼星光”培养计划(HYXG-SQ07,HYXG-SQ04);上海市加强公共卫生体系建设三年行动计划(GWVI-11.2-YQ54)。

摘　　要：目的探索城区和城郊不同年龄和屈光状态儿童屈光发育进展的特征及影响因素,为近视精准防控工作提供科学依据。方法采用整群抽样方法,调查上海市城区和城郊合计10652名儿童,分析等效球镜度(SE)分布和进展及影响因素。结果城区和城郊比较,城区2年ΔSE变化最快的是7~9岁组[ΔSE(-0.96±1.19)D],城郊是10~12岁组[ΔSE(-0.60±1.08)D]。学龄期儿童2年ΔSE变化最快的依次是远视组、近视前期组、低度近视组,高度近视组进展最慢(P<0.05)。基线调查年龄(β=-0.183)、基线SE(β=-0.267)、地区(β=0.300)是3~9岁组儿童屈光度进展的独立影响因素,性别(β=-0.139)、基线调查年龄(β=0.130)、基线SE(β=-0.046)、基线散光度(β=-0.086)、地区(β=0.288)是10~16岁组儿童屈光进展的独立影响因素。结论学龄前儿童应重视远视储备;城区7~9岁、城郊10~12岁及远视和近视前期儿童是重点监测和干预对象,应提高城区建筑物、教室和家庭布局的空间频谱。Objective Explore the characteristics and influencing factors of refractive development in children of different ages and refractive states in urban and suburban areas,and provide the scientific basis for precise prevention and control of myopia.Methods Using cluster sampling,a total of 10652 children in the urban and suburban areas of Shanghai were surveyed to analyze the distribution,progression,and influencing factors of SE.Results Compared to the urban and suburban areas,the maximal SE change in the urban area is 7-9 years group[ΔSE(-0.96±1.19)D],while in the suburban area it is the 10-12 years group[ΔSE(-0.60±1.08)D].Among the school-age children,the hyperopic group has the maximalΔSE change over 2 years,followed by the pre-myopic group and the low myopia group.The high myopia group has the minimal progression(P<0.05).The independent influencing factors ofΔSE for children aged 3-9 years are baseline age(β=-0.183),baseline SE(β=-0.267)and region(β=0.300),and for children aged 10-16 years,they are gender(β=-0.139),baseline age(β=0.130),baseline SE(β=-0.046),baseline astigmatism(β=-0.086)and region(β=0.288).Conclusion Preschool children should pay attention to their"hyperopia reserve";Children aged 7-9 in urban areas,10-12 in suburban areas,or with hyperopia pre-myopia are key monitoring and intervention targets.Improving the spatial spectrum of urban buildings,classrooms,and home layouts is also helpful.

关 键 词：屈光 进展 回归模型 儿童 

分 类 号：R778.2[医药卫生—眼科]