中国某医学高校青年大学生近视进展及危险因素分析:一项2年纵向研究  

Analysis of myopia progression and risk factors among Chinese young medical college students:a two-year longitudinal study

作　　者：张红梅 朱云[2] 宋德胜 张婕 魏瑞华[1] Zhang Hongmei;Zhu Yun;Song Desheng;Zhang Jie;Wei Ruihua(Tianjin Key Laboratory of Retinal Functions and Diseases,Tianjin Branch of National Clinical Research Center for Ocular Disease,Eye Institute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 300384,China;School of Public Health,Tianjin Medical University,Tianjin 300070,China;Tianjin Heping District Education Comprehensive Service Center,Tianjin 300021,China)

机构地区：[1]天津医科大学眼科医院,天津医科大学眼视光学院,天津医科大学眼科研究所,国家眼耳鼻喉疾病临床医学研究中心天津市分中心,天津市视网膜功能与疾病重点实验室,天津300384 [2]天津医科大学流行病与卫生统计学系,天津300070 [3]天津和平区教育综合服务中心,天津300021

出　　处：《中华实验眼科杂志》2025年第2期153-157,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：天津市卫生健康科技项目(TJWJ2022MS014)。

摘　　要：目的调查中国某医学高校青年大学生的近视进展情况,探索影响近视进展的危险因素。方法采用队列研究方法,于2019年对天津某医学高校16~22岁新生1068人进行健康查体,最终共979例近视患者眼部资料纳入基线评估,812例参加了2年后的随访评估。在基线和2年随访时,采用裂隙灯显微镜检查眼前节情况,采用自动验光仪进行非睫状肌麻痹验光,采用Lenstar 900测量眼轴长度(AL)。将近视进展定义为等效球镜度(SE)变化≤-0.50 D/年或AL增长≥0.20 mm/年。采用广义估计方程模型进行多重线性回归分析,探索与近视进展相关的危险因素。结果在2年随访期间,92.5%(751/812)SE保持稳定,96.1%(764/795)AL保持稳定。有7.5%(61/812)出现SE进展,3.9%(31/795)AL有增长,显示出近视进展趋势。多重线性回归分析显示,女性与AL增长显著相关(β=0.064,95%CI:0.002~0.126;P=0.042);与基线为高度近视相比,基线处于中低度近视与AL增长显著相关(β=0.083,95%CI:0.005~0.161;P=0.037)。结论超过92%的青年大学生近视趋于稳定。除高度近视外,仍需加强对女性和中低度近视者的随访和管理,有效防控高度近视。Objective To investigate the myopia progression in Chinese young medical college students and explore the associated risk factors.Methods A cohort study was conducted.Among 1068 freshmen aged 16 to 22 years receiving health checkups at a medical university in Tianjin,979 myopes were ultimately included in the baseline assessment and 812 participated in the follow-up assessment after two years.The anterior segment examination with a slit lamp,non-cycloplegic autorefraction with an autorefractor and axial length(AL)measurements with Lenstar 900 were performed on participants at baseline and during the two-year follow-up.Myopia progression was defined as a spherical equivalent(SE)change of≤-0.50 D/year or an AL increase of≥0.20 mm/year.Multivariate regression analysis with the generalized estimating equation model was employed to identify risk factors associated with myopia progression.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital(No.2021KY-16).Informed consent was obtained from each subject.Results During the two-year follow-up,92.5%(751/812)of the participants had stable SE and 96.1%(764/795)had stable AL.However,7.5%(61/812)showed SE progression and 3.9%(31/795)exhibited AL growth,demonstrating a tendency of myopia progression.Multivariate linear regression analysis revealed that females(β=0.064,95%CI:0.002~0.126;P=0.042)and low to moderate myopia at baseline(β=0.083,95%CI:0.005~0.161;P=0.037)were significantly associated with AL growth compared to high myopia at baseline.Conclusions More than 92%of young college students have stable myopia.In addition to high myopia,there is still a need for better follow-up and management of females and those with low to moderate myopia to control the high prevalence of high myopia.

关 键 词：屈光不正 近视 眼轴长度 屈光度 青年大学生 纵向研究 

分 类 号：R778.11[医药卫生—眼科]