北京市通州区中小学生近视肥胖共患综合干预效果评价  

Evaluation of the effect of integrated interventions on comorbidity of myopia and obesity among primary and secondary school students in Tongzhou District in Beijing

作　　者：杨纲[1] 杨冬梅[1] 宋逸[2] 李晶 文晗[1] 车靖岳 董彦会 YANG Gang;YANG Dongmei;SONG Yi;LI Jing;WEN Han;CHE Jingyue;DONG Yanhui(Department of School Health,Tongzhou District Center for Disease Control and Prevention,Beijing(101100),China)

机构地区：[1]北京市通州区疾病预防控制中心学校卫生科,101100 [2]北京大学儿童青少年卫生研究所

出　　处：《中国学校卫生》2025年第1期39-44,共6页Chinese Journal of School Health

基　　金：首都卫生发展科研专项重点公关项目(首发—1G—4251)。

摘　　要：目的评价中小学生近视肥胖共患共防干预效果,为制定综合干预措施提供科学依据。方法2022年9月-2023年9月,采用整群随机抽样方法从北京市通州区抽取6所小学和6所初中,将其随机分配到干预组(干预前914人,干预后754人)和对照组(干预前868人,干预后652人),干预期为1学年。整合家庭、学校、社区、医疗机构资源,开发基于学校的儿童近视肥胖共患共防干预技术包;干预组按照综合干预技术包实施干预,对照组不采取任何干预措施。测量收集基线期和干预后的相关健康指标,采用χ^(2)检验、t检验和Wilcoxon秩和检验进行组间比较。结果干预后,干预组和对照组中小学生的裸眼视力(4.79±0.30,4.77±0.33)较干预前(4.80±0.30,4.90±0.32)均下降(t值分别为-7.00,-5.24);且干预组下降幅度小于对照组(t=5.33)(P值均<0.01)。干预后,干预组中小学生的体质量指数、腰围、臀围、体脂率较干预前均有下降,但指标变化均无统计学意义(t/Z值分别为-0.03,-0.36,-0.30,-0.01,P值均>0.05);对照组的上述指标与干预前比较均上升,但仅有臀围、体脂率变化有统计学意义(t/Z值分别为2.17,2.62,P值均<0.05)。干预后,干预组和对照组收缩压和舒张压较干预前均上升(t_(干预组)值分别为2.16,5.29;t_(对照组)值分别为6.84,5.07),且干预组均低于对照组(t值分别为-5.27,-2.08)(P值均<0.05)。干预后,干预组“进行户外活动可以预防近视”“应该每天吃5份成人拳头大小的蔬菜水果”的认知正确率与对照组(92.48%,69.33%)比较差异均有统计学意义(χ^(2)值分别为6.30,7.86,P值均<0.05);干预组与对照组中小学生“过去7 d每天都没有喝含糖饮料”的比例(40.98%,35.43%)差异有统计学意义(χ^(2)=4.32,P<0.05)。干预后,干预组和对照组“上学日学校户外活动时长”“休息日户外活动时长”与干预前比较均增加(t/Z值分别为值分别为-13.32,-9.71;-2.59,-2.69);干预组�Objective To evaluate the intervention effectiveness of co-occurrence and prevention for myopia and obesity among primary and secondary school students,so as to provide a scientific basis for the development of comprehensive intervention measures in myopia and obesity.Methods From September 2022 to September 2023,a cluster random sampling method was used to select 6 primary schools and 6 junior high schools from Tongzhou District,Beijing.Participants were randomly assigned to an intervention group(914 before intervention and 754 after intervention)and a control group(868 before intervention and 652 after intervention),with an expected duration of one academic year.Based on the RE-AIM framework,integrate resources from families,schools,communities,and medical institutions to develop a school-based intervention technology packagefor the co-occurrence and prevention of myopia and obesity in children.The intervention group received intervention according to the comprehensive intervention technology package,while the control group did not receive any intervention measures.Relevant health indicators during the baseline period and after intervention were measured and collected,and groups were compared by Chi-quest test,t-test and Wilcoxon rank sum test.Results After intervention,the uncorrected visual acuity of primary and secondary school students in the intervention group(4.79±0.30)and the control group(4.77±0.33)both decreased compared to those before intervention(4.80±0.30,4.90±0.32)(t=-7.00,-5.24);the decrease in uncorrected visual acuity in the intervention group was smaller than that in the control group(t=5.33)(p<0.01).After intervention,body mass index,waist circumference,hip circumference,and body fat percentage of primary and secondary school students in the intervention group decreased compared to those before intervention.However,the changes in these indicators were not statistically significant(t/Z=-0.03,-0.36,-0.30,-0.01,P>0.05);the above indicators in the control group increased compared to those bef

关 键 词：近视 肥胖症 干预性研究 共病现象 学生 

分 类 号：R179[医药卫生—妇幼卫生保健] R778.11[医药卫生—公共卫生与预防医学] R723.14