高原地区军人视疲劳状况及与心理行为因素的关系  

Relationship between visual fatigue and psychological and behavioral factors of soldiers in plateau area

作　　者：庞海莉 王媛[2] 辛莘 孙芹 任飞 李丹妮 石文敏 石磊[2] PANG Haili;WANG Yuan;XIN Shen;SUN Qin;REN Fei;LI Danni;SHI Wenmin;SHI Lei(Department of Ophthalmology,The Fifth Affiliated Hospital of Qinghai,Xining,Qinghai 810000,China;Department of Health Service,The Ninth Medical Center,Chinese PLA General Hospital,Beijing 100101,China;Department of Sonography,The Ninth Medical Center,Chinese PLA General Hospital,Beijing 100101,China)

机构地区：[1]青海省第五人民医院眼科,青海西宁810000 [2]解放军总医院第九医学中心医研部,北京100101 [3]解放军总医院第九医学中心超声医学科,北京100101

出　　处：《环境与职业医学》2025年第1期83-88,共6页Journal of Environmental and Occupational Medicine

摘　　要：[背景]我国高原地区军人常常出现干眼、视疲劳等眼部不适,而视疲劳是影响军人视功能的重要因素之一。[目的]探讨长期驻扎高原地区军人视疲劳状况及其影响因素,为促进军人眼保健及增强视疲劳防护提供理论依据。[方法]2022年9月—2023年9月通过整群随机抽样法对840名高原地区的军人进行视力、眼压等眼部检查并采用视疲劳问卷(VFS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)、匹兹堡睡眠质量指数量表(PSQI)进行问卷调查。采用卡方检验对不同视疲劳程度的一般情况进行单因素分析,采用多元logistic回归模型分析视疲劳的影响因素,并将影响因素纳入决策树模型进行风险预测分析,绘制接受者工作特征曲线评估预测准确率。[结果]共发放问卷840份,回收问卷820份,有效回收率为97.62%,其中男性740人,女性80人。通过筛查视疲劳检出342例(检出率41.71%),视力不良209例(检出率25.49%),抑郁状态179例(检出率21.83%),焦虑状态243例(检出率29.63%),睡眠障碍214例(检出率26.10%),异常眼压66例(检出率8.05%)。视疲劳组与无视疲劳组的高原地区军人在不同工作时长、电子屏幕暴露时长、视力情况、抑郁情况、睡眠质量、眼压情况分布差异有统计学意义(P<0.05)。多元logistic回归结果提示电子屏幕暴露时长≥6 h、有抑郁状态、睡眠障碍、视力不良是视疲劳的影响因素(OR=10.101、5.043、2.306、1.559,P<0.05)。决策树模型分析结果提示电子屏幕暴露时长是视疲劳的主要风险因素,电子屏幕暴露≥6 h且存在抑郁状态和睡眠障碍的军人视疲劳检出率为92.63%,而电子屏幕暴露时长<6 h且视力正常和无睡眠障碍的个体则97.53%的可能无视疲劳(即视疲劳检出率为2.47%),总体预测准确率为83%,敏感度和特异度分别为0.775和0.746。[结论]电子屏幕暴露≥6 h、抑郁状态、睡眠障碍能够增加长期驻扎高原地区军人视疲劳[Background]Military personnel in high-altitude regions often experience dry eye and visual fa-tigue,and visual fatigue is one of the important factors affecting their visual function.[Objective]To investigate the prevalence and influencing factors of visual fatigue among soldiers stationed in plateau areas for an extended period,and to provide a theoretical foundation for promoting eye health care and enhancing measures to prevent visual fatigue.[Methods]From September 2022 to September 2023,840 military personnel in high-altitude re-gions were selected through cluster random sampling for eye examination and survey,including visual acuity,intraocular pressure,and Visual Fatigue Scale(VFS),Self-rating Depression Scale(SDS),Self-rating Anxiety Scale(SAS),and Pittsburgh Sleep Quality Index(PSQI).A logistic regression model was employed to analyze the factors influencing asthenopia.Identified influencing factors were incorporated into a decision tree model for predictive analysis,and a receiver operating characteristic curve was generated to assess prediction accuracy.[Results]A total of 840 questionnaires were distributed and 820 questionnaires were recovered,with an effective recovery rate of 97.62%,of whom 740 were male and 80 were female.There were 342 cases of visual fatigue were identified(41.71%),209 cases of poor vision(25.49%),179 cases of positive depressive symptoms(21.83%),243 cases of positive anxiety synmptoms(29.63%),214 cases of sleep disorders(26.10%),and 66 cases of abnormal intraocular pressure(8.05%).There were statistically significant differences in working hours,electronic screen time,visual acuity,depressive symptom,sleep quality,and intraocular pressure between the visual fatigue group and the non-visual fatigue group(P<0.05).The results of logistic regression indicated that electronic screen time≥6 h,positive depressive symptom,sleep disorder,and low vision were the influencing factors of visual fatigue(OR=10.101,5.043,2.306,1.559,P<0.05).The decision tree model showed that electronic scr

关 键 词：高原地区 军人 视疲劳 电子屏幕暴露 心理行为因素 

分 类 号：R13[医药卫生—劳动卫生]