Analysis on the trend of myopia prevalence and its influencing factors among students in Liaoning Province from 2018 to 2020
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摘要:
目的 了解并评估2018-2020年辽宁省学生视力检出情况及发展趋势,并分析其影响因素,为进一步制定防治学生近视策略和措施提供科学依据。 方法 采用多阶段分层随机整群抽样的方法收集2018-2020年辽宁省学生近视体检资料,3次调查纳入研究对象分别为33 238、49 381和52 083人。分析辽宁省2018-2020年学生近视检出情况及变化趋势,利用Logistic回归分析模型分析学生近视发生的影响因素。 结果 2018-2020年辽宁省学生整体近视检出率呈逐年下降趋势,分别为56.15%、54.0%和53.9%。多因素Logistic回归分析模型分析发现,影响视力的主要因素有经济分类、城乡分类、性别、学校类型、年份、每天早饭情况、中高强度运动情况、班级座椅定期调换情况、课桌椅高度调整情况和每天眼保健操情况(均有P < 0.05)。其中性别女(OR=0.731, 95% CI: 0.711~0.751, P < 0.001)、高年级(小学OR=0.255, 95% CI: 0.235~0.276, P < 0.001;初中OR=0.060, 95% CI: 0.055~0.065, P < 0.001;高中OR=0.031, 95% CI: 0.029~0.034, P < 0.001;职高OR=0.092, 95% CI: 0.083~0.101, P < 0.001)、年份(OR=0.936, 95% CI: 0.909~0.963, P < 0.001)、每天做1~2次眼保健操(1次OR=0.929, 95% CI: 0.887~0.974, P=0.002;2次OR=0.943, 95% CI: 0.898~0.991, P=0.020)、至少每周1次座椅调换(两周1次OR=0.892, 95% CI: 0.842~0.945, P < 0.001;每周1次OR=0.915, 95% CI: 0.866~0.966, P=0.001)、一学期1次课座椅高度调整(OR=0.948, 95% CI: 0.912~0.986, P=0.008)和有中高强度运动(2 d OR=0.942, 95% CI: 0.899~0.988, P=0.014;4 d OR=0.910, 95% CI: 0.856~0.969, P=0.003;7 d OR=0.936, 95% CI: 0.892~0.982, P=0.007)均为近视发生的保护性因素,而经济情况较差(中等OR=1.261, 95% CI: 1.213~1.312, P < 0.001;差等OR=1.127, 95% CI: 1.084~1.172, P < 0.001)、农村(OR=1.239, 95% CI: 1.203~1.275, P < 0.001)、偶尔吃早餐(OR=1.041, 95% CI: 1.006~1.077, P=0.022)都是近视发生的危险性因素。 结论 辽宁省学生近视检出率相对较高,但增长趋势有所放缓,且呈逐年下降的趋势。同时,对于学生近视的防控,应针对其影响因素采取有效措施,进而避免学生近视的发生。 Abstract:Objective To investigate and evaluate the prevalence of myopia and its development trend in students in Liaoning Province from 2018 to 2020, and analyze its influencing factors, to further provides the scientific basis for further formulating the strategy and the measure of preventing myopia. Methods The data of myopic physical examination among students in Liaoning Province from 2018 to 2020 were collected by multistage stratified random cluster sampling, the sample size of three surveys were 33 238, 49 381 and 52 083, respectively. To analyze the prevalence and trend of myopia among students in Liaoning Province from 2018 to 2020, and analyze its influencing factors by Logistic regression. Results The overall myopia detection rate decreased gradually in the students of Liaoning Province from 2018 to 2020, which was 56.15%, 54.0% and 53.9%, respectively. Multiple Logistic regression analysis found that the main factors affecting myopia were economic classification, urban and rural classification, gender, type of school, year, daily breakfast, moderate to high intensity exercise, regular replacement of class seats, height adjustment of desks and chairs, and daily eye exercises (P < 0.05). Among them, gender (OR=0.731, 95% CI: 0.711-0.751, P < 0.001), senior grade (primary school OR=0.255, 95% CI: 0.235-0.276, P < 0.001; junior high school OR=0.060, 95% CI: 0.055-0.065, P < 0.001; senior high school OR=0.031, 95% CI: 0.029-0.034, P < 0.001; vocational high school OR=0.092, 95% CI: 0.083-0.101, P < 0.001), year (OR=0.936, 95% CI: 0.909-0.963, P < 0.001), do 1-2 eye exercises every day (once OR=0.929, 95% CI: 0.887-0.974, P=0.002; twice OR=0.943, 95% CI: 0.898-0.991, P=0.020), change seats at least once a week(twice a week OR=0.892, 95% CI: 0.842-0.945, P < 0.001; once a week OR=0.915, 95% CI: 0.866-0.966, P=0.001), once a semester chair height adjustment (OR=0.942, 95% CI: 0.899-0.988, P=0.014; 4 days OR=0.910, 95% CI: 0.856-0.969, P=0.003; 7 days OR=0.936, 95% CI: 0.892-0.982, P=0.007) were protective factors for myopia, while poor economic condition (moderate OR=1.261, 95% CI: 1.213-1.312, P < 0.001; poor OR=1.127, 95% CI: 0.084-1.172, P < 0.001), rural area (OR=1.239, 95% CI: 1.203-1.275, P < 0.001) and occasional breakfast (OR=1.041, 95% CI: 1.006-1.077, P=0.022) were risk factors for myopia. Conclusions The detection rate of myopia among students in Liaoning Province was relatively high, but it decreased gradually. At the same time, preventive strategies should be taken according to its influencing factors so as to avoid the myopia occurrence. -
Key words:
- Myopia /
- Development trend /
- Students /
- Risk factors
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表 1 2018-2020年辽宁省参加调查的学生基本情况表[n(%)]
Table 1. Basic information of students participating in the survey in Liaoning Province from 2018 to 2020 [n(%)]
条目 2018年 2019年 2020年 调查人数 33 238 49 381 52 083 年龄(x±s, 岁) 11.96±3.68 11.81±3.65 11.71±3.62 性别 男 16 921(50.9) 24 838(50.3) 26 409(50.7) 女 16 317(49.1) 24 543(49.7) 25 674(49.3) 学校分类 幼儿园 2 003(6.0) 2 346(4.8) 2 999(5.8) 小学 15 538(46.7) 23 153(46.9) 25 539(49.0) 初中 7 794(23.4) 12 106(24.5) 12 174(23.4) 高中 6 057(18.2) 8 922(18.1) 8 811(16.9) 职高 1 846(5.6) 2 854(5.8) 2 560(4.9) 表 2 2018-2020年辽宁省学生近视检出情况表
Table 2. The prevalence of myopia among Liaoning Province students from 2018 to 2020
条目 2018年 2019年 2020年 趋势χ2值 P值 近视人数 调查人数 近视人数 调查人数 近视人数 调查人数 性别 736.823 < 0.001 男 8 878 16 921 12 519 24 838 13 250 26 409 女 9 763 16 317 14 146 24 543 14 810 25 674 城市分类 1 101.829 < 0.001 城市 11 842 19 269 16 191 28 282 16 091 27 932 农村 6 800 13 969 10 474 21 099 11 969 24 151 合计 18 642 33 238 26 665 49 381 28 060 52 083 46.864 < 0.001 表 3 2019-2020年辽宁省学生近视率的单因素分析[n(%)]
Table 3. Univariate analysis of myopia rate among students in Liaoning Province from 2019 to 2020 [n(%)]
条目 调查人数 近视人数 χ2值 P值 条目 调查人数 近视人数 χ2值 P值 经济分类 58.600 < 0.001 课间休息活动场所 15.207 < 0.001 好 19 541 10 947(56.02) 教学楼内 36 985 20 246(54.74) 中 41 520 21 900(52.75) 户外 64 479 34 479(53.47) 差 40 403 21 878(54.15) 家长是否会因为作业或补课减少活动时间 11.504 0.003 城乡分类 618.505 < 0.001 经常 11 309 6 023(53.26) 城市 56 214 32 282(57.43) 有时 30 034 16 011(53.31) 农村 45 250 22 443(49.60) 没有 60 121 32 691(54.38) 性别 555.678 < 0.001 家长是否限制电子产品使用 5.597 0.018 男 51 247 25 769(50.28) 是 68 136 36 573(53.68) 女 50 217 28 956(57.66) 否 33 328 18 152(54.46) 学校类型 18 146.578 < 0.001 老师是否提醒读写姿势 3.223 0.359 幼儿园 5 345 727(13.60) 从不 14 057 7 525(53.53) 小学 48 692 18 331(37.65) 偶尔 31 227 16 808(53.83) 初中 24 280 17 383(71.59) 经常 26 762 14 404(53.82) 高中 17 733 14 761(83.24) 总是 29 418 15 988(54.35) 职高 5 414 3 523(65.07) 父母是否提醒读写姿势 0.373 0.946 年份(年) 0.154 0.695 从不 9 820 5 281(53.78) 2019 49 381 26 665(54.00) 偶尔 24 151 13 017(53.90) 2020 52 083 28 060(53.88) 经常 31 240 16 830(53.87) 是否住校 0.738 0.390 总是 36 253 19 597(54.06) 是 16 693 9 054(54.24) 近距离用眼后多久休息远眺闭目或户外活动 5.732 0.333 否 84 771 45 671(53.88) < 15 min 23 224 12 582(54.18) 每天早饭情况 11.048 0.004 15 min < 30 min 24 255 13 043(53.77) 天天吃 76 435 41 453(54.23) 30 min~ < 1 h 20 515 11 077(53.99) 偶尔吃 22 552 11 959(53.03) 1~ < 2 h 12 350 6 583(53.30) 从不吃 2 477 1 313(53.01) 2~ < 3 h 6 644 3 546(53.37) 中高强度运动情况(d) 29.371 < 0.001 ≥3 h 14 476 7 894(54.53) 0 20 011 10 616(53.05) 白天户外运动时间(h) 7.686 0.104 1 14 775 7 835(53.03) <1 24 889 13 463(54.09) 2 16 294 8 980(55.11) 1~ < 2 34 167 18 556(54.31) 3 13 096 7 030(53.68) 2~ < 3 15 569 8 288(53.23) 4 6 945 3 800(54.72) ≥3 20 736 11 187(53.95) 5 11 290 6 067(53.74) 不知道 6 103 3 231(52.94) 6 3 274 1 736(53.02) 是否为核心家庭 37.669 < 0.001 7 15 779 8 661(54.89) 是 35 764 19 755(55.24) 每周体育课情况(节) 59.708 < 0.001 否 65 700 34 970(53.23) 0 3 854 1 933(50.16) 每天眼保健操情况(次) 120.274 < 0.001 1 10 703 5 566(52.00) 在校不做 12 075 6 041(50.03) 2 59 818 32 699(54.66) 1 39 827 21 392(53.71) 3 21 706 11 558(53.25) 2 40 956 22 740(55.52) 4 2 950 1 606(54.44) ≥3 8 606 4 552(52.89) ≥5 2 433 1 363(56.02) 每天作业时长(h) 25.558 < 0.001 班级座椅定期调换情况 43.979 < 0.001 没有作业 2 519 1 390(55.18) 从不或仅个别人轮换 8 281 4 296(51.88) <1 23 774 12 870(54.13) 一学期1次 8 232 4 335(52.66) 1~ < 2 32 487 17 380(53.50) 一个月1次 18 554 9 923(53.48) 2~ < 3 20 264 10 738(52.99) 两周1次 23 186 12 869(55.50) ≥3 18 520 10 241(55.30) 每周1次 43 211 23 302(53.93) 不知道 3 900 2 106(54.00) 课桌椅高度调整情况 15.928 0.001 天黑后在家读书写字用什么灯光 10.461 0.015 从不或不可调 59 242 31 722(53.55) 同时使用台灯和屋顶灯 47 468 25 829(54.41) 一学年1次 12 643 7 011(55.45) 仅使用台灯 11 060 5 852(52.91) 一学期1次 18 437 9 994(54.21) 仅使用屋顶灯 41 834 22 445(53.65) 两至三个月1次 11 142 5 998(53.83) 其他 1 102 599(54.36) 表 4 2019-2020年辽宁省学生近视率的多因素分析
Table 4. Multivariate analysis of myopia rate among students in Liaoning Province from 2019 to 2020
条目 β值 sx值 OR (95% CI)值 P值 条目 β值 sx值 OR (95% CI)值 P值 经济分类 中高强度运动情况(d) 好 1.000 3 -0.025 0.026 0.976(0.928~1.026) 0.337 中 0.232 0.020 1.261(1.213~1.312) < 0.001 4 -0.094 0.032 0.910(0.856~0.969) 0.003 差 0.120 0.020 1.127(1.084~1.172) < 0.001 5 -0.037 0.027 0.963(0.914~1.016) 0.167 城乡分类 6 -0.002 0.042 0.998(0.919~1.085) 0.966 城市 1.000 7 -0.066 0.025 0.936(0.892~0.982) 0.007 农村 0.214 0.015 1.239(1.203~1.275) < 0.001 班级座椅定期调换情况 性别 从不或仅个别人轮换 1.000 男 1.000 一学期一次 -0.068 0.035 0.934(0.872~1.001) 0.053 女 -0.314 0.014 0.731(0.711~0.751) < 0.001 一个月一次 -0.046 0.030 0.955(0.900~1.012) 0.122 学校类型 两周一次 -0.114 0.029 0.892(0.842~0.945) < 0.001 幼儿园 1.000 每周一次 -0.089 0.028 0.915(0.866~0.966) 0.001 小学 -1.368 0.041 0.255(0.235~0.276) < 0.001 课桌椅高度调整情况 初中 -2.813 0.043 0.060(0.055~0.065) < 0.001 从不或不可调 1.000 高中 -3.461 0.045 0.031(0.029~0.034) < 0.001 一学年一次 -0.041 0.023 0.960(0.918~1.004) 0.074 职高 -2.391 0.050 0.092(0.083~0.101) < 0.001 一学期一次 -0.053 0.020 0.948(0.912~0.986) 0.008 年份(年) 两至三个月一次 0.004 0.024 1.004(0.958~1.052) 0.867 2019 1.000 30 min~ < 1 h -0.008 0.022 0.992(0.950~1.035) 0.699 2020 -0.066 0.015 0.936(0.909~0.963) < 0.001 1 h~ < 2 h 0.024 0.026 1.024(0.974~1.077) 0.354 每天早饭情况 2 h~ < 3 h 0.003 0.031 1.003(0.943~1.067) 0.916 天天吃 1.000 ≥3 h -0.042 0.024 0.959(0.915~1.005) 0.078 偶尔吃 0.040 0.017 1.041(1.006~1.077) 0.022 每天眼保健操情况(次) 从不吃 0.047 0.046 1.048(0.958~1.147) 0.308 在校不做 1.000 中高强度运动情况(d) 1 -0.073 0.024 0.929(0.887~0.974) 0.002 0 1.000 2 -0.059 0.025 0.943(0.898~0.991) 0.020 1 0 0.025 1.000(0.953~1.049) 0.998 ≥3 -0.048 0.032 0.953(0.894~1.016) 0.137 2 -0.059 0.024 0.942(0.899~0.988) 0.014 -
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