2018-2020年辽宁省学生近视流行变化趋势与其影响因素

高青; 刘懿卿; 叶茜雯; 孙炜; 吴明

doi:10.16462/j.cnki.zhjbkz.2022.06.010

2018-2020年辽宁省学生近视流行变化趋势与其影响因素

doi: 10.16462/j.cnki.zhjbkz.2022.06.010

高青¹,
刘懿卿¹,
叶茜雯¹,
孙炜²,
吴明^1, ,

1.
110005 沈阳，辽宁省疾病预防控制中心学校卫生所
2.
110005 沈阳，中国医科大学附属第四医院眼科

详细信息

通讯作者:
吴明, E-mail: lncdcgaoqing@163.com

中图分类号: R181.2
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出版历程
- 收稿日期: 2021-08-24
- 修回日期: 2022-01-26
- 网络出版日期: 2022-06-16
- 刊出日期: 2022-06-10

Analysis on the trend of myopia prevalence and its influencing factors among students in Liaoning Province from 2018 to 2020

1.
School Health Department of Liaoning Center for Disease Control and Prevention, Shenyang 110005, China
2.
Ophthalmology Department of the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, China

More Information

Corresponding author: WU Ming, E-mail: lncdcgaoqing@163.com

摘要

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。
- 近视 /
- 发展趋势 /
- 学生 /
- 危险因素
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.
- 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)

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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
条目	近视人数	调查人数	近视人数	调查人数	近视人数	调查人数	趋势χ²值	P值
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

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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)

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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	s_x值	OR (95% CI)值	P值	条目	β值	s_x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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