Status and influencing factors of insufficient hyperopia reserve among children without myopia in Guangzhou in 2021
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摘要:
目的 了解广州市非近视儿童远视储备不足现状及其影响因素。 方法 2021年9―12月，在广州市11个区采取分层整群随机抽样方法，每区抽取2~3所幼儿园、2所小学、2所初中开展眼科检查和问卷调查，对其中6~12岁非近视儿童(8 335名)的屈光度和远视储备不足情况进行分析，采用χ2检验和多因素Log-binomial回归模型分析9~12岁非近视儿童(3 216名)远视储备不足影响因素。 结果 2021年广州市6~12岁非近视儿童等效球镜度数(spherical equivalent, SE)为+0.13(-0.25, +0.50) D，远视储备不足检出率为85.18%。各年龄段SE分别为6岁+0.38(0.00, +0.75) D、7岁+0.25(-0.13, +0.50) D、8岁+0.13(-0.13, +0.50) D、9岁+0.13(-0.25, +0.38) D、10岁0.00(-0.38, +0.38) D、11岁0.00(-0.38, +0.25) D、12岁-0.13(-0.50, +0.25) D；远视储备不足检出率6岁为88.57%、7岁为91.56%，8岁为93.80%，9岁为90.58%，10岁为79.47%，11岁为66.43%，12岁为57.31%。女生(PR=1.08, 95% CI: 1.00~1.28, P=0.047)、年龄＜12岁(PR9岁=4.58, 95% CI: 3.65~5.75; PR10岁=3.92, 95% CI: 3.11~4.95; PR11岁=2.36, 95% CI: 1.86~3.00, 均有P＜0.001)、郊县(PR=1.57, 95% CI: 1.32~1.86, P＜0.001)、平均每天放学后做作业/读写时间≥3 h(PR=1.27, 95% CI: 1.02~1.59, P=0.034)、经常或总是读写时眼睛离书本距离＜33 cm(PR=1.19, 95% CI: 1.05~1.34, P=0.006)、经常或总是躺着或趴着看书或电子屏幕(PR=1.31, 95% CI: 1.07~1.61, P=0.010)、父母一方/双方近视(PR=1.16, 95% CI: 1.03~1.30, P=0.014)可能是9~12岁非近视儿童远视储备不足的危险因素，课间休息活动在户外(PR=0.70, 95% CI: 0.62~0.80, P＜0.001)可能是9~12岁非近视儿童远视储备不足的保护因素。 结论 广州市非近视儿童远视储备不足检出率仍处于较高水平，并受遗传因素、性别、年龄、地区、课间休息活动场所、持续读写时间和距离、用眼姿势等因素综合影响。 Abstract:Objective To understand the status and influencing factors of insufficient hyperopia reserve among children without myopia in Guangzhou. Methods Using stratified cluster random sampling method, 2-3 kindergartens, 2 primary schools and 2 junior high schools were selected from 11 districts in Guangzhou for ophthalmic examinations and questionnaire survey, Sep-Dec, 2021. Among them, 8 335 non-myopic children aged 6-12 years were selected as subjects to analyze the status of refraction and insufficient hyperopia reserve. And the influencing factors of insufficient hyperopia reserve were investigated among 3 216 non-myopic children aged 9-12 years using by χ2 test and multivariate Log-binomial regression models. Results In 2021, the spherical equivalent (SE) of non-myopic children aged 6-12 years in Guangzhou was +0.13(-0.25, +0.50) D, and the detection rate of insufficient hyperopia reserve was 85.18%. The SE of each age group from 6 to 12 years was +0.38(0.00, +0.75) D, +0.25(-0.13, +0.50) D, +0.13(-0.13, +0.50) D, +0.13(-0.25, +0.38) D, 0.00(-0.38, +0.38) D, 0.00(-0.38, +0.25) D, -0.13(-0.50, +0.25) D, and the detection rate of insufficient hyperopia reserve was 88.57%, 91.56%, 93.80%, 90.58%, 79.47%, 66.43%, 57.31%, respectively. Female (PR=1.08, 95% CI: 1.00-1.28, P=0.047), age < 12 years old (PR9=4.58, 95% CI: 3.65-5.75, P < 0.001; PR10=3.92, 95% CI: 3.11-4.95, P < 0.001; PR11=2.36, 95% CI: 1.86-3.00, P < 0.001), suburb area (PR=1.57, 95% CI: 1.32-1.86, P < 0.001), long homework time (≥3 h/d) (PR=1.27, 95% CI: 1.02-1.59, P=0.034), the distance between the eyes and the books always or often < 33 cm when reading and writing (PR=1.19, 95% CI: 1.05-1.34, P=0.006), always or often lying down reading books or watching electronic screen (PR=1.31, 95% CI: 1.07-1.61, P=0.010), parental myopia (PR=1.16, 95% CI: 1.03-1.30, P=0.014) could be the risk factors for insufficient hyperopia reserve of the non-myopic children aged 9-12 years old. However, outdoor activity during recess could be the protective factor (PR=0.70, 95% CI: 0.62-0.80, P < 0.001). Conclusions The detection rate of insufficient hyperopia reserve among non-myopic children aged 6-12 years in Guangzhou was still at a high level. It is associated with genetic factors, gender, age, region, place for recess activity, distance between the eyes and the books when reading and writing, duration of doing homework, reading and writing posture. -
Key words:
- Insufficient hyperopia reserve /
- Myopia /
- Influencing factor /
- Children /
- Cross-sectional studies
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表 1 广州市9~12岁非近视儿童远视储备不足多因素Log-binomial回归分析(n=3 216)
Table 1. Multivariate Log-binomial regression analysis for insufficient hyperopia reserve among non-myopic children aged 9-12 years old in Guangzhou(n=3 216)
自变量 β值 Wald值 PR(95% CI)值 sx P值 性别 男 1.00 女 0.11 3.48 1.08(1.00~1.28) 0.06 0.047 年龄(岁) 12 1.00 11 0.86 49.80 2.36(1.86~3.00) 0.12 < 0.001 10 1.37 134.28 3.92(3.11~4.95) 0.12 < 0.001 9 1.52 173.53 4.58(3.65~5.75) 0.12 < 0.001 地区 城区 1.00 郊县 0.45 26.80 1.57(1.32~1.86) 0.09 < 0.001 课间休息活动场所 教学楼内 1.00 户外 -0.36 30.41 0.70(0.62~0.80) 0.06 < 0.001 过去一周平均每天放学后做作业/读书写字时间(h) ＜3 1.00 ≥3 0.24 4.51 1.27(1.02~1.59) 0.11 0.034 读写时眼睛离书本距离＜33 cm 经常/总是 1.00 从不/偶尔 0.17 7.68 1.19(1.05~1.34) 0.06 0.006 躺着或趴着看书或电子屏幕 从不/偶尔 1.00 经常/总是 0.27 6.71 1.31(1.07~1.61) 0.10 0.010 父母近视情况 都不近视 1.00 一方/双方近视 0.15 6.09 1.16(1.03~1.3) 0.06 0.014 
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