西双版纳傣族自治州青少年儿童斜弱视的流行病学调查

目的：调查云南省西双版纳傣族自治州傣族、哈尼族、拉祜族和当地汉族小学生斜视弱视的患病情况，分析其差异性和危险因素。

方法：选取云南省西双版纳傣族自治州少数民族最集中的勐腊县7 214名6～15岁在校小学生，检查包括裸眼视力和最佳矫正视力、屈光度、眼位、眼前节和眼底情况等，并进行Logistic回归分析影响因素。

结果：(1)所有研究对象中，斜视患病率为2.12%(外斜视占85.62%)，弱视患病率为0.60%(屈光性占74.42%)；(2)斜视患病率在性别、年龄和民族方面比较，差异无统计学意义(P>0.05)，而外斜视患病率在民族方面差异有统计学意义(P<0.05)。拉祜族比汉族发生外斜视风险高(OR=1.86，95% CI：1.12～3.09)。直系亲属斜视或外斜视者、近视、远视均是斜视的危险因素(P<0.05，OR>1)，其中近视是外斜视的危险因素(OR=2.13，95% CI：1.32～3.44)； 随近视度数增加，外斜视的OR值增大(P<0.05)；(3)弱视的患病率在性别、年龄、民族方面无差异性(P>0.05)。Logistic回归分析显示，近视和远视均是弱视的危险因素(P<0.05，OR>1)。

结论：西双版纳傣族自治州少数民族青少年儿童直系亲属有斜视者发生斜视的危险性高，外斜视有一定民族差异性； 近视和远视均是斜视、弱视的主要危险因素，斜视、外斜视的患病风险随近视屈光度的增加而加大。当地的低弱视率和屈光不正患病率较低有关。

Epidemiological investigation on strabismus and amblyopia among minority children

AIM: To investigate the prevalence of strabismus and amblyopia in Dai, Hani, Lahu and local Han nationality pupils in Xishuangbanna, Yunnan Province, and to analyze its differences and risk factors.

METHODS: A cross-sectional study of 7214 patients aged 6-15 years were conducted in Mengla County of Xishuangbanna, Yunnan Province. The investigation included naked eye and best corrected visual acuity, diopter, eye position, anterior segment and fundus examination. The influencing factors were analyzed by Logistic regression analysis.

RESULTS:(1)The case rate of strabismus(exotropia)and amblyopia(refractive amblyopia)were 2.12%(85.62%)and 0.60%(74.42%)respectively;(2)The case rate of strabismus had no difference in sex, age and nationality(P>0.05), however, the case rate of exotropia was different in ethnic groups: the Lahu is more likely to have exotropia than the Han nationality(OR: 1.86, 95% CI: 1.12-3.09). Immediate family with strabismus or exotropia, myopia and hyperopia were all risk factors of strabismus(P<0.05 OR>1), and myopia was the risk factor of exotropia(OR: 2.13, 95% CI: 1.32-3.44). The OR value of exotropia increased with the diopter of myopia(P<0.05);(3)The case rate of amblyopia was not different in sex, age and nationality(P>0.05). Myopia and hyperopia were risk factors of amblyopia(P<0.05, OR>1).

CONCLUSION: There is a high risk of strabismus in the children whose immediate family has exotropia of Xishuangbanna ethnic minority, and there is a certain ethnic difference in strabismus; Both myopia and hyperopia are the main risk factors of strabismus and amblyopia. The disease risk of strabismus and exotropia increases with the increase of refractive diopter; Low local amblyopia was associated with a lower incidence of ametropia.