广东省珠海市与新疆省喀什市小学生视力和屈光状态的比较

目的：对比分析广东省珠海市和新疆省喀什市小学生的视力及屈光状态，为我国不同地区青少年儿童近视的防控工作提供参考。方法：横断面观察性研究。随机抽取2018至2019年珠海市10所小学及喀什市6所小学的学生。通过视力筛查获得裸眼视力、非睫状肌麻痹屈光数据和等效球镜度（SE）。采用倾向性评分匹配法矫正两地性别和年龄差异。正态分布定量数据的比较使用独立样本t检验，非正态分布使用Mann-Whitney U检验，分类数据使用卡方检验进行统计分析。结果：珠海市获得12 001例学生的完整资料，其中男生6 528例（占54.4%），女生5 473例（占45.6%），年龄（8.7±1.6）岁。喀什市获得5 584例完整资料，其中男生2 796例（占50.1%），女生2 788例（占49.3%），年龄（8.3±0.9）岁。两地区性别（χ2=28.60，P<0.001）、年龄（t=-19.27，P<0.001）之间的比较差异有统计学意义。采用1:1倾向性评分匹配法矫正性别年龄混杂因素后，两地均有5 478例纳入统计分析。珠海市小学生右眼SE为-0.25（-0.88，+0.13）D，喀什市为-0.11（-0.30，+0.11）D，差异有统计学意义（Z=-9.32,P<0.001）。两地不同年龄段小学生SE绝对值逐年增加，自8岁起珠海市增加速度较喀什市快。珠海 市和喀什市的裸眼视力不良占比分别为17.7%和15.2%。在裸眼视力不良人群中，珠海市和喀什市的近视临床前期占比分别为18.3%和42.9%，筛查性近视占比为76.3%和51.1%；高度近视仅存在于珠海市，共15例。结论：珠海市筛查性近视率和近视程度高于喀什市，两地的气候、经济、人口、教育差异可能是造成近视发病率不同的主要原因。

Comparation of Visual Acuity and Refractive Status of Primary School Students in Zhuhai and Kashgar

Objective: The visual acuity (VA) and refractive status of primary school students in Zhuhai and Kashgar were compared and analyzed, so as to provide a reference for the prevention and control of juvenile myopia in different regions of China. Methods: This was a cross-sectional observational study of primary school students of 10 schools in Zhuhai and 6 schools in Kashgar from 2018 to 2019. VA, noncycloplegic autorefraction, and spherical equivalent (SE) were obtained via visual screening. Independent sample t-test,Chi-square test, Mann-Whitney U test, Spearman correlation analysis, and 1:1 propensity score match (PSM) were used for statistical analysis. Results: A total of 12 001 students were recruited in Zhuhai, including 6 528 boys (54.4%), 5 473 girls (45.6%), with an average age of 8.7±1.6 years. And 5 584 students were obtained in Kashgar, including 2 796 boys (50.1%), 2 788 girls (49.3%), with an average age of 8.3 ± 0.9 years. There were statistical differences in sex (χ2=28.60, P<0.001) and age (t=-19.27, P<0.001) between zhuhai and Kashgar. PSM was used to eliminate influences of sex and age. After PSM, 5 478 students in both groups entered the following statistical analysis. The average value of SE in the right eye was -0.25 (-0.88, +0.13) D in Zhuhai and -0.11 (-0.30, +0.11) D in Kashgar (Z=-9.32, P<0.001). The absolute value of SE increased year by year in the two groups, but the increase rate in Zhuhai was bigger than that in Kashgar after 8-year-old. In Zhuhai, the proportion of poor vision was 17.7%, of which pre-myopia was 18.3% and screening myopia was 76.3%. Comparatively, it was 15.2%, 42.9%, and 51.1% respectively in Kashgar. A total of 15 students in Zhuhai encountered high myopia. Conclusion: The incidence rate of screening myopia in Zhuhai is higher than that in Kashgar. The differences in climate, economy, population and education may be the main reasons.