学龄前儿童屈光状态影响因素分析

目的探讨视近活动、户外活动和饮食习惯对学龄前儿童屈光状态的影响。方法对象为在我院健康体检的儿童共690名,年龄3~6岁。双眼屈光度检查用Suresight自动屈光筛查仪在自然状态下完成,将球镜屈光度≤+0.75D列为近视眼可能者。受检儿童家长填写调查问卷,问卷内容包括儿童每日在家参与的主要的视近活动时间(读写画画、看电视、电脑游戏)、每日户外活动时间和儿童饮食习惯(甜食、肉类和奶类、蔬菜和水果)。计算总视近强度(屈光度小时)。采用SPSS 11.5软件进行统计学分析,用Logistic回归模型分析近视眼可能者的危险因素。结果共收回有效问卷501份,其中男271名,女230名。左右眼近视眼可能的百分比分别为14.4%和16.0%,两眼间无统计学差异。女童中近视眼可能者的百分比为20%,而男童为12.5%,单因素Logistic回归模型显示女童为近视眼可能的危险是男童的1.74倍(P=0.024,OR:1.743,95%CI:1.075~2.826);户外活动可以降低发展为近视眼可能者的危险(P=0.035,OR:0.683,95%CI:0.479~0.973);各种视近活动均与屈光状态无关,总视近强度与屈光状态也无关(P=0.378,OR:0.949,95%CI:0.845~1.066);饮食习惯与屈光状态无关。多因素Logistic回归模型显示去除性别、总视近强度和户外活动的交互作用后,女童为近视眼可能者的危险仍高于男童,而户外活动与屈光状态无关。结论在学龄前儿童中,女童为近视眼可能者的危险较男童高,环境因素对此年龄段儿童的屈光状态影响小。

Analysis of correlative factors on refraction of preschool children

Objective To identify the associations between the refraction of preschool children and near work,outdoor activity,and food.Methods Survey-based data came from 690 preschool children taking physical health examination in our hospital.Children underwent measurement of refractive error using Suresight Vision Screening under noncycloplegic.Myopia potential was defined as sphere diopter being +0.75D or less.Subjects were administered a questionnaire on time spent every day on near activities(reading and writing,playing video games,watching television),time spent on outdoors and the habit of taking foods.Diopter-hours were calculated.Logistic regression models were used to assess the association between the major risk factors and quick refractive development in right eyes.Results Among 690 children with refraction data,501(230 girls and 271 boys) completed the questionnaire survey.The percents of myopia potential in left and right eyes were 14.4% and 16.0% respectively.Univariate logistic regression showed that girls had more risk of myopia potential than boys(P=0.024,OR:1.743,95%CI:1.075~2.826).More outdoor activities reduced the risk of myopia potential(P=0.035,OR: 0.683,95%CI: 0.479~0.973).All near activities were unassociated with refraction and the diopter-hours was unassociated with refraction too(P=0.378,OR: 0.949,95%CI: 0.845~1.066).The habit of taking foods did not relate to the refraction.Multivariate logistic regression model suggested that gender was still associated with refraction while outdoor activity became unassociated with it after controlling the confounding effects of gender,diopter-hours and outdoor activity.Conclusions Girl had more risk of myopia potential than boy among preschool children.There were no associations between refraction with near work,outdoor activity and food.