2018-2020年辽宁省学生近视流行变化趋势与其影响因素

  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。

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

  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.