湖北省孝感市小学生视力调查及近视相关因素分析

目的：探讨学龄期儿童近视患病率与近视的影响因素，为儿童近视的防控提供理论依据。方法：横断面调查研究。于2017年6月至2019年6月，采用随机整群抽样方法抽取湖北省孝感市一年级小学生675人，对其进行视力检查与屈光状态检查以及一般情况与用眼行为问卷调查，完成每年1次数据收集，共随访3年。采用秩和检验、卡方检验与Logistic回归分析进行统计学分析。结果：3年期间小学生近视患病率逐年增高，分别为14.1%、25.6%、39.6%，差异有统计学意义（χ2=106.25，P<0.001）。3年期间小学生等效球镜度（SE）逐年降低，分别为0.25（-0.25，0.50）D、0.00（-0.50，0.25）D、-0.50 （-1.75，0.00）D，差异有统计学意义（χ2=234.819，P<0.001）。近视每年新发病率为16.0%～22.7%，近视年发病率随年龄增大而增加，差异有统计学意义（χ2=14.233，P<0.001）。早产（P=0.014）、父母近视情况（P=0.029）、每天户外活动时间（P=0.024）、每天放学后近距离学习时间（P=0.006）、家长平时是否督促孩子保护眼睛（P=0.004）、每天使用电子产品时间（P=0.013）等变量与近视发生有相关性。结论：学龄期儿童屈光状态逐年向近视方向发展，近视患病率逐年增加。早产、父母近视、长时间近距离学习以及使用电子产品是近视发生的危险因素，户外活动与家长督促孩子保护眼睛是近视发生的保护因素。

Prevalence and Associated Factors of Myopia among Primary School Students in Xiaogan,Hubei Province

Objective: To study the prevalence and risk factors of myopia among primary students, and to provide a theoretical basis for the prevention and control of myopia. Methods: This was a cross-sectional study. A total of 675 grade 1 primary school students were included in the study and were followed up from June 2017 to June 2019 in Xiaogan, Hubei Province. All students' visual acuities and best corrected visual acuities were measured. Students with an uncorrected visual acuity less than 5.0 were examined with a retinoscope after pupil dilation by cyclopentolate hydrochloride eye drops. General situation and eye behavior questionnaires were completed by the students and their parents. Data were analyzed by a rank sum test, chi square test and logistic regression analysis. Results: The prevalences of myopia amongprimary school students were 14.1%, 25.6%, and 39.6% in years 1, 2 and 3, respectively, and the difference was statistically significant (χ2=106.25, P<0.001). SEs among primary school students were 0.25(-0.25, 0.50)D, 0.00(-0.50, 0.25)D, and -0.50(-1.75, 0.00)D in years 1, 2 and 3, respectively, and the difference was statistically significant (χ2=234.819, P<0.001). The incidence of myopia was 16.0% to 22.7% each year, and the annual incidence of myopia increased with age (χ2=14.233, P<0.001). Logistic regression analysis demonstrated that premature birth (P=0.014), parental history of myopia (P=0.029), time spent doing outdoor activities (P<0.001), time spent on near-work after school (P=0.006), frequency of parental suggestions about eyesight protection (P=0.004) and exposure time to electronic products (P=0.013) were significantly associated with myopia. Conclusions: Primary school students' SEs decreased with age, while the prevalence of myopia increased with age. The risk factors for the prevalence of myopia include premature birth, parental history of myopia, time spent on near-work after school and exposure time to electronic products, while time spent on outdoor activities and frequency of parents' suggestions about eyesight protection act as protective factors.