山东省冠县4~18岁学生屈光不正横断面研究

发布日期:2014-04-08

山东省冠县4~18岁学生屈光不正横断面研究

 吴建峰 毕宏生等 中华眼视光学与视觉科学

【摘要】 目的 调查山东省冠县4~18岁在校(园)学生屈光不正患病状况。方法 横断面调查研究。通过随机整群抽样从冠县幼儿园、小学、初中和高中随机抽取学生进行屈光不正现况调查。所有学生接受裸眼视力、矫正视力、散瞳验光、眼内压、眼前节、眼后节等检查。屈光不正与性别、年龄的关系采用二元Logistic回归模型进行分析。结果 共3 112例4~18岁在校(园)学生接受检查,其中完成散瞳验光检查3 111例,完成视力检查3 094例。近视患病率为31.3%(95%CI:29.7%~33.0%),年龄较大[OR:1.49(95%CI:1.45~1.54),P<0.01]、女性[OR:1.31(95%CI:1.09~1.57),P<0.01]和城镇学生[OR:2.54(95%CI:2.11~3.07),P<0.01] 的近视患病率较高。高度近视总体患病率为1.4%(95%CI:1.0%~1.8%),散光的总体患病率为32.4%(95%CI:30.8%~34.0%),屈光参差的总体患病率为6.2%(95%CI:5.4%~7.1%),高度近视、散光和屈光参差患病率均呈现随年龄增长而上升的趋势(P<0.01),其中散光和屈光参差的患病率与居住地有关(P<0.01),但均与性别无关(P>0.05);远视患病率为8.2%(95%CI:7.2%~9.2%),并随年龄增加而下降[OR:0.72(95%CI:0.68~0.76);P<0.01]。较好眼裸眼视力≤20/40和≤20/200者分别有675例(21.8%)和85例(2.7%)。单眼或双眼裸眼视力≤20/40的880人中,837人(95.1%)是由于屈光不正导致的。结论 山东省冠县4~18岁在校(园)学生的视力损害主要由以近视为主的屈光不正导致,且呈现出随随年龄增加而上升的趋势。

【关键词】 屈光不正; 患病率; 学生; 小地区分析; 数据收集; 横断面研究


DOI:10.3760/cma.j.issn.1674-845X.2014.03.003

基金项目:山东省科技发展计划(2011GGH21835,2011GGB14097);山东省医药卫生科技发展计划(2011HD014);济南市高校自主创新计划(201102061)

作者单位:250014 济南,山东中医药大学(吴建峰);250002 济南,山东中医药大学附属眼科医院山东中医药大学山东中医药大学眼科研究所(毕宏生、吴慧、王兴荣);250001 济南,山东中医药大学第二附属医院(胡媛媛、孙伟、吕太亮)

通信作者:毕宏生,Email:hongshengbi@126.com


A cross-sectional survey on refractive errors in students 4-18 years old in Guanxian county, Shandong province

Wu Jianfeng*, Bi Hongsheng, Hu Yuanyuan, Wu Hui, Sun Wei, Lyu Tailiang, Wang Xingrong. Shandong University of Traditional Chinese Medicine, Jinan 250014, China

Corresponding author:Bi Hongsheng,Email:hongshengbi@126.com

【Abstract】 Objective To examine the prevalence of refractive errors among preschool children and schoolchildren in Guanxian county, Shandong province. Methods Using a random cluster sampling in a cross-sectional school-based study design, children ranging in age from 4 to 18 years were selected from kindergartens, primary schools, and junior and senior high schools in Guanxian county. All children underwent a complete ocular examination including measurement of uncorrected (UCVA) and best corrected visual acuity (BCVA), auto-refractometry under cycloplegia and ophthalmic examination. The prevalence rates of refractive error and its association with age and gender were analyzed by a bivariate regression model. Results Of 3 112 eligible children, cycloplegic refraction was completed on 3 111 and the visual acuity of 3 094 was successfully tested. The overall prevalence of myopia was 31.3%(95%CI: 29.7%-33.0%). Myopia was associated with older children [OR: 1.45(95%CI: 1.41-1.50); P<0.01], female gender [OR: 1.45(95%CI: 1.41-1.50); P<0.01] and children in urban areas [OR: 2.54(95%CI: 2.11-3.07); P<0.01]. The prevalence of high myopia, astigmatism and anisometropia was 1.4%(95%CI: 1.0%-1.8%), 32.4%(95%CI: 30.8%-34.0%) and 6.2%(95%CI: 5.4%-7.1%), respectively. All prevalences were associated with older children (P<0.01) but not gender (P>0.05). The prevalence of astigmatism and anisometropia was also associated with children in urban areas (P<0.01). The overall prevalence of hyperopia was 8.2%(95%CI: 7.2%-9.2%), and the trend decreased with age [OR: 0.72(95%CI: 0.68-0.76); P<0.01]. UCVA was 20/40 or worse in the better eye in 675(21.8%) children, and 20/200 or worse in the better eye in 85(2.7%) children. UCVA≤20/40 in one or both eyes was found in 880(28.4%) children, with undercorrected refractive error as the cause in 837(95.1%) children. Conclusion Visual impairment in students 4-18 years of age in Guanxian county was mainly attributed to refractive errors, especially myopia. The prevalence of refractive errors increased with age.

【Key words】 Refractive error; Prevalence; Students; Small-area analysis; Data collection; Cross-sectional studies


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