吉林市中小学生视力不良现状及增长速度趋势分析
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摘要
目的了解吉林市中小学生视力不良现状并拟合视力不良及各程度不良检出率随年龄增长速度曲线模型,为制定视力不良防控策略提供科学依据。方法于2015年4-5月,采用多阶段分层整群随机抽样方法,抽取吉林市船营区、丰满区、蛟河市和永吉县所在地共9 676名中小学生进行视力检测和问卷调查,分析学生视力不良检出情况。利用曲线拟合的方法获得视力不良及各程度不良的增长速度模型,分析其增长速度在城乡男女生间的变化规律。结果吉林市中小学生视力不良检出率为77. 9%,轻、中和重度视力不良检出率分别为12. 1%、17. 4%和48. 5%。多因素logistic回归分析显示,视力不良及各程度不良检出率的性别、城乡差异有统计学意义(P<0. 05)。视力不良及各程度不良增长速度模型显示,城乡男女生视力不良检出率增长速度曲线呈"抛物线"形,在学龄初期和青春晚期出现"交叉现象",视力不良率增长速度的年龄峰值提前;轻度视力不良率增长速度曲线在7～15岁呈负增长,而城市女生、乡村男生、乡村女生在进入青春晚期后其增速曲线又出现增长倾向;中度视力不良率增长速度曲线呈"U"形变化,在10～15岁呈负增长;重度视力不良率增长速度整体呈下降趋势,在学龄初期增速最快,增速曲线在青春期出现"交叉现象"。结论吉林市中小学生视力不良率随年龄增长明显,增长速度曲线的年龄峰值不断提前,呈进一步低龄化发展,视力不良防控重点应向学龄初期及学前倾斜。
Objective To analyze the prevalence of poor vision and create curve models of increasing velocity with age for poor vision and its various degrees of detection rate among primary and middle school students in Jilin City,and to provide a scientific basis for formulating poor vision prevention and control strategies. Methods Multi-stage stratified cluster random sampling method was used to select 9,676 primary and middle school students in Chuanying District,Fengman District,Jiaohe City and Yongji County in April-May,2015. Visual acuity examinations and questionnaire surveys were conducted,and the detection rate of poor vision was analyzed. Curve fitting method was used to get the models of increasing velocity for poor vision and its various degrees,and the changing regularity of increasing velocity of the prevalence in urban-rural and male-female students was analyzed.Results The detection rate of poor vision in the primary and middle school students in Jilin City was 77.9%,and the detection rates of mild,moderate and severe poor vision were 12.1%,17.4% and 48.5% respectively. Multivariate logistic regression analysis showed that there were statistically significant differences in the prevalence of poor vision and its various degrees between genders as well as between urban and rural students( all P<0.05). The models of increasing velocity for poor vision and its various degrees showed a parabola-like shape of increasing velocity of the prevalence of poor vision in urban-rural and male-female students,and a cross phenomenon during early school-age and the latter puberty period. The age peak of increasing velocity of the prevalence of poor vision became earlier. The curve model of increasing velocity for mild poor vision had a negative growth between the ages of 7 and 15 years old,while an increasing tendency was observed in urban female,rural male and rural female in the latter puberty period. The curve model of increasing velocity for moderate poor vision showed a U-like shape,and it had a negative increase between the ages of 10 and 15 years old. The curve model of increasing velocity for severe poor vision showed a downward trend as a whole,but it was increased rapidly in early school-age and had a cross phenomenon in puberty period. Conclusions The prevalence of poor vision among the primary and secondary school students in Jilin City significantly increases with age. The age peak of increasing velocity of the prevalence continually becomes earlier,and shows a tendency toward younger age. Poor vision prevention and control should focus on early school-age students and preschoolers.
Objective To analyze the prevalence of poor vision and create curve models of increasing velocity with age for poor vision and its various degrees of detection rate among primary and middle school students in Jilin City,and to provide a scientific basis for formulating poor vision prevention and control strategies. Methods Multi-stage stratified cluster random sampling method was used to select 9,676 primary and middle school students in Chuanying District,Fengman District,Jiaohe City and Yongji County in April-May,2015. Visual acuity examinations and questionnaire surveys were conducted,and the detection rate of poor vision was analyzed. Curve fitting method was used to get the models of increasing velocity for poor vision and its various degrees,and the changing regularity of increasing velocity of the prevalence in urban-rural and male-female students was analyzed.Results The detection rate of poor vision in the primary and middle school students in Jilin City was 77.9%,and the detection rates of mild,moderate and severe poor vision were 12.1%,17.4% and 48.5% respectively. Multivariate logistic regression analysis showed that there were statistically significant differences in the prevalence of poor vision and its various degrees between genders as well as between urban and rural students( all P<0.05). The models of increasing velocity for poor vision and its various degrees showed a parabola-like shape of increasing velocity of the prevalence of poor vision in urban-rural and male-female students,and a cross phenomenon during early school-age and the latter puberty period. The age peak of increasing velocity of the prevalence of poor vision became earlier. The curve model of increasing velocity for mild poor vision had a negative growth between the ages of 7 and 15 years old,while an increasing tendency was observed in urban female,rural male and rural female in the latter puberty period. The curve model of increasing velocity for moderate poor vision showed a U-like shape,and it had a negative increase between the ages of 10 and 15 years old. The curve model of increasing velocity for severe poor vision showed a downward trend as a whole,but it was increased rapidly in early school-age and had a cross phenomenon in puberty period. Conclusions The prevalence of poor vision among the primary and secondary school students in Jilin City significantly increases with age. The age peak of increasing velocity of the prevalence continually becomes earlier,and shows a tendency toward younger age. Poor vision prevention and control should focus on early school-age students and preschoolers.
引文
[1]董彦会,刘慧彬,王政和,等.中国2005-2014年7~18岁汉族儿童青少年近视现状和增长速度趋势分析[J].中华流行病学杂志,2017,38(5):583-587.
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[11]Terasaki H,Yamashita T,Yoshihara N,et al. Association of lifestyle and body structure to ocular axial length in Japanese elementary school children[J]. BMC Ophthalmol,2017,17(1):123.
[12]石一宁,孙烨.儿童青少年正视化过程监测研究进展[J].中国实用眼科杂志,2010,28(11):1166-1170.
[13]季成叶.中国学生视力不良和疑似近视流行的动态分析[J].中国学校卫生,2008,29(8):677-680.
[14]胡卜丹,杜慧斌,税丹,等. 2014年犍为县初中学生视力状况调查及近视相关因素研究[J].实用预防医学,2017,24(2):215-217.
[15]曹型厚,窦义蓉,陈德东,等.重庆市中小学生视力不良与体格发育关系分析[J].中国学校卫生,2011,32(5):604-606.
[16]王萍,韦琳,蓝剑,等.广西城乡学生视力不良检出现状及动态变化分析[J].实用预防医学,2012,19(4):545-548.
[17]岳江,岳辉,任秋锦,等.视觉训练对青少年假性近视正相对调节的影响[J].国际眼科杂志,2014,14(4):717-719.
[18]罗军,陈树昶,朱晓霞.杭州市2010年中小学生视力不良状况调查[J].中国学校卫生,2013,34(3):372-373.
[19]郭玉麟,王朝霞,崔铁琦,等. 2009-2010年烟台市城市中学生视力不良分析[J].中国校医,2011,25(9):659-661.
[2] Sun HP,Li A,Xu Y,et al. Secular trends of reduced visual acuity from 1985 to 2010 and disease burden projection for 2020 and 2030 among primary and secondary school students in China[J]. J Ophthalmol,2015,133(3):262.
[3]Saw SM,Gazzard G,Shih-Yen EC,et al. Myopia and associated pathological complications[J]. Ophthalmic Physiol Opt,2005,25(5):381-391.
[4]Smith TS,Frick KD,Holden BA,et al. Potential lost productivity resulting from the global burden of uncorrected refractive error[J]. Bull World Health Organ,2009,87(6):431-437.
[5]季成叶.我国中小学生视力不良和疑似近视流行现状[J].中国学校卫生,2008,29(2):97-99.
[6]刘佳帅,马军,付连国,等.中国汉族中小学生近视现状及增长速度数学模型分析[J].中国学校卫生,2013,34(2):152-155.
[7]黄晓燕.吉林省城市中小学生视力不良现况调查及影响因素研究[D].长春:吉林大学,2014.
[8]马军.“十三·五”中国学校卫生工作任务与展望[J].中国学校卫生,2016,37(4):481-483.
[9]宋逸,胡佩瑾,董彦会,等. 2014年全国各省、自治区、直辖市汉族学生视力不良现况分析[J].北京大学学报(医学版),2017,49(3):433-438.
[10]Gwiazda J,Deng L,Manny R,et al. Seasonal variations in the progression of myopia in children enrolled in the correction of myopia evaluation trial[J]. Invest Ophthalmol Vis Sci,2014,55(2):752-758.
[11]Terasaki H,Yamashita T,Yoshihara N,et al. Association of lifestyle and body structure to ocular axial length in Japanese elementary school children[J]. BMC Ophthalmol,2017,17(1):123.
[12]石一宁,孙烨.儿童青少年正视化过程监测研究进展[J].中国实用眼科杂志,2010,28(11):1166-1170.
[13]季成叶.中国学生视力不良和疑似近视流行的动态分析[J].中国学校卫生,2008,29(8):677-680.
[14]胡卜丹,杜慧斌,税丹,等. 2014年犍为县初中学生视力状况调查及近视相关因素研究[J].实用预防医学,2017,24(2):215-217.
[15]曹型厚,窦义蓉,陈德东,等.重庆市中小学生视力不良与体格发育关系分析[J].中国学校卫生,2011,32(5):604-606.
[16]王萍,韦琳,蓝剑,等.广西城乡学生视力不良检出现状及动态变化分析[J].实用预防医学,2012,19(4):545-548.
[17]岳江,岳辉,任秋锦,等.视觉训练对青少年假性近视正相对调节的影响[J].国际眼科杂志,2014,14(4):717-719.
[18]罗军,陈树昶,朱晓霞.杭州市2010年中小学生视力不良状况调查[J].中国学校卫生,2013,34(3):372-373.
[19]郭玉麟,王朝霞,崔铁琦,等. 2009-2010年烟台市城市中学生视力不良分析[J].中国校医,2011,25(9):659-661.