Xiong X W, Zhou L H, Zeng C Q, Wang J, Ye M H, Meng Y F, Hu X M, Yi B Q
Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Zhonghua Yan Ke Za Zhi. 2021 Oct 11;57(10):749-756. doi: 10.3760/cma.j.cn112142-20201106-00740.
To investigate the longitudinal epidemiological characteristics of myopia in primary school students from grade one to grade three in Hubei province, and to analyze the main factors affecting the occurrence and development of myopia, so as to provide the direction and theoretical basis for the prevention and control of myopia in children and adolescents. Longitudinal study. A total of 13, 244 primary school students from grade one to grade three in 17 prefectures and forest districts of Hubei province were included in the study by means of random stratified cluster sampling. Among them, there were 7, 331 boys and 5, 913 girls with an age of (7.7±1.0) years. The same group of students were followed up for two years from October 2017 to October 2019 to complete three data collections. All included subjects underwent visual acuity examination, which required further automatic computer optometry after using cyclopentolate hydrochloride eye drops if the visual acuity was less than 1.0. In the questionnaire, the general situation and eye behavior of the included subjects were collected. The Chi-square test was used to compare the prevalence of myopia among different genders,different reproductive history and grades. The Kruskal-Wallis H test was used to compare the difference in the mean spherical equivalent refraction, and logistic regression was used to analyze the influencing factors of myopia. The prevalence of myopia was 23.10% at baseline in 2017, 28.67% after one year's follow-up and 33.26% after two years' follow-up among primary school students in grade one to grade three in Hubei province. The overall prevalence of myopia increased with time (χ²307.47, <0.05). It also increased with the increase of grades. After two years of follow-up, the myopia rate of students in grades one through three was 25.62%, 35.07% and 41.05%, respectively (χ²200.98, <0.05). In 2017, the prevalence of myopia was 21.62% in boys and 24.93% in girls, and it increased to 31.20% and 35.69% after 2 years of follow-up, respectively. Both the prevalence of myopia and the spherical equivalent refraction were higher in girls than in boys. Moreover, myopia was associated with parents' myopia (=1.17), less time for outdoor activities (=1.06), no rest after half an hour's study (=1.18), more time for daily exposure to electronic products (=1.07), longer time for extracurricular study (=1.09), and higher grades (=1.78). Children whose parents were more myopic and who ate sweets and fizzy drinks more often had greater levels of myopia. Myopia occurs early in primary school students of grade one to grade three in Hubei province and increases rapidly. More attention should be paid to good habits for eyes, regular screening, outdoor activities and girls. .
为调查湖北省小学一至三年级学生近视的纵向流行病学特征，分析影响近视发生发展的主要因素，为儿童青少年近视防控提供方向和理论依据。采用纵向研究。通过随机分层整群抽样的方法，纳入湖北省17个市州及林区小学一至三年级的13244名小学生。其中男生7331名，女生5913名，年龄为（7.7±1.0）岁。对同一组学生从2017年10月至2019年10月进行两年随访，完成三次数据收集。所有纳入对象均进行视力检查，若视力小于1.0，则使用复方托吡卡胺滴眼液后进一步进行电脑自动验光。在问卷中，收集纳入对象的一般情况和用眼行为。采用卡方检验比较不同性别、不同生育史和年级的近视患病率。采用Kruskal-Wallis H检验比较等效球镜度数的差异，采用logistic回归分析近视的影响因素。湖北省小学一至三年级学生2017年基线近视患病率为23.10%，随访1年后为28.67%，随访2年后为33.26%。近视总体患病率随时间增加（χ²=307.47，P<0.05）。也随年级升高而增加。随访两年后，一至三年级学生的近视率分别为25.62%、35.07%和41.05%（χ²=200.98，P<0.05）。2017年，男生近视患病率为21.62%，女生为24.93%，随访2年后分别升至31.20%和35.69%。女生的近视患病率和等效球镜度数均高于男生。此外，近视与父母近视（OR=1.17）、户外活动时间少（OR=1.06）、学习半小时后不休息（OR=1.18）、每日接触电子产品时间长（OR=1.07）、课外学习时间长（OR=1.09）以及年级高（OR=1.78）有关。父母近视程度越高且经常吃甜食和喝碳酸饮料的儿童近视程度越高。湖北省小学一至三年级学生近视发病早且增长迅速。应更加关注良好的用眼习惯、定期筛查、户外活动和女生。
