CAJ | 학술논문

背景流行病学调查表明,青少年视力损伤是一个全球性的公共卫生问题,其首要原因是未矫正的屈光不正,因此一定规模的流行病学调查对儿童屈光不正的矫正具有重要意义.目前尚缺乏上海市大规模儿童视力损伤和屈光不正的流行病学调查资料. 目的调查上海市6 ～12岁小学生视力损伤与屈光不正的患病情况.方法采用横断面调查研究设计,于2010年5月至2011年4月分层随机整群抽取上海市宝山区6所学校的4 686名小学生进行研究,眼部检查包括视力、外眼、眼前节、屈光间质、眼底和眼压检查,并记录睫状肌麻痹后电脑验光的结果和眼位.结果实际受检学生4 594人,应答率为98.0％,接受睫状肌麻痹后验光者3 975人,占84.8％.双眼裸眼视力≤0.5者占14.4％(662/4 594),其中343人配戴眼镜,占51.8％.所有受检者中,任一眼裸眼视力≤0.5者1 031人,占22.4％.受检的视力损伤者中屈光不正占96.9％(999/1 031),弱视占3.6％(37/1 031).接受睫状肌麻痹后验光的小学生中,近视、远视和散光的患病率分别为31.1％、4.3％和33.0％.公办学校的小学生近视患病率高于外来务工随迁子女学校的学生,差异有统计学意义(x2=5.46,P=0.02).Logistic回归分析显示,年龄和女生与近视的发生及发展明显有关(年龄:OR=1.60,95％ CI:1.53 ～ 1.68,P＜0.01;女生:OR=1.33,95％CI:1.16～1.54,P＜0.01). 结论中国上海市小学生视力损害的主要原因是近视,应注意筛查并提高小学生屈光不正的矫正覆盖率.
배경 류행병학조사표명,청소년시력손상시일개전구성적공공위생문제,기수요원인시미교정적굴광불정,인차일정규모적류행병학조사대인동굴광불정적교정구유중요의의.목전상결핍상해시대규모인동시력손상화굴광불정적류행병학조사자료. 목적 조사상해시6 ～12세소학생시력손상여굴광불정적환병정황.방법 채용횡단면조사연구설계,우2010년5월지2011년4월분층수궤정군추취상해시보산구6소학교적4 686명소학생진행연구,안부검사포괄시력、외안、안전절、굴광간질、안저화안압검사,병기록첩상기마비후전뇌험광적결과화안위.결과 실제수검학생4 594인,응답솔위98.0％,접수첩상기마비후험광자3 975인,점84.8％.쌍안라안시력≤0.5자점14.4％(662/4 594),기중343인배대안경,점51.8％.소유수검자중,임일안라안시력≤0.5자1 031인,점22.4％.수검적시력손상자중굴광불정점96.9％(999/1 031),약시점3.6％(37/1 031).접수첩상기마비후험광적소학생중,근시、원시화산광적환병솔분별위31.1％、4.3％화33.0％.공판학교적소학생근시환병솔고우외래무공수천자녀학교적학생,차이유통계학의의(x2=5.46,P=0.02).Logistic회귀분석현시,년령화녀생여근시적발생급발전명현유관(년령:OR=1.60,95％ CI:1.53 ～ 1.68,P＜0.01;녀생:OR=1.33,95％CI:1.16～1.54,P＜0.01). 결론 중국상해시소학생시력손해적주요원인시근시,응주의사사병제고소학생굴광불정적교정복개솔.
Background Epidemiologieal survey suggests that visual impairment in teenagers is a worldwide public health problem,and its leading cause is uncorrected refractive error.To conduct an extensive screening of visual impairment in teenagers and analyze the relevant affecting factors are significant works for the prevention and management of refractive errors.But high-quality epidemiological data on visual impairment and refractive error from large groups of children are lacking in Shanghai.Objective This study was to investigate the prevalence of ametropia and visual impairment in schoolchildren aged 6 to 12 years old.Methods In this cross-sectional study,4 686 students from 6 elementary schools in Baoshan District of Shanghai,a rural-urban fringe zone,China were selected by clustering sampling from May 2010 to April 2011.The eye examinations included visual acuity,ocular surface,ocular anterior segment,ocular media,fundus and intraocular pressure measurement,and the data autorefraction under cycloplegia and eye position were recorded.The cause of visual impairment was evaluated.Results A total of 4 594 students received examination with the response rate 98.0％,and autorefraction under cycloplegia was completed in 84.8％ schoolchildren (3 975/4 594).The prevalence rate of uncorrected visual acuity 0.5 or worse in both eyes was 14.4％ (662/4 594),with the wearing glasses rate 51.8％ (343/662).The percentage of students with the uncorrected visual acuity 0.5 or worse in at least one eye was 22.4％ (1 031/4 594).The prevalence rate of refractive error in the visual impaired students was 96.9％ (999/1 031),followed by amblyopia (37/1 031,3.6％).The prevalence rate of myopia,hyperopia,and astigmatic in the pupils after cycloplegia was 31.1％,4.3 ％ and 33.0％,respectively.In addition,the prevalence rate of myopia in public elementary schools was higher than that in migrant elementary schools (33.9％ versus 30.3％) (x2 =5.46,P =0.02).Logistic regression analysis showed that myopia was associated with age (OR =1.60,95 ％ CI:1.53-1.68,P ＜ 0.01) and female (OR =1.33,95％ CI:1.16-1.54,P＜0.01).Conclusions The leading cause of vision impairment is myopia in the elementary school students in Shanghai,China.The screening-ratio of refractive error and the coverage of refractive correction in the elementary school students in Shanghai are matters of urgent concern.