CAJ | 학술논문

目的通过对青少年儿童人群的眼轴增长的相关因素分析,探讨近视发生发展的规律,为预防和控制近视提供依据.方法前瞻性研究.分层随机抽样选取上海市徐汇区和虹口区2个区12所中小学,6～13岁的学生4 651例(取右眼数据),进行屈光相关检查(包括裸眼远视力、屈光度、眼轴、角膜曲率等),测身高、体质量,对性别、年龄、家族史等进行问卷调查,完成2年3次(初查,每隔1年复查)的数据收集.SAS 9.3建立混合模型(mixed model),对眼轴增长相关因素进行统计分析.结果眼轴随时间变量而增加,第1年和第2年的系数估计分别为0.247、0.491 (P＜0.01);性别、体质指数、等效球镜度(SE)、平均角膜曲率等变量的系数估计分别为-0.307、0.006、-0.303、-0.297(P＜0.01);在年龄变量中,相对于6岁年龄组,7～13岁各组变量的系数估计分别为0.115、0.392、0.471、0.600、0.816、0.865、0.909(P＜0.01);在家族史变量中,相对于父母双方均无近视组,一人中低度数组、一人高度数组、双方均中低度数组、一人高度一人中低度数组、双方均高度数组的系数估计分别为0.122、0.257、0.238、0.429、0.429(P＜0.01).右眼2年眼轴变化值与2年SE变化值呈负相关(r=-0.462,P＜0.01).结论在青少年儿童人群中,眼轴随时间增长,并且与年龄、体质指数、家族史、平均角膜曲率相关.眼轴随年龄逐步增长;体质指数越高,增长越快;父母近视程度越高,增长越快;平均角膜曲率越高,增长越慢.SE为正值时,数值越高,眼轴增长越慢;SE为负值时,数值越高,眼轴增长越快.
목적 통과대청소년인동인군적안축증장적상관인소분석,탐토근시발생발전적규률,위예방화공제근시제공의거.방법 전첨성연구.분층수궤추양선취상해시서회구화홍구구2개구12소중소학,6～13세적학생4 651례(취우안수거),진행굴광상관검사(포괄라안원시력、굴광도、안축、각막곡솔등),측신고、체질량,대성별、년령、가족사등진행문권조사,완성2년3차(초사,매격1년복사)적수거수집.SAS 9.3건립혼합모형(mixed model),대안축증장상관인소진행통계분석.결과 안축수시간변량이증가,제1년화제2년적계수고계분별위0.247、0.491 (P＜0.01);성별、체질지수、등효구경도(SE)、평균각막곡솔등변량적계수고계분별위-0.307、0.006、-0.303、-0.297(P＜0.01);재년령변량중,상대우6세년령조,7～13세각조변량적계수고계분별위0.115、0.392、0.471、0.600、0.816、0.865、0.909(P＜0.01);재가족사변량중,상대우부모쌍방균무근시조,일인중저도수조、일인고도수조、쌍방균중저도수조、일인고도일인중저도수조、쌍방균고도수조적계수고계분별위0.122、0.257、0.238、0.429、0.429(P＜0.01).우안2년안축변화치여2년SE변화치정부상관(r=-0.462,P＜0.01).결론 재청소년인동인군중,안축수시간증장,병차여년령、체질지수、가족사、평균각막곡솔상관.안축수년령축보증장;체질지수월고,증장월쾌;부모근시정도월고,증장월쾌;평균각막곡솔월고,증장월만.SE위정치시,수치월고,안축증장월만;SE위부치시,수치월고,안축증장월쾌.
Objective To investigate the principles influencing the occurrence and development of myopia by analyzing factors relevant to axial length growth in teenagers and children;to provide a basis for prevention and control of myopia.Methods In a prospective study,a stratified random sampling was used to select 12 middle schools and primary schools in the Shanghai Xuhui and Hongkou districts.The study enrolled 4 651 students,ranging in age from 6 to 13 years.Visual acuity,refractive error,axial length,and corneal curvature were tested and height and weight were recorded.A survey questionnaire that included information about the students' age,gender,family history,etc.,was completed and follow-up surveys were repeated 2 times over a 2-year period.Census data were analyzed with a mixed model using SAS 9.3 software.Results Axial length increased as a function of time.The coefficient estimate was 0.247,0.491 (P＜0.01).Variables such as gender,body mass index (BMI),spherical equivalent (SE),and an estimation of the average corneal curvature coefficient were-0.307,0.006,-0.303,-0.297,respectively (P＜0.01).For the age variable,the 6-year-old group was compared to the 7-to 13-year-old groups and the variable coefficient estimates were 0.115,0.392,0.471,0.600,0.816,0.865,0.909 (P＜0.01).For family history variables,parents were grouped as follows:neither parent was myopic,one was in the low or middle myopia group,one was in the high myopia group,both were in the low or middle myopia group,one was in the low or middle and one was in the high myopia group,both were in the high myopia group,coefficient estimates were 0.122,0.257,0.238,0.429,0.429,the differences were statistically significant (P＜0.01).The change in 2 years of axial length of right eye shows negative relation with the change in 2 years of SE.Conclusion In this population of teenagers and children,relevant findings revealed that axial length increases with time,age,BMI,family history,spherical equivalent,and average corneal curvature.Axial length increased gradually as age increased.The higher the BMI was,the faster the growth.The higher the degree of myopia in parents,the faster the growth.The higher the average corneal curvature was,the slower the axial length growth was.When the spherical equivalent was positive,a higher number corresponded with a slower growth in axial length.When the spherical equivalent was negative,a higher number corresponded with a faster growth in axial length.