摘要
目的观察城区中小学生眼屈光状态中的高度近视在不同年龄构成比的变化。方法采用横断面调查设计，对城区中小学生308人615只眼动态眼屈光状态等指标进行采集，等效球镜〉-6D为高度近视人选标准，输入编辑的专项应用程序，用SPSS10．0软件行统计分析。结果（1）中小学生（年龄7～18岁）5757人11514只眼中，近视9376只眼，近视构成比为81．4％，其中高度近视615只眼（占总眼数的5．3％），右眼300只眼（2．6％），左眼315只眼（2．7％）；男生275只眼（2．4％），女生340只眼（3．0％）。高度近视构成比小学1年级为0．9％、6年级1．6％，初中3年级8．0％、高中3年级12．5％；6年分段，小学阶段6年平均为1．1％，中学阶段6年平均7．7％；3年分段，小学1-3年级为0．8％，小学4—6年级1．6％，初中1-3年级4．9％，高中1-3年级12．3％。（2）中小学高度近视平均屈光度（-7．43±1．29）D，95％可信区间（-7．54，-7．33）D；小学1年级（-7．26±0．62）D，小学6年级（-6．95±0．58）D，初中3年级（-7．41±1．37）D，高中3年级（-7．30±1．13）D。各年级间差异有统计学意义（P=0．009）。（3）以6年划分阶段，小学阶段总平均（-6．97±0．6）D，95％可信区间-7．16，-6．78D；中学阶段总平均（-7．474-1．33）D，95％可信区间（-7．58，-7．36）D；各阶段之间差异显著有统计学意义（P=0．011）。（4）以3年划分阶段，小学的l～3年级总平均（-6．88±0．60）D，95％可信区间-7．19，-6．57D，小学4～6年级总平均（-7．02＋0．68）D，95％可信区间-7．27，-6．77D，初中1-3年级总平均（-7．45±1．41）D，95％可信区间（-7．63，-7．26）D，高中1-3年级总平均（-7．494-1．28），95％可信区间-7．62，-7．35D；各阶段之间差异无统计学意义（P=O．080）。（5）高度近视各年级女生、男生以及右眼、左眼间差异无统计学意义（P〉0．05）。（6）高度近视在小学最高度数-8D，初中2年级、高中3年级-13D。结论中小学12年间高度近视构成持续上升，并在小学高年级-初中阶段、初中～高中阶段呈现跳跃式上升。小学阶段、特别是低年级阶段高度近视的分布在低端的-6D，在初中阶段高度近视的分布进入偏高端的-8．0D，而在初二-高中阶段进入具有病理性意义的-10．0D的重度高度近视范围。提示青春发育期的14-18岁阶段是形成病理性近视的关键。
Objective To observe the eyes＇ refractive status, especially the evolution tendency of high myopia in Xi＇an city schoolchildren of China. Methods The cross-sectional study was con- ducted in the 308 schoolchildren of 615 eyes in Xi＇ an city schools. The inclusion criteria on was 〉-6D of the spherical equivalent refraction. The object ophthalmic examinations were done on all participants, which included non-cycloplegic objective refraction, visual acuity, ocular pressure, fun- dus evaluation by special trained ophthalmologists and nurses. The special designed inventory scale was filled in and input special computer program, then the data were statistically analyzed with SPSS10.0. Results l.In the 5757 students of 11514 eyes, whose ages were between 7-18 years, the detective rate of myo- pia was 81.4% （9376 eyes） and the high myopia 5.3% （615 eyes）. Of high myopia, the right eye was 2.6% （300 eyes）, the left was 2.7% （315 eyes）, and the boys 2.4% （275 eyes）, the girls 3.0% （340 eyes）. Among 12 grades, the detective rate of high myopia groups were significantly increased with the age＇s growing, including 0.9% in 1st grade of primary school and 1.6% in 6th grade of primary school, 8.0% in 3rd year of junior middle school, and 12.5% in 3rd year of se- nior middle school. The average detective rates were 1.1% and 7.7% separately in 6-year＇ primary school and middle school. The average detective rates were 0.8%, 1.6%, 4.9%, 12.3% by sequence in 3-year＇ junior primary school, senior primary school, junior middle school and senior middle school. 2.The average refractive error of spherical equivalent refrac- tion was （-7.43±1.29）D with 95% contqdence interval （-7.54, -7.33）D. Among 12 grades, there were signilqcant differences （P =0.009）, the 1st grade of primary school was （-7.26±0.62）D, the 6th grade of primary school （-6.95±0.58）D, the 3rd year of junior middle school was （-7.41±1.37）D, the 3rd year of senior middle school was （7.30±1.13D. 3.The average refractive error in 6-year primary school was （-6.97±0.6）D with 95% confidence interval （-7.16, -6.78）D, while in middle school was （-7.47±1.33）D with 95% confidence interval （-7.58,-7.36）D, there was significant difference （P =0.011） between them. 4.The average refractive error in 3-year junior and senior primary school, junior and senior middle school were （-6.88±0.60）D with CI （-7.19, -6.57）D, （-7.02±0.68D with CI （-7.27, -6.77）D, （-7.45±1.41）D with CI （-7.63, -7.26）D, and （-7.49±1.28）D with CI （-7.62,-7.35）D by sequence （P =0.080）. 5. There were no differences between right or left eyes and gender （P 〉0.05）. 6.The distribution was in lower level of-6D, in primary school, and, up to a higher level of-8D, in junior middle school, and to -13D in junior and senior middle school. Conclusions There is continuous in- creasing trend in high myopia＇ constitute during 12-year schoolchildren, in which it shows an increase by leap type be- tween senior primary and junior middle school stage, and between junior and senior middle school stage. The distribution of high myopia is in lower level of -6D, in primary stage and goes up to a higher level of -8D, in junior middle school stage, while progressing to -10D in senior middle school which means high risk of pathologic myopia formation during their late lifespan. The key stage is in their adolescent development state between 14 to 18 years old with a pathological significance.
出处
《中国实用眼科杂志》
CSCD
北大核心
2012年第5期620-624,共5页
Chinese Journal of Practical Ophthalmology
基金
陕西省科技厅科技研究发展项目（2009K17-02）,西安市科技局社会发展基金资助项目（GG2006156）陕西省科技厅科技研究发展项目（2004K16-G11）,西安市科技局社会发展基金资助项目（SF200319）
关键词
中小学生
高度近视
近视眼
构成比
Schoolchildren
High myopia
Myopia
Detective rate
作者简介
通信作者：石一宁，Email：shi_yi_ning@163．com
