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中文摘要: 摘 要：目 的 ：调查分析社区内小学生筛查性近视的流行现状及其影响因素，探讨遗传与环境因素对上海小学生近视的 独立及交互影响。方法：2024年5月，针对上海市某公立小学1~5年级的695名学生开展了屈光筛查与问卷调查。采用x² 检验和多因素logistic 回归分析探讨影响小学生筛查性近视的相关因素。结果：695名小学生中，男生371人，女生324人， 总体近视率为35.40。多因素logistic 回归分析显示，近视遗传史、户外活动时间不足、睡眠时间不足、开灯睡觉习惯、读书 写字时眼睛与书本距离过近、写字时歪头及饮食不均衡是近视形成的独立影响因素( P<0.05), 进一步分析发现，父母均 近视( OR=2.890,95%CI 为1.684~4.950)、平均每周户外活动时间<2h(OR=2.427,95%CI 为1.295~4.545)、读书/写字时 眼睛与书本的距离<20cm(OR=2.066,95%CI 为1.175~3.623)是近视的独立危险因素；父母均近视且读书/写字时眼睛与 书本的距离<20cm 者 的( OR=6.410, 95% CI 为1.730~23.810)近视风险高于单独因素效应叠加，提示协同作用趋势。结论： 应针对遗传史与用眼距离过近的协同作用采取需优先干预措施，严格控制用眼距离，构建家庭、学校与医疗机构的联动干预 体 系 ，强化近视防控知识教育，采用有效的近视防控技术手段，以降低近视的发生概率，并延缓近视疾病的进一步发展。
Abstract:Abstract: OBJECTIVE To investigate the prevalence and influencing factors of screening-detected myopia among primary school students in a community,and to explore the independent and interactive effects of genetic and environmental factors on myopia among primary school students in Shanghai.METHODS In May 2024,refractive screening and a questionnaire survey were conducted among 695 students in grades 1 to 5 of a public primary school in Shanghai.x²tests and multivariate logistic regression analyses were used to identify factors associated with screening-detected myopia.RESULTS Among the 695 primary school students,371 were boys and 324 were girls,with an overall myopia rate of 35.40%.Multivariate logistic regression analysis showed that family history of myopia, insufficient outdoor activity time,insufficient sleep duration,habit of sleeping with lights on,close eye-to-book distance while reading and writing,head tilt while writing,and unbalanced diet were independent influencing factors for myopia(P<0.05).Further analysis revealed that both parents myopic(OR=2.890,95%CI:1.684-4.950),outdoor activity <2 hours/week(OR=2.427, 95%CI:1.295-4.545),and eye-to-book distance<20cm(OR=2.066,95%CI:1.175-3.623)were independent risk factorsfor myopia.The risk of myopia among students with both parents myopic and an eye-to-book distance<20cm(OR=6.410,95%CI: 1.730-23.810)was higher than the additive effect of each factor alone,suggesting a synergistic interaction.CONCLUSION Priority intervention measures should target the synergistic effect of family history and excessively close reading distance.Strictly controlling eye- to-book distance,establishing a collaborative intervention system involving families,schools,and medical institutions,strengthening education on myopia prevention and control,and adopting effective technical strategies are recommended to reduce the incidence of myopia and delay its progression.
keywords: Keywords:primary school students myopia genetic factors outdoor activity eye-to-book distance interaction
文章编号：3202410022 中图分类号：R195 文献标志码：
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