作者：郝广煜 徐凌忠 王 英 崔春霞 谢竟芳 作者单位：1.包头医学院公共卫生学院，内蒙古包头 014060；2.山东大学公共卫生学院
【摘要】 目的：探讨小学生近视患病率及影响因素。方法：采用整群抽样、问卷调查，调查了包头市4所小学1 275名 6～14岁小学生，以近视学生为病例组、非近视学生为对照组，利用Logistic回归多因素分析筛检影响近视因素。结果：筛选出11个与近视眼发生有统计学关联的因素，家中有无电脑、每次玩电脑最长时间、母亲是否近视与近视关联较强。结论：把母亲近视及家中有无电脑的小学生作为预防近视的重点人群，限制学生玩电脑时间、改善家庭桌椅高差、注意读写姿势等作为预防近视的重点工作。
【关键词】 小学生；近视；患病率；影响因素；Logistic回归
A Survey and Analysis of Contributing Factors of Myopia among 1 275 Pupils in Baotou
HAO Guangyu1, XU Lingzhong2, WANG Ying1, CUI Chunxia1, XIE Jingfang1
(1.School of Public Health，Baotou Medical College,Baotou014010,China；
2.School of Public Health，Shandong University)
Abstract Objective: To probe into the rate of myopia and possible causal factors. Methods: A statistics sample survey was conducted among 1 275 pupils, aged 6～14,form 4 primary schools in Baotou. In contrast with the non-near-sighted pupils, an analsis of Logistic regression was made among the near-sighted ones. Results: Of 11 possible factors, 3 were found to be closely related to myopia: whether there is a home computer, how much time is spent on computer, whether the mother is near-sighted. Conclusion: In order to prevent myopia and reduce its incidence rate among pupils, especially among those whose mothers are near-sighted and those who have home computers, such effective measures must be taken as limiting their time spent on computer, fitting their chairs to desks in height at home and improving their writing posture.
Key words Pupils; Myopia; Incidence rate of myopia; Contributing factors; Logistic regression
目前，小学生近视患病率迅速上升，其危害已引起社会各界广泛的关注。为了解包头市小学生近视患病率及影响因素，对包头市三区1 275名小学生进行调查，用病例对照研究方法，采用Logistic回归对近视影响因素进行了筛检。
1 对象与方法
1.1 调查对象 选包头市在教学条件、设备、生源居于当地中等水平的4所小学（东河区2所，青山区、昆区各1所），采用整群抽样方法，各年级抽取一半班级，年龄在6～14岁的小学生作为调查对象。
1.2 方法 采用问卷调查，问卷经过小范围预调查后反复调整而成。近视判断标准统一采用《全国学生常见病综合防治方案技术规范》要求进行，左右眼分别记录，裸眼视力≥5.0为正常，＜5.0为近视。采用SPSS11.0软件对资料进行分析处理。以317名近视小学生为病例组，其余958名非近视者为对照组进行Logistic回归分析，变量分级及数量化见表1。表1 Logistic回归分析变量分级及数量化
2 结果
结合专业知识选择了29个可能与视力有关的因素（详见表1）代入Logistic回归模型，进行多因素分析。最终筛检出11个因素：年龄、对戴眼镜的看法、看电视距离、家中有无电脑、玩电脑最长时间、是否注意读写光线、是否注意读写姿势、户外活动时间、母亲是否近视、母亲文化程度、学生家庭学习桌椅高差与小学生近视有关联；而其余18个因素，性别、课外用眼学习时间、平均玩电脑时间、课间户外活动、看课外书、平均睡眠时间、有无躺着看书的习惯、有无走路乘车看书的习惯、上电脑课持续时间、父亲是否近视、父亲文化程度、健康状况、体重指数、对戴眼镜坏处的认识、对近视原因的认识、预防近视的知识、黑板照度、家庭采光与小学生近视无关联（表2）。 表2 小学生近视眼影响因素Logistic回归多因素分析结果
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