我国儿童青少年近视患病率及影响因素的meta分析

摘要/Abstract

摘要： 目的系统评价过去十年内我国儿童青少年近视患病率及影响因素。方法本研究通过计算机检索多个数据库并纳入相关文献,检索时限从2013年1月1日—2023年9月10日,采用美国医疗保健研究与质量局的横断面研究质量评价标准对纳入文献进行质量评价,利用Sata 16.0软件进行meta分析。结果共纳入19篇文献,涵盖1 329 784名研究对象,其中742 649名儿童青少年被诊断为近视。Meta分析结果显示,我国儿童青少年近视患病率为60.0%（95%CI：56%~0.64%,P<0.01）,女生发生近视的风险要远高于男生（OR=1.51,95%CI：1.39~1.62）。连续近距离用眼时长≥1 h、年级、经常躺着或趴着看书或屏幕、每天不做眼保健操、每天户外活动时间<1 h、父母一方或双方都近视、平均每天睡眠时间<8 h、平均每天用电子设备上网时间≥2 h、平均每天做作业时间过长均是我国儿童青少年近视的独立危险因素（P<0.05）。而学生课桌椅高度定期根据身高调整、天黑后在家读书写字同时使用屋顶灯和台灯、课间在户外休息是中国儿童青少年的保护因素（P<0.05）。结论我国儿童青少年近视发生率处于较高水平,近视率随着年级增长不断升高,其发生受多因素共同影响,社会应更加关注儿童青少年的视力情况,引导儿童青少年养成正确的用眼习惯,加强近视干预措施的力度。

关键词: 近视, 儿童青少年, 发生率, 影响因素, 系统评价

Abstract: Objective To systematically evaluate the prevalence and influencing factors of myopia in children and adolescents in China over the past decade. Methods This study searched multiple databases using a computer and included relevant literature from January 1,2013 to September 10,2023. The quality of the included literature was evaluated by the quality evaluation criteria of the cross-sectional study of the American Healthcare Research and Quality Bureau（AHRQ）,and meta-analysis was conducted using Sata 16.0 software. Results A total of 19 articles were included,covering 1 329 784 study subjects,of which 742 649 children and adolescents were diagnosed with myopia. The meta-analysis results showed that the incidence of myopia in Chinese children and adolescents in China was 60.0%（95%CI：0.56%-0.64%,P<0.01）,and the risk of myopia in girls was much higher than that in boys（OR=1.51,95%CI：1.39-1.62）. Continuous close-range eye use for ≥ 1 hour,grade level,frequent lying down or screen reading, no eye exercises per day,less than 1 hour of outdoor activity per day,myopia of one or both parents,average daily sleep time less than 8 hours,average daily use of electronic equipment internet time ≥2 hours,and excessive homework time per day were all independent risk factors for myopia in children and adolescents in China（all P<0.05）. Regularly adjusting the height of student desks and chairs according to their height,using roof lights and desk lamps at the same time while reading and writing at home after dark,and resting outdoors during breaks were protective factors for Chinese children and adolescents（all P<0.05）. Conclusion The incidence of myopia in children and adolescents in China is at a relatively high level,and the myopia rate continues to increase with grade. Its occurrence is influenced by multiple factors. Society should pay more attention to the visual condition of children and adolescents,guide them to develop correct eye habits,and strengthen the intervention measures for myopia.

Key words: Myopia, Children and adolescents, Incidence rate, Influencing factors, System evaluation

中图分类号:

R181.2

刘庆伟, 郭丽, 樊爱平, 张衡, 高凡, 辛姝. 我国儿童青少年近视患病率及影响因素的meta分析. [J]职业与健康, 2025, 41(3): 399-404.

LIU Qingwei, GUO Li, FAN Aiping, ZHANG Heng, GAO Fan, XIN Shu. Meta-analysis of the incidence and influencing factors of myopia in children and adolescents in China. [J]OCCUPATION AND HEALTH, 2025, 41(3): 399-404.

参考文献

[1] BREMOND-GIGNAC D.Myopie de I'enfant[J].Med Sci(Paris),2020, 36(8-9):763-768.
[2] HOLDEN B A,FRICKE T R,WILSON D A,et al.Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J].Ophthalmol,2016,123(5):1036-1042.
[3] 王宁利,李仕明,魏士飞.我国儿童青少年近视眼防控工作中的重点和难点[J].中华眼科杂志,2021,57(4):241-244.
[4] 陈军,何鲜桂,王菁菁,等.2021至2030年我国6~18岁学生近视眼患病率预测分析[J].中华眼科杂志,2021,57(4):261-267.
[5] 陈思童. 近视防控新进展[J].中国眼镜科技杂志,2023(10):103-104.
[6] 柏红梅,黄小君.海南省2021年中小学生筛查性近视风险因素[J].中国学校卫生,2023,44(8):1242-1246.
[7] 孙力菁,张喆,周月芳,等.上海市中小学生视力不良相关健康危险行为分析[J].中国学校卫生,2018,39(10):1565-1567.
[8] 田华,谭卫星,王秀琴,等.2019—2021年宁夏儿童青少年近视及主要影响因素分析[J].宁夏医学杂志,2023,45(7):635-639.
[9] 李国峰,张晨光,张秀红,等.2020年内蒙古自治区学生近视流行现状及相关影响因素分析[J].中国健康教育,2022,38(5):408-413.
[10] 王丽茹,李凤娟,许凤鸣,等.河南省中小学生视力不良现况及影响因素分析[J].河南预防医学杂志,2022,33(3):167-170.
[11] 石龙华,荣爽,程茅伟,等.湖北省中小学生近视流行现状及其影响因素分析[J].现代预防医学,2021,48(4):649-653.
[12] 范奕,陈婷,陈福辉,等.江西省儿童青少年近视流行现状及影响因素[J].中国学校卫生,2020,41(9):1413-1416.
[13] 高青,刘懿卿,叶茜雯,等.辽宁省学生近视情况及其影响因素[J].中华疾病控制杂志,2021,25(2):222-226.
[14] 周亮,师春立,陈剑宇.四川省儿童青少年近视现状及其影响因素研究[J].华南预防医学,2023,49(4):407-411.
[15] 夏志伟,王路,赵海,等.北京市2017—2018学年中小学生视力不良及影响因素分析[J].中国学校卫生,2018,39(12):1841-1844.
[16] 郑祥丽,唐姝.重庆市儿童青少年近视现状及影响因素[J].职业与健康,2020,36(7):963-966,970.
[17] 王妍昕,王甜,赵静珺,等.陕西省儿童青少年近视现状及遗传度分析[J].首都公共卫生,2023,17(3):161-163.
[18] 王美琳,时瑞霞,丁婷婷,等.2020年河北省儿童青少年近视现状及其影响因素分析[J].现代预防医学,2023,50(7):1234-1239,1244.
[19] 徐渴,刘忠慧,冯宝佳,等.天津市2018年中小学生视力不良现状及影响因素分析[J].中国慢性病预防与控制,2021,29(8):589-592,596.
[20] 杨云娟,常利涛,吕慧,等.云南省中小学生视力不良现况及影响因素分析[J].中国学校卫生,2015,36(12):1855-1858.
[21] 曾霞,潘德鸿,刘金东,等.辽宁与广东两省中小学生视力不良现况比较[J].中国学校卫生,2016,37(12):1848-1850,1855.
[22] 王非,李开宇,陈艳华,等.2017年湖南省中小学生视力不良现况及环境影响因素分析[J].实用预防医学,2019,26(8):900-903.
[23] LIN T,HU J,LIN J,et al.Epidemiological investigation of the status of myopia in children and adolescentsin Fujian Province in 2020[J].Jpn J Ophthalmol,2023,67(3):335-345.
[24] ZHUANG M,XIE H,ZHANG Y,et al.Prevalence and influence factors for myopia and high myopia in schoolchildren in Shandong,China[J].Cent Eur J Public Health,2022,30(3):190-195.
[25] 刘畅,刘文莲,王婕,等.2018—2020年我国中小学生近视患病率的meta分析[J].职业与健康,2021,37(22):3145-3148,3153.
[26] SINGH N K,JAMES R M,YADAV A,et al.Prevalence of myopia and associated risk factors in schoolchildren in North India[J].Optom Vis Sci, 2019,96(3):200-205.
[27] ADHIKARI S.Myopia in school children from high mountain region of Nepal[J].Nepal J Ophthalmol,2013,5(2):246-249.
[28] 董慧. 脊柱健康方案延缓儿童轻、中度近视进展的效果观察[D].北京:国家体育总局体育科学研究所,2023.
[29] 杨佳蓉. 西安市学龄前幼儿近视防治及其影响因素研究[D].沈阳:沈阳师范大学,2022.
[30] 杜康,黄珏瑢,关宏宇,等.西部农村学校同伴效应对青少年近视的影响[J].西北农林科技大学学报(社会科版),2022,22(1):77-87.
[31] 吴琼,周剑,韦企平,等.基于数据挖掘技术探讨针刺治疗近视的选穴规律[J].针灸临床杂志,2021,37(10):52-58.
[32] 边红霞,边梦婷,郭宓,等.包头市小学生近视现况调查及相关因素分析[J].国际眼科杂志,2021,21(10):1834-1838.
[33] 张金娇,常利涛,肖洁,等.云南省儿童青少年近视危险因素列线图判别分析[J].中国学校卫生,2023,44(9):1387-1391.
[34] SAW S M,ZHANG M Z,HONG R Z,et al.Near-work activity,night-lights,and myopia in the Singapore-China study[J].Arch Ophthalmol,2002,120(5):620-627.
[35] HE M,XIANG F,ZENG Y,et al.Effect of time spent outdoors at school on the development of myopia among children in China:A randomized clinical trial[J].JAMA,2015,314(11):1142-1148.
[36] 郭丽娇,杜宁,周健,等.佳木斯郊区儿童青少年近视防控的现况调查[J].黑龙江医药科学,2023,46(3):28-30.
[37] 罗连捷. 青少年屏幕时间对身心健康的影响研究[D].重庆:西南大学,2023.
[38] 杨露,李盛,郑艳妮,等.某市中小学生视力现状及影响因素分析[J].疾病预防控制通报,2022,37(2):22-26.
[39] 田向杰. 2017—2021年蒙自市中小学生常见病现状及影响因素分析[D].兰州:兰州大学,2023.
[40] 李丹琳,刘民歆,梁刚,等.睡眠及昼夜节律与儿童青少年近视发生的关联[J].中国学校卫生,2022,43(9):1428-1431,1435.
[41] CHAKRABORTY R,OSTRIN L A,NICKLA D L,et al.Circadian rhythms, refractive development,and myopia[J].Ophthalmic Physiol Optics,2018, 38(3):217-245.
[42] WEISS S,SCHAEFFEL F.Diurnal growth rhythms in the chicken eye:Relation to myopia development and retinal dopamine levels[J].J Comp Physiol A,1993,172(3):263-270.
[43] 陈彦哲,田欣杰,邢艺苑,等.郑州市中学生超重肥胖与近视的关联[J].中国学校卫生,2023,44(4):502-505,511.
[44] 王会会,张晓红,霍俊锋,等.山西省四至六年级小学生近视现状及影响因素分析[J].中国健康教育,2022,38(6):483-486,490.