高原地区3～6岁儿童眼病危险因素及早期防治措施

Risk factors and strategies for early prevention and treatment of eye diseases in children aged 3 to 6 years in highland areas

摘要:

目的 分析高原地区3～6岁儿童眼病危险因素。方法 2020年7月10日分别在青海省西宁市幼儿园、玉树市幼儿园、海西蒙古族藏族自治州（以下简称海西州）幼儿园随机选择1 352例、593例、935例3～6岁儿童，使用伟伦视力筛查仪检测所有儿童屈光状态，记录视力异常、急性结膜炎、斜视、眼球震颤、角膜炎等眼病的发生情况。通过问卷调查收集儿童及家长资料，采用一般多因素Logistic回归分析影响高原地区3～6儿童眼病的危险因素。结果 青海省西宁市和玉树市非感染性眼病的发生率高于海西州（P <0.05）；玉树市非感染性眼病的发生率高于西宁市（P <0.05）。青海省海西州感染性眼病的发生率高于西宁市和玉树市（P <0.05），玉树市的感染性眼病的发生率高于西宁市（P <0.05）。一般多因素Logistic回归分析结果表明，居住地平均海拔［O^R=3.963（95% CI：0.187，0.341）］、每日观看电视和使用电子设备的时间［O^R=0.938（95% CI：1.269，1.678）］、父亲屈光状态［O^R=0.997（95% CI：1.151，1.956）］、母亲屈光状态［O^R=0.914（95% CI：1.313，1.695）］是影响3～6岁儿童非感染性眼病发生的危险因素（P <0.05）；居住地平均海拔［O^R=1.659（95% CI：0.287，0.316）］、挑食［O^R=1.980（95% CI：1.218，2.316）］、每日睡眠时间［O^R=5.291（95% CI：1.639，1.835）］、年平均日照时间［O^R=5.558（95% CI：1.021，1.935）］是影响3～6岁儿童感染性眼病发生的危险因素（P <0.05）。结论 青海省玉树市视力异常发病率高于其他地区，居住地平均海拔、每日观看电视和使用电子设备的时间、父母屈光状态是影响3～6岁儿童非感染性眼病发生的独立危险因素，而居住地平均海拔、挑食、年平均日照时间、每日睡眠时间是影响3～6岁儿童感染性眼病发生的独立危险因素。普及眼保健操知识并且制定相关干预措施，有助于降低3～6岁儿童眼部患病率。

Abstract:

Objective To analyze the risk factors of eye diseases in children aged 3 to 6 years in highland areas.Methods On July 10, 2020, 1352, 593 and 935 children aged 3 to 6 years were randomly selected from kindergartens in Xining, Yushu and Haixi Mongolian and Tibetan Autonomous Prefecture (Haixi) in Qinghai province, respectively. The refractive status of all children was measured with the Welch Allyn vision screener, and the incidence of eye diseases such as abnormal visual acuity, acute conjunctivitis, strabismus, nystagmus, and keratitis was recorded. The data of the children and their parents were collected by questionnaire survey, and the risk factors affecting the occurrence of eye diseases in children aged 3 to 6 years in highland areas were determined via Logistic regression analysis.Results The incidence of non-infectious eye diseases in Xining and Yushu was higher than that in Haixi (P < 0.05), and the incidence of non-infectious eye diseases in Yushu was even higher than that in Xining (P < 0.05). The incidence of infectious eye diseases in Haixi was higher than that in Xining and Yushu (P < 0.05), and the incidence of infectious eye diseases in Yushu was even higher than that in Xining (P < 0.05). The multivariable Logistic regression analysis revealed that the average altitude of residence [O^R = 3.963 (95% CI: 0.187, 0.341) ], time spent watching TV and using electronic devices [O^R = 0.938 (95% CI: 1.269, 1.678) ], the refractive status of father [O^R= 0.997 (95% CI: 1.151, 1.956) ] and that of mother [O^R = 0.914 (95% CI: 1.313, 1.695) ] were the factors affecting the occurrence of non-infectious eye diseases in children aged 3 to 6 years (P < 0.05). In contrast, the factors affecting the occurrence of infectious eye diseases in children aged 3 to 6 years include the average altitude of residence [O^R = 1.659 (95% CI: 0.287, 0.316) ], picky eating [O^R = 1.980 (95% CI: 1.218, 2.316) ], daily amount of sleep [O^R = 5.291 (95% CI: 1.639, 1.835) ], and average annual sunshine duration [O^R = 5.558 (95% CI: 1.021, 1.935) ] (P < 0.05).Conclusions The incidence of abnormal visual acuity in Yushu is higher than that in other areas. The average altitude of residence, time spent watching TV and using electronic devices, the refractive status of father and that of mother are the independent factors affecting the occurrence of non-infectious eye diseases among children aged 3 to 6 years old, while the average altitude of residence, picky eating, average annual sunshine duration and daily amount of sleep are independent factors affecting the occurrence of infectious eye diseases among these children. To raise the public awareness of eye care and to work out relevant interventions are conducive to reducing the incidence of eye diseases in children aged 3 to 6 years.