6～14岁儿童筛查性近视及疑似远视储备量不足现状分析

刘诗蒙; 戴映雪; 刘艳; 郭正梅; 王成; 鹿茸

doi:10.12182/20260960103

6～14岁儿童筛查性近视及疑似远视储备量不足现状分析

Current Status of Screening-Detected Myopia and Suspected Insufficient Hyperopic Reserve in Children Aged 6-14 Years

摘要

摘要:
目的了解2022—2024年间成都市6～14岁在校儿童筛查性近视与疑似远视储备量不足的流行病学特征，为实施早期近视防控策略提供数据支持。
方法 2022—2024年间，采用分层整群随机抽样方法，在成都23个区市县抽取110654名6～14岁儿童进行调查。调查内容包括远视力检查与非睫状肌麻痹状态下电脑验光。
结果 2022—2024年6～14岁近视儿童总体等效球镜度（SE）（中位数（P₂₅，P₇₅））为－1.81（－2.56，－1.06） D，不同年份6～14岁近视儿童总体SE比较差异有统计学意义（H=52.82，P<0.001）。2022—2024年6～14岁儿童总体近视检出率为47.32%，儿童近视检出率从6岁的9.50%上升至14岁的79.45%，随着年龄的增加儿童近视检出率逐渐上升，趋势检验差异有统计学意义（χ_趋势²=2697.59，P<0.001）。男生近视检出率为44.91%，女生为49.82%，差异有统计学意义（χ²=267.09，P<0.001）。2022—2024年6～14岁非近视儿童总体SE（中位数（P₂₅，P₇₅））为0（－0.38，0.44） D，不同年份6～14岁非近视儿童总体SE比较差异有统计学意义（H=129.18，P<0.001）。2022—2024年6～14岁非近视儿童总体疑似远视储备量不足检出率53.09%，检出率由6岁的37.62%上升至13岁的68.13%，然后下降至14岁的66.99%，不同年龄间检出率差异有统计学意义（χ²=16626.19，P<0.001）。6～14岁非近视儿童中，男生疑似远视储备量不足检出率为53.05%，女生为53.13%，差异有统计学意义（χ²=81.50，P<0.001）。城区非近视儿童疑似远视储备量不足检出率为50.90%，郊县为55.93%，差异有统计学意义（χ²=145.38，P<0.001)。
结论 2022—2024年成都市6～14岁在校儿童近视患病率处于较高水平，且远视储备量不足和远视储备量过早消耗现象普遍，呈现出明显的低龄化趋势。建议将近视防控的关口前移至学龄前及小学低年级阶段，实施综合性干预措施。

Abstract:
Objective To investigate the epidemiological characteristics of screening-detected myopia and suspected insufficient hyperopic reserve among schoolchildren aged 6-14 years in Chengdu from 2022 to 2024, and to provide data to inform the implementation of early myopia prevention and control strategies.
Methods From 2022 to 2024, a total of 110654 children aged 6-14 years were recruited from 23 districts, cities, and counties of Chengdu using stratified cluster random sampling. The participants underwent hyperopia examination and non-cycloplegic autorefraction.
Results From 2022 to 2024, the overall spherical equivalent (SE) of myopic children aged 6-14 years was －1.81 (－2.56, －1.06) D (median P₂₅, P₇₅), with a statistically significant difference across age groups (H = 52.82, P < 0.001). The overall myopia detection rate was 47.32%, increasing from 9.50% among 6-year-old participants to 79.45% among 14-year-old participants. The myopia detection rate rose gradually with increasing age, with the trend test showing statistical significance (χ² for trend = 2697.59, P < 0.001). The myopia detection rate was 44.91% in boys and 49.82% in girls, with a statistically significant difference between the sexes (χ² = 267.09, P < 0.001). Among non-myopic children aged 6-14 years, the overall SE was 0 (－0.38, 0.44) D, with a statistically significant difference across participants of different ages (H = 129.18, P < 0.001). The overall detection rate of suspected insufficient hyperopic reserve in non-myopic children was 53.09%. The detection rate increased gradually from 37.62% among 6-year-old participants to a peak of 68.13% among 13-year-old participants and then declined to 66.99% at among 14-year-old participants, exhibiting a significant difference across the age groups (χ² = 16626.19, P < 0.001). Among non-myopic children aged 6-14 years, the detection rate of suspected insufficient hyperopic reserve was 53.05% in boys and 53.13% in girls, with a statistically significant difference between the sexes (χ² = 81.50, P < 0.001). The detection rate of suspected insufficient hyperopic reserve among nonmyopic children was significantly higher in suburban/county areas (55.93%) than that in urban areas (50.90%) (χ² = 145.38, P < 0.001).
Conclusion From 2022 to 2024, the prevalence of myopia among schoolchildren aged 6-14 years in Chengdu remained relatively high. Insufficient hyperopic reserve and premature depletion of hyperopic reserve were common, with a clear trend toward an earlier age of onset. Myopia prevention and control should therefore be initiated at an earlier stage, with comprehensive interventions implemented from the preschool and early primary school years.

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