【摘要】 目的了解学龄期儿童散光的基本规律,指导临床屈光检查及验光配镜,对改善学龄期儿童的视功能有重要的临床意义。方法以7～12岁学龄期儿童为研究对象,采用随机分层抽样方法,抽取武汉市城区经教育局注册在案的5所小学一至三年级学生共3434人,视力低于1.0者使用赛飞杰睫状肌麻痹后检影验光,以散光绝对值≥0.50D为标准,纳入1435眼进行分析。采用卡方检验及Fisher确切概率法比较不同性别、年龄学龄期儿童散光程度、散光类型、散光轴向的分布情况。结果(1)不同年龄间散光类型(χ~2=197.09,P<0.001)及散光轴向(χ~2=97.80,P<0.001)构成比不同,差异有统计学意义。其中,复合近视型散光919眼(64.04%)占比最高,且占比随着年龄的增长呈上升趋势。逆规散光共862眼(60.07%),7～11岁逆规散光及斜轴散光的占比都呈上升趋势,顺规散光占比则呈下降趋势。(2)复合近视散光中男生502眼(67.47%)高于女生的417眼(60.35%),不同性别散光类型分布差异有统计学意义(χ~2=14.82,P=0.005)。(3)不同散光程度间散光类型(χ~2=121.36,P<0.001)及散光轴向(χ~2=87.28,P<0.001)构成比差异有统计学意义。其中,轻度散光818眼(57.00%),随着散光程度的加重,复合近视散光的比例逐渐下降,混合散光的占比逐渐上升,逆规散光的占比呈下降趋势,顺规散光的占比呈上升趋势。(4)散光类型及散光轴向的Pearson列联系数C=-0.45,P=0.025<0.05,两者间存在中度密切关系。近视型散光中逆规散光占主体,远视性及混合散光中顺规散光占主体。不同散光类型的散光轴向分布差异有统计学意义(χ~2=829.75,P<0.001)。结论武汉市7～12岁学龄期儿童散光以轻度散光、复合近视型散光、逆规散光为主体,随着年龄增长复合近视型散光、逆规散光有上升趋势。而随着散光程度的增加,复合近视型散光、逆规散光则有下降趋势。更多还原

【Abstract】 Objective The basic rules of astigmatism in school-age children are beneficial to guide clinical refractive examination and optometry,and have important clinical significance in improving the visual function of school-age children.Method In this study,a total of 3,434 primary school students from grade 1 to grade 3 were selected from 5 primary schools in Wuhan city by means of random stratified sampling with school children aged between 7 and 12.If the visual acuity was lower than 1.0,the objects were examined with cyclopentolate ciliaiy muscle paralysis.The astigmatism absolute value≥0.50 D was used as the standard,and 1435 eyes were included for analysis.Results(1)Astigmatism type(X~2=197.09,P<0.001)and axial(χ~2=97.80,P<0.001)composition ratio were different among different ages,and the difference was statistically significant.Among them,919 eyes(64.04%)of composite myopic astigmatism had the highest proportion,and showed an increasing trend with the growth of age.There were 862 eyes(60.07%)in ATR,and the proportion of ATR and oblique astigmatism at 7～11 years old was on the rise,while WRA was on the decline.(2)In composite myopic astigmatism,502 eyes(67.47%)of male students were higher than that of 417 eyes(60.35%)of female students.The distribution of astigmatism type was statistically significant in different sexes(χ~2=14.82,P =0.005).(3)astigmatism type(χ~2 = 121.36,P<0.001)and astigmatism axis(χ~2=87.28,P<0.001)showed statistically significant difference among different astigmatism degrees.Among them,Light astigmatism was found in818 eyes(57.00%).With the aggravation of astigmatism,the proportion of composite myopia astigmatism gradually decreased,the proportion of mixed astigmatism gradually increased,the proportion of ATR decreased,and the proportion of WRA increased.(4)There is a medium close relationship between astigmatism type and astigmatism axis,Pearson coefficient C=-0.45,P=0.025<0.05.In myopic astigmatism,ATR accounts for the majority,while in hyperopia and mixed astigmatism,WRA accounts for the majority.The chi-square test showed significant difference in the axial distribution of different astigmatism types(χ~2 =829.75,P<0.001).Conclusions Light astigmatism,composite myopic astigmatism and ATR were the main types of astigmatism in school children aged 7 to 12 years old in Wuhan.Astigmatism of composite myopia type and ATR increased with age.With the increase of astigmatism,the composite myopic astigmatism and ATR have a decreasing trend.更多还原