【摘要】 目的 分析2020年河北省儿童青少年近视现状及其相关影响因素，为制定防控政策提供科学依据。方法采用整群分层抽样的方法，共抽取河北省13个市167个县（市、区）373 483名学生，对抽取的学生进行远视力和屈光检查，并在每市随机抽取其中一区一县，对小学四至六年级、初中和高中参加视力筛查的学生开展近视影响因素问卷调查。数据分析组间比较选择χ~2检验和χ~2趋势检验，采用多因素logistic回归分析近视影响因素。结果 2020年河北省儿童青少年近视率为54.27%，其中，轻度近视率为29.59%、中度近视率为19.73%、高度近视率为4.96%；女生近视率为57.96%，高于男生的50.88%，城区为56.76%，高于郊县的53.52%，差异均有统计学意义（均有P<0.001）；幼儿园6岁儿童近视率为17.54%，小学生近视率为40.61%，初中生近视率为73.96%，高中生近视率为84.09%，各阶段视力近视率不全相等（χ~2=65 854.637,P<0.001），随着学龄段的增加近视率呈上升趋势（趋势性χ~2=6 524 339,P<0.001）；高度近视率随着学段的增加占比也呈上升趋势，幼儿园6岁儿童、小学生、初中生和高中生高度近视占近视人数的比例分别为1.39%、2.66%、9.95%和18.69%；多因素logistic回归分析结果显示，父母近视、每天户外活动时间少于2 h、课间休息选择在室内、作业时间大于1 h及以上、天黑后看电子书关灯和每天不做眼保健操均的学生患近视的风险较高（均有P<0.01）。结论 河北省儿童青少年近视率较高，高度近视比例也相对较高，近视影响因素复杂，防控形势严峻，建议开展针对性防控措施。更多还原

【Abstract】 Objective To analyze the current situation of myopia among children and adolescents in Hebei Province in 2020,and to provide a scientific basis for formulating prevention and control policies. Methods Through stratified cluster sampling method, a total of 373 483 students from 167 counties in 13 cities in Hebei Province were selected for visual acuity and re-fraction examination. One district and one county were randomly selected from each city, and a questionnaire survey on the influencing factors of myopia was carried out among the students from grades four to six in primary schools, junior high schools and high schools who participated in vision screening. The χ²test and χ²trend test were used for comparison between groups, and multivariate logistic regression analysis were performed to explore the influencing factors of myopia. Results In2020, the myopia rate of children and adolescents in Hebei Province was 54.27%, including 29.59% for mild myopia,19.73% for moderate myopia, and 4.96% for high myopia. The myopia rate of girls（57.96%） was higher than that of boys（50.88%）, and that of urban areas（56.76%） was higher than that of suburban counties（53.52%）, with statistically significant difference（P<0.001）. The myopia rates were 17.54% in 6-year-old children in kindergarten, 40.61% in primary school students, 73.96% for junior high school students, and 84.09% for senior high school students, respectively, and the differences were statistically significant（χ²=65 854.637, P<0.001）. The myopia rate of each school age group increased with school period increase(χ_trend²=6 524.339, P<0.001). The proportion of high myopia also increased with school period increase, and the proportion of high myopia of kindergarten, primary school, junior middle school, and senior high school students were 1.39%,2.66%, 9.95%, and 18.69% respectively. The multivariate logistic regression analysis showed that parents with myopia, outdoor activities less than 2 hours a day, indoor breaks during class, homework time of more than 1 hour, reading e-books and turning off lights after dark, and not doing eye exercises every day were all at higher risk of myopia（all P<0.01）. Conclusion The myopia rate and the proportion of high myopia of children and adolescents in Hebei Province are both relatively high,with complicated influencing factors. The prevention and control situation is challenging, and it is recommended to carry out targeted prevention and control measures.更多还原