中国公共卫生

目的 了解河南省中小学生戴镜和视力矫正情况，为开展中小学生近视防控提供理论依据。方法 于2023年9—10月，采取分层整群抽样方法在河南省158个县区选取351 497名中小学生进行视力筛查和问卷调查，分析不同人口学特征和影响因素下学生视力矫正情况。结果 2023年河南省中小学生戴镜率为30.24%(106 292/351 497)，其中女生戴镜率为33.63%(56 473/167 906)，高于男生的27.14%(49 819/183 591)；城区为33.35%(44 597/133 707)，高于郊县的28.33%(61 695/217 790)；戴镜率随学段呈上升趋势，差异均有统计学意义（P<0.05）。50.34%(101 948/202 518)的近视学生进行配镜矫正。视力未矫欠矫率达64.42%(130 469/202 518)，其中男生未矫欠矫率为65.71%(65 789/100 113)，高于女生的63.16%(64 680/102 405)；郊县为65.53%(80 322/122 579)，高于城区的62.73%(50 147/79 939)；未矫欠矫率随学段呈下降趋势，差异均有统计学意义（P<0.05）。logistic回归分析显示，自认为不近视（OR=3.940,95%CI=3.122～4.973）、有时佩戴眼镜（OR=2.157,95%CI=2.090～2.227）、从不佩戴眼镜（OR=2.592,95%CI=2.488～2.701）与近视学生视力未矫欠矫率升高有关；近1年视力检查1～2次（OR=0.593,95%CI=0.557～0.631）和≥3次（OR=0.494,95%CI=0.462～0.529）、配镜前仅验光（OR=0.616,95%CI=0.586～0.648）、仅散瞳（OR=0.733,95%CI=0.669～0.797）以及验光和散瞳（OR=0.593,95%CI=0.563～0.624）与近视学生视力未矫欠矫率降低有关。结论 河南省中小学戴镜率较低，但近视学生视力未矫欠矫率较高，应加强中小学生科学视力矫正的宣传教育。

Objective To investigate the conditions of glasses wearing and vision correction among primary and secondary school students in Henan province, thus providing a theoretical basis for the prevention and control of myopia.Methods From September to October 2023, a stratified cluster sampling method was adopted to select 351 497 primary and secondary school students from 158 counties and districts in Henan province for vision screening and questionnaire surveys. The vision correction condition was analyzed according to different demographic characteristics and influencing factors. Results In 2023, the glasses-wearing rate among primary and secondary school students in Henan province was 30.24%(106 292/351 497). The rate among girls was 33.63%(56 473/167 906), which was higher than that among boys at 27.14%(49 819/183 591). The rate in urban areas was 33.35%(44 597/133 707), higher than that in suburban and rural areas at 28.33%(61 695/217 790). The glasses-wearing rate showed an increasing trend as the phase of studying increased(P < 0.05). Among students with myopia, 50.34%(101 948/202 518) had their vision corrected with glasses,while the rate of uncorrected or undercorrected vision reached 64.42%(130 469/202 518). The rate of uncorrected or undercorrected vision was higher among boys at 65.71%(65 789/100 113) than among girls at 63.16%(64 680/102 405).It was also higher in suburban and rural areas at 65.53%(80 322/122 579) than in urban areas at 62.73%(50 147/79 939).The rate of uncorrected or undercorrected vision showed a decreasing trend as the phase of studying increased(P < 0.05).Logistic regression analysis showed that self-assessment of no myopia(OR = 3.940, 95%CI: 3.122–4.973), sometimes wearing glasses(OR = 2.157, 95%CI: 2.090–2.227), never wearing glasses(OR = 2.592, 95%CI: 2.488–2.701) were associated with an increased rate of uncorrected or undercorrected vision among myopic students. In contrast, visual acuity examination 1–2 times(OR=0.593, 95%CI: 0.557–0.631) and 3 times or more(OR=0.494, 95%CI: 0.462–0.529)in the past year, optometry only(OR = 0.616, 95%CI: 0.586–0.648), pupil dilation exam only(OR = 0.733, 95%CI:0.669–0.797), optometry and pupil dilation exam(OR = 0.593, 95%CI: 0.563–0.624) before optometry were associated with an decreased rate of uncorrected or undercorrected vision among myopic students. Conclusions The glasseswearing rate is not high among primary and secondary schools in Henan province, while the rate of uncorrected or undercorrected vision is high among in myopic students. It is necessary to strengthen the publicity and education of scientific vision correction.