目的·探索儿童高度近视与其生活质量的关联。方法·采用横断面研究方法。基于上海市儿童青少年大规模高度近视眼病研究项目，选择上海市16个区4~10岁高度近视儿童作为研究对象，选取2020年度基线期睫状肌麻痹后等效球镜度数及问卷数据；并纳入静安区、浦东新区16所幼儿园和小学一、二年级4~10岁非近视儿童，通过入校近视筛查测量其裸眼视力、矫正视力及非睫状肌麻痹等效球镜度数并进行生活质量问卷调查。生活质量通过长处与困难问卷（Strengths and Difficulties Questionnaire，SDQ）和欧洲五维健康量表视觉模拟评分法（EuroQol Five Dimensions Questionnaire Visual Analogue Scale，EQ-VAS）进行测量。对高度近视组和非近视组间变量分布差异进行统计学描述和检验后，使用线性回归分析2组间儿童生活质量得分的差异，以及高度近视组内等效球镜度数和儿童生活质量得分之间的关系。结果·共193名高度近视和209名非近视儿童纳入分析，高度近视组和非近视组间年龄［（9.58±0.94）岁 vs（7.63±1.50）岁，P<0.001］、性别分布（男性46.6% vs 男性62.7%，P=0.001）差异有统计学意义。调整年龄、性别因素后，发现高度近视组与非近视组儿童SDQ得分差异无统计学意义（β=0.313，95%CI -0.723~1.349，P=0.553），但高度近视组EQ-VAS得分较非近视组低（β=-3.805，95%CI -6.593~-1.017，P=0.008）；高度近视组内等效球镜度数与SDQ得分（β=0.297，95%CI -0.035~0.628，P=0.079）、EQ-VAS得分（β=0.579，95%CI -0.330~1.489，P=0.211）均无显著关联。结论·高度近视儿童由EQ-VAS量表反映的总体健康状况自评情况劣于非近视儿童，但评分高低不随高度近视程度变化。
关键词：儿童
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高度近视
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生活质量
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相关因素
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近视防控
Abstract
Objective ·To explore the association between high myopia and life quality among children. Methods ·Cross-sectional study method was adopted in this study. Highly myopic children aged 4‒10 from 16 districts in Shanghai were enrolled through Shanghai Child and Adolescent Large-scale Eye Study-High Myopia Registration Study. Baseline data for spherical equivalent after cycloplegia and questionnaire data in 2020 were collected. Emmetropic children aged 4‒10 from 16 kindergartens and elementary schools in Jing'an District and Pudong New Area were enrolled. The uncorrected visual acuity, corrected visual acuity and spherical equivalent without cycloplegia were measured through myopia screening in schools, and the questionnaire on quality of life was filled out. Quality of life was measured by the Strengths and Difficulties Questionnaire (SDQ) and EuroQol Five Dimensions Questionnaire Visual Analogue Scale (EQ-VAS). After describing and testing the differences in variable distributions between the highly myopic children group and the emmetropic children group, the differences in life quality between the two groups, and the association between spherical equivalent and life quality scores of the highly myopic children were examined by a linear regression model. Results ·A total of 193 children with high myopia and 209 children with emmetropia were enrolled. There were statistically significant differences in age [(9.58±0.94) years vs (7.63±1.50) years, P<0.001] and gender distribution (46.6% males vs 62.7% males, P=0.001) between the highly myopic children and emmetropic children. After adjusting for age and gender, it was found that there was no statistically significant difference in SDQ score between the highly myopic children and emmetropic children (β=0.313, 95%CI -0.723‒1.349, P=0.553), but the EQ-VAS score in the highly myopic children was lower than that in the emmetropic children (β=-3.805, 95%CI -6.593‒ -1.017, P=0.008). There was no significant relationship between spherical equivalent and SDQ score (β=0.297, 95%CI -0.035‒0.628, P=0.079) and EQ-VAS score (β=0.579, 95%CI -0.330‒1.489, P=0.211) in the highly myopic children. Conclusion ·In children with high myopia, self-evaluated overall health status reflected by EQ-VAS score is poorer compared with that in children with emmetropia. However, the EQ-VAS score is not associated with the degree of high myopia.
Keywords：children
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high myopia
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quality of life
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related factor
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myopia control
LIU Zhehui, XIE Hui, WANG Jingjing, YANG Jinliuxing, ZHANG Bo, HE Xiangui, XU Xun. Analysis on life quality of children with high myopia. Journal of Shanghai Jiao Tong University (Medical Science)[J], 2023, 43(12): 1548-1553 doi:10.3969/j.issn.1674-8115.2023.12.010
高度近视组193人，其中男生90人（占46.6%），女生103人（占53.4%）；年龄最小为5岁，最大为10岁，平均年龄（9.58±0.94）岁；非近视组209人，其中男生131人（占62.7%），女生78人（占37.3%）；年龄最小为4岁，最大为10岁，平均年龄（7.63±1.50）岁。2组间年龄［高度近视组（9.58±0.94）岁 vs 非近视组（7.63±1.50）岁，P<0.001］、性别（高度近视组男性46.6% vs 非近视组男性62.7%，P=0.001）分布差异具统计学意义。总体屈光度分布方面，高度近视组平均左眼SE为-6.40（1.81）D，平均右眼SE为-6.42（1.38）D，平均较弱眼SE为-6.88（1.75）D；非近视组平均左眼SE为0.28（0.63）D，平均右眼SE为0.21（0.38）D，平均较弱眼SE为0.11（0.63）D。
LIU Zhehui and XIE Hui contributed to essay writing and data analysis; WANG Jingjing and YANG Jinliuxing participated in questionnaire design; WANG Jingjing, YANG Jinliuxing and ZHANG Bo participated in data collection; HE Xiangui and XU Xun contributed to research design and manuscript revision. All authors have read the paper and consented for submission.
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所有作者声明不存在利益冲突。
COMPETING INTERESTS
All authors disclose no relevant conflict of interests.
The State Council Information Office of the People's Republic of China. The Ministry of Education held a press conference on the comprehensive prevention and control of myopia among children and adolescents since August 2018[EB/OL]. (2021-10-26) [2022-12-22]. http://www.scio.gov.cn/xwfb/bwxwfb/gbwfbh/jyb/202207/t20220716_239921.html.
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