目的 了解江苏省南通市中小学生脊柱侧弯患病情况及其影响因素,为开展脊柱侧弯干预提供参考依据。方法 采用分层整群随机抽样的方法,于2021年在南通市崇川区和启东市抽取12所小学、中学的4 196名学生为调查对象,进行脊柱检查和脊柱侧弯相关影响因素调查。采用多因素Logistic回归模型分析中小学生脊柱侧弯的影响因素。结果 南通市中小学生脊柱侧弯检出率为3.69%(155/4 196),胸段、腰胸段、腰段侧弯检出率分别为1.36%(57/4 196)、1.67%(70/4 196)和1.91%(80/4 196)。中小学生脊柱侧弯检出率与近视、学段、体育课频率、过去7d内达到60min以上中高强度运动的天数、每天白天户外活动时间、睡眠时间、室内静坐时间以及学生对坐姿、站姿的自我要求不同有关(P＜0.05)。多因素Logistic回归分析结果显示,初中(OR=2.781,P=0.006)、高中(OR=2.819,P=0.009)阶段是中小学生脊柱侧弯的危险因素;体育课频率≥每周4节/周(OR=0.432,P=0.003)、过去7d内达到60min以上中高强度运动≥3d(OR=0.676,P=0.045)、每天睡眠7~＜9h(OR=0.551,P=0.003)是中小学生脊柱侧弯的保护因素。 结论 南通市中小学生脊柱侧弯情况不容忽视,学段、体育课频率、睡眠时间等是脊柱侧弯阳性的影响因素,应针对这些影响因素对学生进行干预,以降低脊柱侧弯发生率。
Abstract
Objective To understand the detection rate of scoliosis and its influencing factors among primary and secondary students in Nantong City, Jiangsu Province, so as to provide reference basis for the development of scoliosis intervention. Methods A stratified cluster random sampling method was used to select 4 196 students from 12 primary and middle schools in Chongchuan and Qidong District of Nantong City in 2021. The students were investigated for spinal examinations and influencing factors of adolescent scoliosis. Multivariate Logistic regression model was used to analyze the risk and protective factors of adolescent scoliosis in students. Results The detection rate of adolescent scoliosis in primary and middle school students in Nantong was 3.69% (155/4 196), and the detection rates of thoracic, lumbar thoracic and lumbar scoliosis were 1.36% (57/4 196), 1.67% (70/4 196) and 1.91% (80/4 196), respectively. The detection rate of adolescent scoliosis significantly varied among primary and middle school students, which was related to whether myopia or not, different grades and different frequency of physical education classes, days with high-intensity exercise above 60min in the past week, daily outdoor time, sleep time, indoor sedentary time, as well as students' different self-requirements for sitting and standing positions(P＜0.05). Multivariate Logistic regression analysis showed that junior high school (OR=2.781) and senior high school (OR=2.819) were risk factors for adolescent scoliosis, while physical education classes frequency ≥ 4 sessions a week (OR=0.432), days with high-intensity exercise above 60min in the past week≤3days and daily sleep duration of 7 - <9 hours (OR=0.551) were protective factors against scoliosis. Conclusions The situation of adolescent scoliosis among primary and middle school students in Nantong City should not be ignored.The influencing factors for adolescent scoliosis include academic grade, frequency of physical education classes and sleep time etc. Interventions are of great significance to be targeted at these factors to reduce the incidence of scoliosis among students.
关键词
青少年 /
脊柱侧弯 /
中小学生
Key words
adolescen /
scoliosis /
primary and middle school students
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 吴春丽, 李东方, 张晓辉. 郑州市儿童青少年脊柱侧弯现状及影响因素[J]. 华南预防医学, 2021, 47(5): 673-675.
Wu CL, Li DF, Zhang XH.Status and influencing factors of scoliosis in children and adolescents in Zhengzhou City[J]. South China J Prev Med, 2021, 47(5): 673-675. (in Chinese)
[2] 叶华韵, 王正飞. 青少年特发性脊柱侧凸的流行病学研究进展[J]. 系统医学, 2022, 7(20): 192-196.
Ye HY, Wang ZF.Progress of epidemiological study on adolescent idiopathic scoliosis[J]. Syst Med, 2022, 7(20): 192-196. (in Chinese)
[3] Tung R, Uvodich M, Anderson JT, et al. Do heavier patients with adolescent idiopathic scoliosis have more preserved thoracic kyphosis and pulmonary function?[J]. Spine Deform, 2018, 6(6): 704-706.
[4] 孙艺, 刘伟佳, 熊莉华, 等. 广州市中学生脊柱侧弯现状及影响因素分析[J]. 中国学校卫生, 2021, 42(12): 1867-1870, 1873.
Sun Y, Liu WJ, Xiong LH, et al. Scoliosis and associated factors among middle school students in Guangzhou City[J]. Chin J Sch Health, 2021, 42(12): 1867-1870, 1873. (in Chinese)
[5] 李娜, 张丽霞, 李彩红, 等. 脊柱侧弯患儿术前心理状况及相关因素调查研究[J]. 心理月刊, 2021, 12(16): 8-10.
Li N, Zhang LX, Li CH, et al. Psychological status and related factors of children with scoliosis before operation[J]. Psychol M, 2021, 12(16): 8-10. (in Chinese)
[6] 陈澄, 曾碧静, 颜滨, 等. 深圳市青少年脊柱侧弯防治标准体系的构建[J]. 中国标准化, 2022(9): 110-114.
Chen C, Zeng BJ, Yan B, et al. Construction of Shenzhen's standards system of the prevention and treatment of adolescent scoliosis[J]. Chin Stand, 2022(9): 110-114. (in Chinese)
[7] 田沛茹, 任兴全. 高中生脊柱侧弯疑似症状检出率及相关因素logistic回归分析[J]. 吉林医药学院学报, 2016, 37(1): 30-33.
Tian PR, Ren XQ. Detection rate and related factors of suspected symptoms of scoliosis in high school students[J]. J J Med Univ, 2016, 37(1): 30-33. (in Chinese)
[8] Kota W, Takehiro M, Ikuho Y, et al. Physical activities and lifestyle factors related to adolescent idiopathic scoliosis[J]. J Bone Joint Surg Am, 2017, 99A(4): 284-294.
[9] Maria CCC, Julia S de C, Mariana AR, et al. Prevalence of scoliosis in public elementary school students[J]. Rev Paul Pediatr, 2017, 35(2): 191-198.
[10] 中华人民共和国国家卫生和计划生育委员会, 国家标准化管理委员会. 儿童青少年脊柱弯曲异常的筛查: GB/T 16133-2014 [S]. 北京: 中国标准出版社, 2014: 1-12.
National Health Commission of the PRC,Standardization Administration. Screening of spinal curvature abnormality of children and adolescents: GB/T 16133-2014 [S]. Beijing: Standards Press of China, 2014: 1-12. (in Chinese)
[11] 中华人民共和国国家卫生健康委办公厅, 教育部办公厅, 财政部办公厅关于开展2018年儿童青少年近视调查工作的通知[EB/OL]. (2018-10-25) [2024-03-28]. http://www.nhc.gov.cn/jkj/s5898bm/201810/08e2b45092d346a8a8c960d3e3d98b62.shtml.
[12] Zhang H, Guo C, Tang M, et al. Prevalence of scoliosis among primary and middle school students in the Chinese Mainland: A systematic review and meta-analysis[J]. Spine (Phila Pa 1976), 2015, 40(1): 41-49.
[13] 缪国忠. 中国儿童青少年脊柱侧凸筛查方法与患病率调查研究[J]. 疾病预防控制通报, 2016, 31(1): 11-14, 27.
Miao GZ. Screening method of scoliosis in children and adolescents and prevalence survey in China[J]. Bull Dis Control Prev, 2016, 31(1): 11-14, 27. (in Chinese)
[14] Sung S, Chfae HW, Lee HS, et al. Incidence and surgery rate of idiopathic scoliosis: A nationwide database study[J]. Int J Environ Res Public Health, 2021, 18(15): 8152.
[15] 王富百慧, 李雅倩, 郭晓丹, 等. 久坐时间、身体活动与青少年身体姿态异常[J]. 中国青年研究, 2021, 304(6): 5-12.
Wang FBH, Li YQ, Guo XD, et al. Sedentary time, physical activity and abnormal body posture in adolescents[J]. Chin Youth Stud, 2021, 304(6): 5-12. (in Chinese)
[16] 张亚钦, 李辉, 季成叶. 中国0至18岁正常儿童青少年身体比例生长规律的研究[J]. 中国循证儿科杂志, 2010, 5(5): 349-354.
Zhang YQ, Li H, Ji CY. Study on body proportions of 0 - 18 years old children and adolescents in China[J]. Chin J Evid Based Pediatr, 2010, 5(5): 349-354. (in Chinese)
[17] 张勇, 赵黎, 王瑞, 等. 坐高与站高的比率和青少年特发性脊柱侧弯关系的分析[J]. 中华小儿外科杂志, 2006, 27(11): 581-584.
Zhang Y, Zhao L, Wang R, et al. Correlation of sitting height to standing height ratio with Cobb's angle in children with idiopathic scoliosis: A mathematical analysis in the cases with single curve[J]. Chin J Pediatr Surg, 2006, 27(11): 581-584. (in Chinese)
[18] Prssinen O, Kauppinen M. Risk factors for high myopia:A 22-year follow-up study from childhood to adulthood[J]. Acta Ophthalmol, 2019, 97(5): 510-518.
[19] 安娜, 卢网珍, 钟恩德, 等. 南通市儿童青少年近视现状调查[J]. 中国校医, 2021, 35(1): 封二-封三, 26.
An N, Lu WZ, Zhong ED, et al. Investigation of current status of myopia in adolescents in Nantong City[J]. Chin J School Doctor, 2021, 35(1): cover2-cover3, 26. (in Chinese)
[20] Cai Z, Wu R, Zheng S, et al. Morphology and epidemiological study of idiopathic scoliosis among primary school students in Chaozhou, China[J]. Environ Health Prev Med, 2021, 26: 71.
[21] 武俸羽, 李丽, 刘宇飞. 体育锻炼对青少年脊柱侧弯的预防与纠正思路探索[J]. 佳木斯职业学院学报, 2022, 38(5): 49-51.
Wu FY, Li L, Liu YF. Exploration on the prevention and correction of adolescent scoliosis through physical exercise[J]. J J Vocat Inst, 2022, 38(5): 49-51. (in Chinese)
[22] 胡永欣. 功能性锻炼对青少年身体姿势异常的预防作用[J]. 广东第二师范学院学报, 2017, 37(6): 103-107.
Hu YX. Preventive effect of functional exercise on abnormal body posture in adolescents[J]. J G Univ Educ, 2017, 37(6): 103-107. (in Chinese)
[23] Stefano N, Sabrina D, Alessandra N, et al. Specific exercises reduce the need for bracing in adolescents with idiopathic scoliosis: A practical clinical trial[J]. Ann Phys Rehabil Med, 2019, 62(2): 69-76.
[24] Ceballos LL, Tejedor CC, Mingo GT, et al. Effects of corrective, therapeutic exercise techniques on adolescent idiopathic scoliosis. A systematic review[J]. Arch Argent Pediatr, 2018, 116(4): e582-e589.
[25] Vitale JA, Negrini F, Rebagliati G, et al. Actigraphy-based sleep parameters and rest-activity circadian rhythm in a young scoliotic patient treated with rigid bracing: A case study[J]. Yale J Biol Med, 2019, 92(2): 205-212.
[26] 陈斯, 史仍飞, 马文领. 慢性睡眠剥夺对大鼠骨骼肌质量和运动能力的影响[J]. 中国运动医学杂志, 2015, 34(3): 242-246.
Chen S, Shi RF, Ma WL. The effect of chronic sleep deprivation on skeletal muscle mass and exercise capacity of rats[J]. Chin J Sports Med, 2015, 34(3): 242-246. (in Chinese)
[27] 朱佳琳, 曹书勤, 杜星海. 芎归活血通痹汤联合针刀治疗瘀血型腰肌劳损38例[J]. 中国中医药科技, 2023, 30(3): 561-563.
Zhu JL, Cao SQ, Du XH. Treatment of 38 cases of lumbar muscle strain of blood stasis type with Xionggui Huoxue Tongbi decoction combined with needle knife[J]. Chin J Tradit Med Sci & Tech, 2023, 30(3): 561-563. (in Chinese)
[28] Li H, Liang C, Shen C, et al. Decreased sleep duration:A risk of progression of degenerative lumbar scoliosis[J]. Med Hypotheses, 2012, 78(2): 244-246.
基金
南通市卫生健康委科研课题项目(MS2022088)
PDF(977 KB)
