目的 了解四川省成都市6~12岁儿童特发性脊柱侧弯(AIS)、身高增长、视力发育和肺活量现状,探讨其在儿童AIS发生中的意义。方法 2019年对成都市青羊区5所小学各年级儿童进行AIS筛查,筛查方法包括目测体检、前屈试验和脊柱测量尺测量。同时,监测青少年裸眼视力水平和肺活量,并对其近1~3年身高变化、每日学习和运动时长进行问卷调查。根据筛查结果和年龄段进行分组,分析各组指标差异性及相关性。结果 963名儿童中,共928名同意进行AIS筛查,其中Adams试验阳性63例(6.79%),男女患病比例1∶6。AIS阳性23例(2.48%),与AIS阴性组儿童相比,AIS阳性组儿童肺活量降低,每日运动时间减少,差异有统计学意义(t＝-2.088、-2.104,P<0.05);两组儿童根据年龄段分为6~7岁、8~9岁和10~12岁3个亚组,与AIS阴性组相比,阳性组6~7岁儿童近3年以及8~9岁儿童近1年和近2年身高增长缓慢,10~12岁儿童运动时间降低,差异均有统计学意义(t＝0.691、4.176、4.246、5.788,P<0.05)。相关性分析结果显示,AIS阳性组儿童近1~3年身高增长两两正相关(近1~2年,近1~3年,近2~3年,r＝0.920、0.830、0.813,P<0.001),且与每日运动时长呈负相关(r＝-0.521、-0.533、-0.536,P<0.05),肺活量与年龄呈正相关(r＝0.512,P<0.05);AIS阴性组儿童近1~3年身高增长两两正相关(近1~2年,近1~3年,近2~3年,r＝0.827、0.765、0.855,P<0.001),与年龄呈负相关(r＝-0.109、-0.112、-0.086,P<0.05),肺活量与年龄和运动时间呈正相关(r＝0.595、0.148,P<0.001)。结论 AIS发生和进展与运动时长呈负相关。延长运动时间,增强运动能力和肺活量,可降低儿童AIS发生率。
Abstract
Objective To investigate the current status of adolescent idiopathic scoliosis (AIS), height growth, visual development and spirometry in children aged 6 - 12 years in Chengdu, Sichuan Province, and to explore the significance of these indicators in the development of AIS in children.Methods Children in all grades of five elementary schools in Chengdu were screened for AIS in 2019. The screening methods included visual physical examination, anterior flexion test and spine measuring tape measurement. Meanwhile, adolescents' bare eye visual acuity levels and spirometry were measured, and questionnaires were administered on their height changes, daily study and exercise hours over the past 1 to 3 years. Then children were grouped according to the screening results, and were divided into different subgroups according to their age. The differences and correlations of the indicators in each group were analyzed.Results Among the 963 children, a total of 928 agreed to undergo AIS screening, including 63(6.79%)positive Adams tests(male-to-female prevalence ratio 1∶6). And 23(2.48%) cases were positive for AIS. Compared with children in the AIS-negative group, children in the AIS-positive group had significantly lower spirometry and reduced daily exercise time (t=2.088, 2.104, P<0.05). Children were divided into three subgroups according to their age groups:6-7 years old, 8-9 years old, and 10 - 12 years old. Compared with the AIS-negative group, slower increase of stature was found in children of positive group aged 6 to 7 years over the last 3 years and children aged 8 to 9 years over the last 1 and 2 years, and reduced exercise time in children aged 10 to 12 years(t=0.691, 4.176, 4.246, 5.788, P<0.05). Pearson correlation analysis showed that positive correlations existed in the increase of stature over the past 1, 2 and 3 years for children in the AIS positive group (r=0.920, 0.830, 0.813, P<0.001), and the increase of stature was negatively related to everyday exercise time(r=-0.521, -0.533, -0.536, P<0.05).And a positive correlation between spirometry and age was also found in children in the AIS positive group (r=0.512, P<0.05). For children in the AIS negative group, positive correlations existed in the increase of stature over the past 1, 2 and 3 years for children in the AIS positive group (r=0.827, 0.765, 0.855, P< 0.001), the increase of stature was negatively related to age(r=-0.109, -0.112, -0.086, P<0.05), and spirometry was related to age and exercise time(r=0.595, 0.148, P<0.001).Conclusions The development and progression of AIS is negatively correlated withexercise duration. Prolonging the exercise duration, enhancing exercise capacity and lung capacity may reduce the incidence of AIS in children.
关键词
特发性脊柱侧弯 /
裸眼视力 /
肺活量 /
学习时长 /
运动时长
Key words
idiopathic scoliosis /
uncorrected visual acuity level /
lung capacity /
study time /
exercise duration
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基金
成都市青羊区科经局重点项目(2018JHYY13286)
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