河南地区7~15岁中小学生脊柱侧弯流行特征及影响因素调查

doi:10.12183/j.scjpm.2023.1239

摘要/Abstract

摘要： 目的调查河南地区7~15岁中小学生脊柱侧弯流行特征及其影响因素,为该地区相关部门制定中小学生脊柱侧弯防治策略提供重要参考依据。方法使用分层整群抽样方法抽取河南省14个地级市中小学校年龄在7~15岁的中小学生为研究对象,对其开展脊柱侧弯的筛查并进行调查问卷,采用单、多因素分析方法分析中小学生发生脊柱侧弯的影响因素。结果共调查27 926名中小学生,男生14 784人,女生13 142人,共检出脊柱侧弯1 067例,检出率为3.82%。二分类logistic回归分析结果显示女生（OR=1.853）、年龄10~12及13~15岁（OR=1.808、2.136）、父母有脊柱侧弯史（OR=1.536）、营养不良（OR=1.413）、背单肩包（OR=1.806）、书包负担较重或很重（OR=1.390）、每日体育锻炼<1 h（OR=1.868）、每日静坐时长≥10 h（OR=1.608）及体育锻炼以单侧力量为主（OR=1.670）是中小学生脊柱侧弯的危险因素。结论河南地区7~15岁中小学生脊柱侧弯检出率偏高,教育及卫生部门应加以重视,定期进行脊柱侧弯筛查,并加强脊柱侧弯相关健康知识教育。

关键词: 学生, 脊柱侧弯, 流行病学, 影响因素

Abstract: Objective To investigate the epidemiological characteristics and influencing factors of scoliosis among primary and secondary school students aged 7-15 years in Henan Province, aiming to provide a valuable reference for regional authorities in formulating effective strategies for scoliosis prevention and control among this specific population. Methods The stratified cluster sampling method was used to select primary and secondary school students aged 7-15 years in Henan Province for this study. The scoliosis screening was carried out and the questionnaire was filled out. The univariate and multivariate analysis methods were used to analyze the influencing factors of scoliosis among primary and secondary school students. Results A total of 27 926 primary and secondary school students were surveyed, comprising 14 784 boys and 13 142 girls. A total of 1 067 cases of scoliosis were identified, resulting in a detection rate of 3.82%. Binary logistic regression analysis showed that girls （OR=1.853）, aged 10-12 years （OR=1.808） and 13-15 years （OR=2.136）, parents with a history of scoliosis （OR=1.536）, dystrophy （OR=1.413）, back single shoulder bag （OR= 1.806）, heavy or very heavy bag burden （OR=1.390）, daily physical exercise < 1 hour （OR=1.868）, daily sitting time≥10 hours （OR=1.608）, and physical exercise mainly unilateral strength （OR=1.670） were risk factors for scoliosis among primary and secondary school students. Conclusions The prevalence of scoliosis among primary and secondary school students aged 7-15 years in Henan Province is significantly high. It is imperative for education and health authorities to prioritize this issue by conducting regular scoliosis screenings and enhancing the dissemination of comprehensive knowledge on scoliosis-related health aspects.

Key words: Students, Scoliosis, Epidemiology, Influencing factor

中图分类号:

R179

张玮, 刘锋伟, 王俊辉, 罗丽, 马丹丹, 王鹏亮, 程明高, 牛东林. 河南地区7~15岁中小学生脊柱侧弯流行特征及影响因素调查[J]. 华南预防医学, 2023, 49(10): 1239-1242.

ZHANG Wei, LIU Fengwei, WANG Junhui, LUO Li, MA Dandan, WANG Pengliang, CHENG Minggao, NIU Donglin. Epidemiological characteristics and influencing factors of scoliosis among primary and secondary school students aged 7-15 years in Henan Province[J]. South China Journal of Preventive Medicine, 2023, 49(10): 1239-1242.

参考文献

[1] Labrom FR,Izatt MT,Claus AP,et al.Adolescent idiopathic scoliosis 3D vertebral morphology,progression and nomenclature:A current concepts review[J].Eur Spine J,2021,30(7):1823-1834.
[2] 徐帅,苏永佳,王振波,等.中国大陆中小学生脊柱侧凸的患病特点:关于72项研究的meta分析[J].中国脊柱脊髓杂志,2021,31(10):901-910.
[3] 农工党中央.关于尽快开展儿童青少年脊柱侧弯防控工作的提案[J].前进论坛,2020,27(7):60.
[4] Dantas MGB,Aquino AN,Correia HJ,et al.Prevalence of back pain and idiopathic scoliosis in adolescents from the semiarid region of Brazil:A cross-sectional study[J]. J Chiropr Med,2021,20(3):97-107.
[5] Hudec J,Prokopová T,Kosinová M,et al.Anesthesia and perioperative management for surgical correction of neuromuscular scoliosis in children:A narrative review[J].J Clin Med,2023,12(11):3651.
[6] Campbell M,Matsumoto H,St Hilaire T,et al.Burden of care in families of patients with early onset scoliosis[J].J Pediatr Orthop B,2020,29(6):567-571.
[7] 刘沛昕,江鸿,孙军辉,等.珠海市青少年特发性脊柱侧弯现况及相关因素分析[J].华南预防医学,2022,48(11):1370-1373.
[8] 中华医学会骨科学分会脊柱外科学组.中国青少年脊柱侧凸筛查临床实践指南及路径指引[J].中华骨科杂志,2020,40(23):1574-1582.
[9] 张书豪,李富丽,刘梦迪,等.儿童青少年脊柱侧凸筛查与保守治疗的研究进展[J].中国学校卫生,2022,43(9):1423-1427.
[10] 胡希鉴,赵斌,柴火,等.体表形态度量在脊柱弯曲异常中的应用[J].中国组织工程研究,2023,27(9):1462-1468.
[11] Płaszewski M,Grantham W, Jespersen E.Screening for scoliosis-new recommendations,old dilemmas,no straight solutions[J].World J Orthop,2020,11(9):364-379.
[12] 国家卫生和计划生育委员会.学龄儿童青少年营养不良筛查 WS/T 456—2014[S].北京:中国标准出版社, 2014.
[13] 国家卫生和计划生育委员会.学龄儿童青少年超重与肥胖筛查 WS/T 586—2018[S].北京:中国标准出版社, 2018.
[14] Senkoylu A, Riise R, Acaroglu E, et al.Diverse approaches to scoliosis in young children[J].Efort Open Rev,2020,5(10):753-762.
[15] Li XK,Wu ZG,Wang HQ.Adolescent idiopathic scoliosis in China:An ongoing warm debate from bedside to public[J].Spine,2016,41(5):369-370.
[16] 郭海滨,黄蛟灵,金红芳,等.青海省儿童脊柱侧弯发病筛查及相关因素分析[J].中华全科医学,2022,20(8):1273-1276,1282.
[17] 张献伟,孙志颖,刘忠慧,等.天津市中学生脊柱侧弯流行特征及影响因素分析[J].中国学校卫生,2023,44(1):115-118.
[18] Gashaw M,Janakiraman B,Belay GJ.Idiopathic scoliosis and associated factors among school children:A school-based screening in Ethiopia[J].Arch Public Health,2021,79(1):107.
[19] 施冬冬,陈前芬.青少年特发性脊柱侧凸病因学的研究进展[J].中国学校卫生,2021,42(2):316-320.
[20] 廖粤生,白莉莉.青少年特发性脊柱侧弯发病机制及运动干预研究进展[J].中国学校卫生,2022,43(9):1436-1440.
[21] Miyagi M,Saito W,Imura T, et al.Body composition in Japanese girls with adolescent idiopathic scoliosis[J].Spine Surg Relat Res,2020,5(2):68-74.
[22] Scaturro D,Balbo A,Vitagliani F,et,al.Is There a relationship between idiopathic scoliosis and body mass?A scoping review[J]. Nutrients,2022,14(19):4011.
[23] 李梦,曲亚斌,孙艺,等.广东省中小学生脊柱侧凸流行特征及影响因素分析[J].中国学校卫生,2022,43(2):292-295.
[24] 李凯洋,郭建军,荣湘江,等.青少年特发性脊柱侧弯可控的危险因素分析[J].中国预防医学杂志,2023,24(1):73-76.
[25] 国家卫生健康委员会.中小学生书包卫生要求:WS/T 585—2018[S].北京:中国标准出版社, 2018.
[26] 杨田,张秀红,高昇,等.内蒙古自治区中学生脊柱弯曲异常现状及影响因素分析[J].中国学校卫生,2023,44(3):447-450.
[27] Bull FC,Al-Ansari SS,Biddle S,et al.World Health Organization 2020 guidelines on physical activity and sedentary behaviour[J].Br J Sports Med,2020,(24):1451-1462.