Investigation of children's scoliosis and analysis of related factors in Qinghai Province
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摘要:
目的 研究青海省多地5~18岁儿童脊柱侧弯发生情况,为疾病防治提供理论参考。 方法 于2020年10月—2021年2月在青海省西宁市、海东市各简单随机抽样3个区,应用分层整群抽样法在各区抽取2所小学(部分含学前班)、2所初中,每个年级抽取1~2个班,共抽取24所学校,3 582名符合要求的儿童作为研究对象,进行脊柱侧弯筛查和问卷调查。采用SPSS 25.0统计学软件进行数据分析,对影响因素进行总结。 结果 脊柱侧弯筛查阳性率为5.6%(201/3 582),其中≥10岁为9.2%(143/1 549),<10岁为2.9%(58/2 033)。单因素分析显示年龄、户口、家庭年收入、父母学历、父母职业、出生季节及胎次等差异有统计学意义(均P<0.05)。多因素非条件logistic回归模型显示,年龄、体重增长,父亲职业(对比农民)为牧民,母亲职业(对比农民)为牧民、个体户、自由职业为危险因素;而身高、BMI增大,二胎及以上,秋季出生,城镇户口,母亲高学历为保护因素。 结论 青海省儿童因父母职业的特殊性(牧民)、文化程度和家庭收入较低及农村户口,更易患脊柱侧弯。青春期发生率较高,临床应了解危险因素,及时发现脊柱畸形,制定有效措施培养健康用脊习惯,积极预防侧弯的发生和进展。 Abstract:Objective To explore and study the incidence of scoliosis in children aged 5-18 years in Qinghai Province, provide a theoretical reference for the prevention of scoliosis. Methods From October 2020 to February 2021, three districts were selected from Xining City and Haidong City, Qinghai Province, by simple random sampling and two primary schools (partially including preschool classes) and two junior high schools were selected from each district by using stratified cluster sampling. Classes (1-2) were selected for each grade and a total of 12 schools and 3 582 children were selected as the research objects. Scoliosis screening and questionnaire surveys were performed. SPSS 25.0 statistical software was used to process and analyse the collected data and the related factors affecting scoliosis were summarised. Results The positive rate of screening for abnormal spine curvature was 5.6% (201/3 582). Amongst them, the positive rate of children over 10 years was 9.2% (143/1 549) and the positive rate of children less than 10 years was 2.9% (58/2 033). Univariate analysis showed that adolescence, rural household registration, low annual family income, low parents' educational level, parents' occupations as herders, birth season and parity may be factors influencing the onset of scoliosis (all P < 0.05). Multivariate unconditional logistics regression model showed that age growth, weight gain, father's occupation as herder (compared with farmer), mother's occupation as herder (compared with farmer), wholly-owned retail shops and odd jobs were risk factors for scoliosis. Meanwhile, height increase, increased BMI, second child and above, born in autumn, urban household registration and mother's high education were protective factors for the onset of scoliosis (all P < 0.05). Conclusion The children in Qinghai are more susceptible to scoliosis due to their parents' occupational characteristics (herders), education level, lower family income and rural household registration. The incidence of scoliosis in adolescents is relatively higher. Spinal deformities must be detected in clinic in time, risk factors must be explored, effective measures to cultivate good habits must be formulated to promote spine health, and the occurrence and progression of scoliosis must be actively prevented. -
Key words:
- Scoliosis /
- Screening /
- Influencing factors /
- Socioeconomic status
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表 1 3 582例儿童人口学特征
Table 1. Demographic characteristics of 3 582 children
项目 类别 例数 ATR<5°(n=3 381) ATR≥5°(n=201) 统计量 P值 性别[例(%)] 男 1 845 1 748(94.7) 97(5.3) 0.900d 0.343 女 1 737 1 633(94.0) 104(6.0) 年龄[例(%)] ≥10岁 1 549 1 406(90.8) 143(9.2) 67.539d <0.001 <10岁 2 033 1 975(97.1) 58(2.9) 身高(x±s,cm) 3 582 133.68±16.98 132.46±15.03 0.976e 0.329 体重(x±s,kg) 3 582 30.46±10.46 33.03±9.17 -3.401e 0.001 BMI(x±s) 3 582 16.81±4.10 18.82±3.52 -6.686e <0.001 异常产[例(%)] 否 3 574 3 373(94.4) 201(5.6) 0.477d 0.490 是 8 8(100.0) 0 早产[例(%)] 否 3 474 3 277(94.3) 197(5.7) 0.765d 0.382 是 108 104(96.3) 4(3.7) 出生体重a[例(%)] 正常体重儿 3 244 3 055(94.2) 189(5.8) 4.771d 0.092 低体重儿 6 6(100.0) 0 巨大儿 329 319(97.0) 10(3.0) 胎次b[例(%)] 第一胎 1 059 1 024(96.7) 35(3.3) 15.264d <0.001 第二胎及以上 2 521 2 355(93.4) 166(6.6) 出生季节[例(%)] 春 892 828(92.8) 64(7.2) 19.454d <0.001 夏 855 799(93.5) 56(6.5) 秋 990 961(97.1) 29(2.9) 冬 845 793(93.8) 52(6.2) 户口c[例(%)] 农村 2 967 2 768(93.3) 199(6.7) 39.103d <0.001 城镇 614 612(99.7) 2(0.3) 父亲学历[例(%)] 小学及以下 1 052 872(82.9) 180(17.1) -16.449f <0.001 初中 1 563 1 547(99.0) 16(1.0) 高中 524 521(99.4) 3(0.6) 大学及以上 443 441(99.5) 2(0.5) 母亲学历[例(%)] 小学及以下 1 028 850(82.7) 178(17.3) -16.462f <0.001 初中 1 609 1 591(98.9) 18(1.1) 高中 513 510(99.4) 3(0.6) 大学及以上 432 430(99.5) 2(0.5) 父亲职业c[例(%)] 农民 1 527 1 516(99.3) 11(0.7) 1 646.140d <0.001 牧民 223 76(34.1) 147(65.9) 个体户 476 465(97.7) 11(2.3) 企事业单位 366 365(99.7) 1(0.3) 自由职业 610 586(96.1) 24(3.9) 其他 295 293(99.3) 2(0.7) 无业 84 79(94.0) 5(6.0) 母亲职业c[例(%)] 农民 1 600 1 585(99.1) 15(0.9) 1 646.499d <0.001 牧民 206 65(31.6) 141(68.4) 个体户 354 342(96.6) 12(3.4) 企事业单位 309 308(99.7) 1(0.3) 自由职业 531 506(95.3) 25(4.7) 其他 259 258(99.6) 1(0.4) 无业 322 316(98.1) 6(1.9) 家庭年收入c[例(%)] <3万元 957 850(88.8) 107(11.2) -8.536f <0.001 3万元~8万元 2 020 1 938(95.9) 82(4.1) 8万元~15万元 509 497(97.6) 12(2.4) ≥15万元 95 95(100.0) 0 注:a数据缺失3例,b数据缺失2例,c数据缺失1例。d为χ2值,e为t值,f为Z值。 表 2 青海省儿童发生脊柱侧弯影响因素的多因素分析
Table 2. Multivariate analysis of influencing factors of scoliosis in children in Qinghai province
变量 B SE Wald χ2 P值 OR(95% CI) 年龄(岁) 0.376 0.054 47.983 <0.001 1.456(1.309~1.620) 身高(cm) -0.129 0.033 15.443 <0.001 0.879(0.824~0.937) 体重(kg) 0.182 0.059 9.576 0.002 1.200(1.069~1.346) BMI -0.267 0.101 6.984 0.008 0.766(0.628~0.933) 胎次(第二胎及以上)a -0.616 0.306 4.043 0.044 0.540(0.296~0.985) 出生季节(秋)b -0.706 0.355 3.945 0.047 0.246(0.194~0.991) 户口(城镇)c -1.608 0.791 4.133 0.042 0.200(0.042~0.944) 母亲学历(小学及以下)d -0.757 0.270 7.832 0.005 0.469(0.276~0.797) 父亲职业(牧民)e 2.948 0.607 23.611 <0.001 19.072(5.807~62.638) 母亲职业(牧民)e 2.707 0.580 21.785 <0.001 14.985(4.808~46.705) 母亲职业(个体户)e 2.331 0.761 9.390 0.002 10.289(2.317~45.696) 母亲职业(自由职业)e 2.216 0.628 12.446 <0.001 9.169(2.677~31.405) 注:a参照项为“第一胎”;b参照项为“春”;c参照项为“农村”;d参照项为“小学及以下”;e参照项为“农民”。 -
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