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青海省儿童脊柱侧弯发病筛查及相关因素分析

郭海滨 黄蛟灵 金红芳 周璇 陈楠 李欣 杨宇琪 杜青

郭海滨, 黄蛟灵, 金红芳, 周璇, 陈楠, 李欣, 杨宇琪, 杜青. 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. doi: 10.16766/j.cnki.issn.1674-4152.002575
引用本文: 郭海滨, 黄蛟灵, 金红芳, 周璇, 陈楠, 李欣, 杨宇琪, 杜青. 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. doi: 10.16766/j.cnki.issn.1674-4152.002575
GUO Hai-bin, HUANG Jiao-ling, JIN Hong-fang, ZHOU Xuan, CHEN Nan, LI Xin, YANG Yu-qi, DU Qing. Investigation of children's scoliosis and analysis of related factors in Qinghai Province[J]. Chinese Journal of General Practice, 2022, 20(8): 1273-1276. doi: 10.16766/j.cnki.issn.1674-4152.002575
Citation: GUO Hai-bin, HUANG Jiao-ling, JIN Hong-fang, ZHOU Xuan, CHEN Nan, LI Xin, YANG Yu-qi, DU Qing. Investigation of children's scoliosis and analysis of related factors in Qinghai Province[J]. Chinese Journal of General Practice, 2022, 20(8): 1273-1276. doi: 10.16766/j.cnki.issn.1674-4152.002575

青海省儿童脊柱侧弯发病筛查及相关因素分析

doi: 10.16766/j.cnki.issn.1674-4152.002575
基金项目: 

国家自然科学基金面上项目 81972030

上海市卫生健康委员会卫生行业临床研究专项 202040292

上海市卫生健康委先进适宜技术推广项目 2019SY021

上海市崇明区科学技术委员会项目 CKY2021-50

上海申康医院发展中心临床三年行动计划 SHDC2020CR3041B

详细信息
    通讯作者:

    杜青, E-mail: duqing@xinhuamed.com.cn

  • 中图分类号: R681.5  R195.4

Investigation of children's scoliosis and analysis of related factors in Qinghai Province

  • 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。

     

  • 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
    性别[例(%)] 1 845 1 748(94.7) 97(5.3) 0.900d 0.343
    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(%)] 3 574 3 373(94.4) 201(5.6) 0.477d 0.490
    8 8(100.0) 0
    早产[例(%)] 3 474 3 277(94.3) 197(5.7) 0.765d 0.382
    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(%)] 892 828(92.8) 64(7.2) 19.454d <0.001
    855 799(93.5) 56(6.5)
    990 961(97.1) 29(2.9)
    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,et值,fZ值。
    下载: 导出CSV

    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 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”。
    下载: 导出CSV
  • [1] NEGRINI S, DONZELLI S, AULISA A G, et al. 2016 SOSORT guidelines: Orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth[J]. Scoliosis Spinal Disord, 2018, 13(1): 3. doi: 10.1186/s13013-017-0145-8
    [2] YILMAZ H, ZATERI C, KUSVURAN OZKAN A, et al. Prevalence of adolescent idiopathic scoliosis in Turkey: An epidemiological study[J]. Spine J, 2020, 20(6): 947-955. doi: 10.1016/j.spinee.2020.01.008
    [3] ADAMCZEWSKA K, WIERNICKA M, MALCHROWICZ-MOŚKO E, et al. The angle of trunk rotation in school children: A study from an idiopathic scoliosis screening. Prevalence and optimal age screening value[J]. Int J Environ Res Public Health, 2019, 16(18): 3426. doi: 10.3390/ijerph16183426
    [4] 龙凤, 魏海亮, 梁宇霆, 等. 2015年海淀区青少年脊柱侧弯发生率及其危险因素分析[J]. 中国公共卫生, 2020, 36(10): 1496-1498. doi: 10.11847/zgggws1124441

    LONG F, WEI H L, LIANG Y T, et al. Prevalence and risk factors of scoliosis among senior high school graduates in Haidian district of Beijing, 2015[J]. Chinese Journal of Public Health, 2020, 36(10): 1496-1498. doi: 10.11847/zgggws1124441
    [5] 唐倩如, 祝明利, 商毅, 等. 上海市原静安区在校初中生青少年特发性脊柱侧弯患病率的调查[J]. 国际骨科学杂志, 2017, 38(3): 205-206. doi: 10.3969/j.issn.1673-7083.2017.03.015

    TANG Q R, ZHU M L, SHANG Y, et al. A survey on the prevalence of idiopathic scoliosis among junior high school students in the former Jing' an District of Shanghai[J]. International Journal of Orthopaedics, 2017, 38(3): 205-206. doi: 10.3969/j.issn.1673-7083.2017.03.015
    [6] ZHANG H Q, GUO C F, TANG M X, et al. Prevalence of scoliosis among primary and middle school students in Mainland China: A systematic review and meta-analysis[J]. Spine(Phila Pa 1976), 2015, 40(1): 41-49. doi: 10.1097/BRS.0000000000000664
    [7] DU Q, ZHOU X, NEGRINI S, et al. Scoliosis epidemiology is not similar all over the world: A study from a scoliosis school screening on Chongming Island (China)[J]. BMC Musculoskelet Disord, 2016, 17: 303. doi: 10.1186/s12891-016-1140-6
    [8] THÉROUX J, LE MAY S, HEBERT J J, et al. Back pain prevalence is associated with curve-type and severity in adolescents with idiopathic scoliosis: A cross-sectional study[J]. Spine(Phila Pa 1976), 2017, 42(15): E914-E919. doi: 10.1097/BRS.0000000000001986
    [9] 陈梦婕, 罗义, 马琪超, 等. 青少年特发性脊柱侧弯的冠状位平衡与足底压力的相关性[J]. 中华全科医学, 2020, 18(4): 542-546. doi: 10.16766/j.cnki.issn.1674-4152.001293

    CHEN M J, LUO Y, MA Q C, et al. Correlation between coronal balance and static plantar pressure in children with adolescent idiopathic scoliosis[J]. Chinese Journal of General Practice, 2020, 18(4): 542-546. doi: 10.16766/j.cnki.issn.1674-4152.001293
    [10] 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. https://www.cnki.com.cn/Article/CJFDTOTAL-QJLT202007043.htm

    Chinese Peasants and Workers Democratic Party. Proposal for the prevention and control of scoliosis in children and adolescents as soon as possible[J]. Forward Forum, 2020, 27(7): 60. https://www.cnki.com.cn/Article/CJFDTOTAL-QJLT202007043.htm
    [11] ADAMCZEWSKA K, WIERNICKA M, KAMIÑSKA E, et al. Annual observation of changes in the angle of trunk rotation. Trunk asymmetry predictors. A study from a scoliosis screening in school adolescents[J]. Int J Environ Res Public Health, 2020, 17(6): 1899. doi: 10.3390/ijerph17061899
    [12] 姚泉丞, 蓝常贡. 青少年特发性脊柱侧弯易感性与相关基因多态性研究进展[J]. 中华实用诊断与治疗杂志, 2020, 34(8): 855-857. doi: 10.13507/j.issn.1674-3474.2020.08.026

    YAO Q C, LAN C G. Adavances in adolescent idiopathic scoliosis susceptibility and related gene polymorphisms[J]. Journal of Chinese Practical Diagnosis and Therapy, 2020, 34(8): 855-857. doi: 10.13507/j.issn.1674-3474.2020.08.026
    [13] OETGEN M E, HEYER J H, KELLY S M. Scoliosis screening[J]. J Am Acad Orthop Surg, 2021, 29(9): 370-379. doi: 10.5435/JAAOS-D-20-00356
    [14] KUZNIA A L, HERNANDEZ A K, LEE L U. Adolescent idiopathic scoliosis: Common questions and answers[J]. Am Fam Physician, 2020, 101(1): 19-23.
    [15] COELHO D M, BONAGAMBA G H, OLIVEIRA A S. Scoliometer measurements of patients with idiopathic scoliosis[J]. Braz J Phys Ther, 2013, 17(2): 179-184. doi: 10.1590/S1413-35552012005000081
    [16] SUDO H, KOKABU T, ABE Y, et al. Automated noninvasive detection of idiopathic scoliosis in children and adolescents: A principle validation study[J]. Sci Rep, 2018, 8(1): 17714. doi: 10.1038/s41598-018-36360-w
    [17] TARRANT R C, QUEALLY J M, MOORE D P, et al. Prevalence and impact of low body mass index on outcomes in patients with adolescent idiopathic scoliosis: A systematic review[J]. Eur J Clin Nutr, 2018, 72(11): 1463-1484. doi: 10.1038/s41430-018-0095-0
    [18] GOODBODY C M, ASZTALOS I B, SANKAR W N, et al. It' s not just the big kids: Both high and low BMI impact bracing success for adolescent idiopathic scoliosis[J]. J Child Orthop, 2016, 10(5): 395-404. doi: 10.1007/s11832-016-0763-3
    [19] NEGRINI S, DONZELLI S, LUSINI M, et al. The effectiveness of combined bracing and exercise in adolescent idiopathic scoliosis based on SRS and SOSORT criteria: A prospective study[J]. BMC Musculoskelet Disord, 2014, 15: 263. doi: 10.1186/1471-2474-15-263
    [20] KAROL L A, WINGFIELD J J, VIROSTEK D, et al. The influence of body habitus on documented brace wear and progression in adolescents with idiopathic scoliosis[J]. J Pediatr Orthop, 2020, 40(3): e171-e175. doi: 10.1097/BPO.0000000000001420
    [21] MARGALIT A, MCKEAN G, CONSTANTINE A, et al. Body mass hides the curve: Thoracic scoliometer readings vary by body mass index value[J]. J Pediatr Orthop, 2017, 37(4): e255-e260. doi: 10.1097/BPO.0000000000000899
    [22] GILBERT S R, SAVAGE A J, WHITESELL R, et al. BMI and magnitude of scoliosis at presentation to a specialty clinic[J]. Pediatrics, 2015, 135(6): e1417-e1424. doi: 10.1542/peds.2014-2000
    [23] 胡乾. 规模经济视角下中国城乡收入差距原因分析[J]. 贵州师范大学学报(社会科学版), 2021, 46(3): 34-44. https://www.cnki.com.cn/Article/CJFDTOTAL-GZSF202103004.htm

    HU Q. Analysis of the causes of China's urban-rural income gap between areas in China from the perspective of scale economy[J]. Journal of Guizhou Normal University(Social Sciences), 2021, 46(3): 34-44. https://www.cnki.com.cn/Article/CJFDTOTAL-GZSF202103004.htm
    [24] 梅红, 王璇, 司如雨. 西部农村家庭父母教育卷入现状及成效: 基于陕西省宁强县4 643份数据的实证研究[J]. 西北农林科技大学学报(社会科学版), 2019, 19(2): 65-73. https://www.cnki.com.cn/Article/CJFDTOTAL-NLXS201902009.htm

    MEI H, WANG X, SI R Y. Status and effect of parents' education involvement in in western rural families: Empirical research based on Ningqiang County (2017) data of Shaanxi Province[J]. Journal of Northwest A & F University(Social Science Edition), 2019, 19(2): 65-73. https://www.cnki.com.cn/Article/CJFDTOTAL-NLXS201902009.htm
    [25] 周祖辉, 吴卫军, 徐艳萍, 等. 基于家庭因素视角下的学生体质健康研究[J]. 体育科技文献通报, 2018, 26(9): 18-19, 88. https://www.cnki.com.cn/Article/CJFDTOTAL-SPOR201809008.htm

    ZHOU Z H, WU W J, XU Y P, et al. Students' fitness reseach from family factors[J]. Bulletin of Sport Science & Technology, 2018, 26(9): 18-19, 88. https://www.cnki.com.cn/Article/CJFDTOTAL-SPOR201809008.htm
    [26] 罗巧, 向丹, 殷佳. 广安市青少年健康素养现状及其影响因素分析[J]. 社会与公益, 2020, 11(11): 58-62. https://www.cnki.com.cn/Article/CJFDTOTAL-SHGI202011020.htm

    LUO Q, XIANG D, YIN J. Status and influencing factors of adolescent health literacy in Guang' an City[J]. Society and Public Welfare, 2020, 11(11): 58-62. https://www.cnki.com.cn/Article/CJFDTOTAL-SHGI202011020.htm
    [27] 邹艳, 章荣华, 陈丽艳, 等. 中小学生躯干旋转角异常的影响因素研究[J]. 预防医学, 2021, 33(5): 462-467. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202105008.htm

    ZOU Y, ZHANG R H, CHEN L Y, et al. Influencing factors for abnormal of the angle of trunk rotation in primary and secondary school students[J]. Preventive Medicine, 2021, 33(5): 462-467. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202105008.htm
    [28] 任丽慧. 扎实推进民族团结和边疆稳固视角下的内蒙古牧区公共服务供给研究[J]. 内蒙古统战理论研究, 2020(6): 38-42. https://www.cnki.com.cn/Article/CJFDTOTAL-LMTZ202006011.htm

    REN L H. Research on the supply of public services in pastoral areas of Nei Mongol from the perspective of solidly promoting national unity and frontier stability[J]. Research on United Front Theory of Nei Mongol, 2020(6): 38-42. https://www.cnki.com.cn/Article/CJFDTOTAL-LMTZ202006011.htm
    [29] GINÉS-DÍAZ A, MARTINEZ-ROMERO M T, CEJUDO A, et al. Sagittal spinal morphotype assessment in dressage and show jumping riders[J]. J Sport Rehabil, 2019, 29(5): 1-23.
    [30] SCHROTER C, SCHULTE-SUTUM A, ZECKEY C, et al. Accidents in equestrian sports: Analysis of injury mechanisms and patterns[J]. Unfallchirurg, 2017, 120(2): 129-138.
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  • 收稿日期:  2021-10-16
  • 网络出版日期:  2022-09-26

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