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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
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  • 收稿日期:  2021-10-16
  • 网络出版日期:  2022-09-26

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