调查甘肃省武威市民勤县小学生视力不良及近视的现状。

采用随机分层整群抽样的方法，于2023年5月至6月选择甘肃省武威市民勤县城区5所小学一至六年级学生5284人(10 568只眼)进行研究。其中，男性2832人(5664只眼)，女性2452人(4904只眼)；年龄7～13岁，平均年龄(9.9±1.8)岁。按裸眼视力分为视力正常和视力不良，视力不良又按程度分为轻度、中度及重度。按等效球镜屈光度(SE)分为近视眼和非近视眼，近视眼又分为轻度、中度及高度。不同性别和不同年龄的总体视力不良及近视眼的患病情况以频数和率表示，组间比较采用卡方检验；不同性别、年龄、视力不良程度及近视眼的患病情况以频数和率表示，组间比较采用秩和检验。当不同年龄、视力不良程度及近视眼的患病情况差异有统计学意义时，使用Bonferroni法进行两两比较。

民勤县小学生视力不良人数3047例(4594只眼)，视力不良率为57.66%。其中，男性和女性视力不良人数分别为1560例(2328只眼)和1487例(2266只眼)，视力不良率分别为55.08%及60.64%。女性视力不良率高于男性，差异有统计学意义(χ²＝16.64，P<0.05)。随着年龄的增长，民勤县小学生视力不良率呈现出上升趋势，有统计学意义(χ_趋势²＝454.22，P_趋势<0.05)。民勤县小学生近视眼人数2034例(3048只眼)，患病率为66.38%。其中，男性和女性近视眼人数分别为1070例(1613只眼)和964例(1435只眼)，患病率分别为64.26%及68.91%。女性近视眼的患病率高于男性，差异有统计学意义(χ²＝7.34，P<0.05)。随着年龄的增长，民勤县小学生近视患病率呈现出上升趋势，有统计学意义(χ_趋势²＝305.49，P_趋势<0.05)。各年龄不同程度视力不良率与近视眼的患病率比较，差异均有统计学意义(H＝712.21，454.18；P<0.05)。性别间不同程度视力不良率与近视眼患病率比较，差异均有统计学意义(H＝17.63，6.74；P<0.05)。经Bonferroni法两两比较，12岁与13岁小学生的视力不良率比较，差异无统计学意义(H＝－128.67，P>0.05)；7岁与8岁，10岁与11岁，12岁与13岁小学生不同程度近视眼患病率比较，差异无统计学意义(H＝－86.86，－77.92，63.29；P>0.05)。

甘肃省武威市民勤县小学生视力不良率及近视眼患病率较高。视力不良及近视防控要更加关注女性、城区学生及远视储备不足者。

The aim of this study is toinvestigate the current status of poor vision and myopia among primary school students in Minqin County, Wuwei City, Gansu Province.

A total of 5284 students (10 568 eyes) in grades 1 to 6 of five elementary school in the urban area of Minqin County, Wuwei City, Gansu Province, were selected for the study from May to June 2023 by using random stratified cluster sampling. Among them, there were 2832 (5664 eyes) male and 2452 (4904 eyes) female with a mean age of (9.9±1.8) years (ranging from 7 to 13 years old). They were categorized by naked eye vision into normal vision and poor vision, and poor vision was further categorized by degree into mild, moderate and severe. According to the values of equivalent spherical refraction (SE), they were categorized as myopic and non-myopic, and myopia was further categorized as mild, moderate and high. The prevalence of overall poor vision and myopia by gender and age was expressed as frequency and rate, and the chi-square test was used for comparison between groups; the prevalence of different degrees of poor vision and myopia by gender and age was expressed as frequency and rate, and the rank-sum test was used for comparison between groups. When the differences in the prevalence of different degrees of poor vision and myopia among different ages were statistically significant, two-by-two comparisons between the groups were made using the Bonferroni method.

There were 3047 cases (4594 eyes) of poor vision among primary school students in Minqin County, with a rate of 57.66%. Among them, the number of males and females with poor vision was 1560 cases (2328 eyes) and 1487 cases (2266 eyes), and the rates of poor vision were 55.08% and 60.64%, respectively, and the rate of poor vision in females was higher than that in males, with a statistically significant difference (χ² = 16.64, P<0.05). With the increase of age, the rate of poor vision among elementary schools students in Minqin County showed an increasing trend, which was statistically significant (χ_trend ²= 454.22, P_trend<0.05). The number of myopia cases among elementary school students in Minqin County was 2034 (3048 eyes), with a prevalence of 66.38%. Among them, the numbers of male and female myopia were 1070 cases (1613 eyes) and 964 cases (1435 eyes), with prevalence rates of 64.26% and 68.91%, respectively, and the prevalence of female myopia was higher than that of males, with a statistically significant difference (χ² = 7.34, P<0.05). With the increase of age, the prevalence of myopia among elementary school students in Minqin County showed an increasing trend, which was statistically significant (χ_trend ²= 305.49, P_trend <0.05). The difference between the prevalence of different degrees of poor vision and the prevalence of myopia at all ages was statistically significant (H=712.21, 454.18; P<0.05). The comparison of the prevalence of different degrees of poor vision with the prevalence of myopia between genders showed statistically significant differences (H=17.63, 6.74; P<0.05). After two-by-two comparisons by the Bonferroni method, the difference between the rates of poor vision and the prevalence of myopia of different degrees was not statistically significant when comparing 12 year-old and 13 year-old primary school students (H= -128.67, P>0.05), and the differences were not statistically significant among 7 year-old and 8 year-old, 10 year-old and 11 year-old, and 12 year-old and 13 year-old primary school students (H= -86.86, -77.92, 63.29; P>0.05).

The prevalence of poor vision and myopia among elementary school students in Minqin County, Wuwei City, Gansu Province is high. However, more attention should be paid to females, students in urban areas and those with insufficient reserve of hyperopia for the prevention and control of poor vision and myopia.