2022年内蒙古自治区中小学生近视分布的特征

doi:10.19723/j.issn.1671-167X.2026.03.011

摘要/Abstract

摘要：

目的: 了解2022年内蒙古自治区中小学生近视分布特征，并从学校与个体两个层面综合分析其影响因素，为制定有针对性的近视防控策略提供科学依据。方法: 采用多阶段分层随机整群抽样方法，对内蒙古自治区四年级至高中三年级学生进行视力检查和问卷调查，收集学生用眼习惯、学校及家庭环境因素等信息。运用多水平回归模型分析近视检出率在学校和个体层面的影响因素。结果: 调查共纳入中小学生130 601例，近视检出率为68.42%，其中女生近视检出率(72.75%)高于男生(64.13%)，城区近视检出率(73.63%)高于郊县(66.38%)，整体随学段的增加呈上升趋势(趋势检验χ²=4 545.53，P＜0.001)。多水平分析结果显示，在个人层面，女生(OR= 1.553)、高年级学生(初中OR=2.049，高中OR=3.061)、放学后作业时长≥1 h(≥1 h OR=1.050, ≥2 h OR=1.079)、近距离用眼习惯不良(OR=1.059)、长时间近距离用眼(0.5 h OR=1.070，≥1 h OR=1.061)、课桌椅高度根据身高调整周期长(OR=1.006)、父母近视(仅一方近视OR=1.822，均近视OR=2.412)是近视的危险因素；少数民族(蒙古族OR=0.956，其他民族OR=0.929)、每天户外活动时间超过2 h(OR=0.986)、做眼保健操(1次OR=0.891，≥2次OR=0.920)、睡眠充足(OR=0.925)为保护因素。在学校层面，黑板反射比合格(OR=0.874)与黑板面照度均匀度合格(OR=0.973)与学生近视风险降低有关。模型显示，所纳入的变量共同解释了约31.04%的学校水平方差。结论: 内蒙古自治区中小学生近视检出率处于较高水平，且影响因素分布于个体和学校多个层面；建议采取综合防控策略，在重点关注女生、高年级及有遗传背景学生的同时，加强对户外活动、用眼行为等可改变因素的干预，并改善教室光环境，以降低学生近视发生风险。

关键词: 中小学生, 近视, 影响因素, 多水平模型

Abstract:

Objective: To investigate the distribution characteristics of myopia among primary and secondary school students in Inner Mongolia Autonomous Region in 2020, and to comprehensively analyze its influencing factors at both school and individual levels, thereby providing scientific evidence for developing targeted myopia prevention and control strategies. Methods: A multistage stratified random cluster sampling method was employed to conduct vision examinations and questionnaire surveys among students from fourth grade to senior high school in Inner Mongolia Autonomous Region, collecting information on students' visual habits, school and family environmental factors. A multilevel regression model was used to analyze the factors influencing myopia detection rates at both school and individual levels. Results: A total of 130 601 students were included, with a myopia prevalence rate of 68.42%. The prevalence was higher among females (72.75%) than males (64.13%), in urban areas (73.63%) than in suburban counties (66.38%), and overall rates increased with educational level (trend test χ²=4 545.53, P < 0.001). Multilevel analysis revealed that at the individual level, female gender (OR=1.553), higher grade level (junior high OR=2.049, senior high OR=3.061), homework duration ≥1 h after school (≥1 h OR=1.050, ≥2 h OR=1.079), poor close-up vision habits (OR=1.059), prolonged close-up vision activities (0.5 h OR=1.070, ≥1 h OR=1.061), infrequent desk/chair height adjustments based on height (OR=1.006), and parental myopia (one parent OR=1.822, both parents OR=2.412) were risk factors for myopia; while ethnic minority status (Mongolian OR=0.956, other ethnicities OR=0.929), daily outdoor activity exceeding 2 hours (OR=0.986), performing eye exercises (1 session OR=0.891, ≥2 sessions OR=0.920), and adequate sleep (OR=0.925) served as protective factors. At the school level, qualified blackboard reflectance ratio (OR=0.874) and qualified blackboard surface illuminance uniformity (OR=0.973) were associated with reduced myopia risk among students. The model indicated that the included variables collectively explained approximately 31.04% of the variance at the school level. Conclusion: The prevalence of myopia among primary and secondary school students in Inner Mongolia Autonomous Region remains high, with influencing factors distributed across multiple levels including individual and school contexts. Comprehensive prevention strategies are recommended, focusing on female students, older grades, and those with genetic predispositions while intensifying interventions on modifiable factors like outdoor activities and visual habits. Improving classroom lighting environments is also crucial to reduce students' myopia risk.

Key words: Primary and secondary school students, Myopia, Influencing factors, Multilevel model

中图分类号:

R179

芦利利, 李佳欣, 黄天彧, 杨若澜, 刘云飞, 党佳佳, 蔡珊, 孙子曰, 刘梅珠, 杨旸, 朱凯恒, 宋逸. 2022年内蒙古自治区中小学生近视分布的特征[J]. 北京大学学报（医学版）, 2026, 58(3): 520-527.

Lili LU, Jiaxing LI, Tianyu HUANG, Ruolan YANG, Yunfei LIU, Jiajia DANG, Shan CAI, Ziyue SUN, Meizhu LIU, Yang YANG, Kaiheng ZHU, Yi SONG. Analysis of the prevalence and influencing factors of myopia among primary and secondary school students in Inner Mongolia Autonomous Region in 2022[J]. Journal of Peking University (Health Sciences), 2026, 58(3): 520-527.

图/表 4

表1

表2

表3

2022年内蒙古自治区不同特征中小学生近视检出率"

Variable	Number examined	Number of myopia cases, n (%)	χ²	P
Individual level
Gender			1 122.48	＜0.001
Male	65 570	42 052 (64.13)
Female	65 031	47 311 (72.75)
Grade level			4 545.53	＜0.001
Primary school	50 308	29 104 (57.85)
Middle school	50 600	36 852 (72.83)
High school	29 693	23 407 (78.83)
Ethnicity			973.05	＜0.001
Han	90 469	64 284 (71.06)
Mongolian	33 676	20 860 (61.94)
Other	6 456	4 219 (65.35)
Homework duration after school /h			962.66	＜0.001
＜1	32 943	20 610 (62.56)
≥1-＜2	50 295	34 111 (67.82)
≥2	47 363	34 642 (73.14)
Daily outdoor activity time /h			16.70	＜0.001
＜2	84 567	58 217 (68.84)
≥2	46 034	31 146 (67.66)
Near-vision habits			359.15	＜0.001
Good	100 453	67 393 (67.09)
Poor	30 148	21 970 (72.87)
Rest interval after near work /h			276.83	＜0.001
＜0.5	61 387	40 629 (66.19)
≥0.5-＜1	31 684	22 137 (69.87)
≥1	37 530	26 597 (70.87)
Daily eye exercises frequency			879.63	＜0.001
0 times	15 439	12 095 (78.34)
1 time	32 165	22 225 (69.10)
≥2 times	82 997	55 043 (66.32)
Desk/chair height adjustment cycle			403.22	＜0.001
≤1 semester	35 874	23 041 (64.23)
>1 semester	94 727	66 322 (70.01)
Sleep adequacy			197.67	＜0.001
Adequate	26 171	16 962 (64.81)
Inadequate	104 430	72 401 (69.33)
Parental myopia			2127.23	＜0.001
Neither	84 309	54 038 (64.10)
One parent	35 703	26 909 (75.68)
Both parents	10 589	8 416 (79.48)
School level
Urban-rural			642.74	＜0.001
Urban	36 790	27 089 (73.63)
Suburban	93 811	62 274 (66.38)
Blackboard reflectance ratio			165.68	＜0.001
Qualified	71 023	47 592 (67.01)
Unqualified	59 334	41 732 (70.33)
Blackboard illuminance uniformity			26.12	＜0.001
Qualified	103 559	70 615 (68.19)
Unqualified	26 798	18 709 (69.81)
Desk surface illuminance uniformity			0.59	0.441
Qualified	92 480	63 311 (68.46)
Unqualified	37 877	26 013 (68.68)

表3

表4

2022年内蒙古自治区中小学生近视影响因素的多水平回归模型拟合结果"

Variable	OR (95%CI)
Variable	Total	Male	Female
Individual level
Gender (ref: Male)
Female	1.553 (1.547-1.558)
Grade level (ref: Primary school)
Middle school	2.094 (2.088-2.101)	1.948 (1.946-1.950)	2.299 (2.297-2.300)
High school	3.061 (3.058-3.063)	2.869 (2.852-2.887)	3.281 (3.264-3.299)
Ethnicity (ref: Han)
Mongolian	0.956 (0.955-0.956)	0.925 (0.922-0.929)	0.936 (0.935-0.938)
Other	0.929 (0.926-0.931)	0.908 (0.905-0.910)	0.946 (0.946-0.946)
Homework duration after school /h (ref: ＜1)
≥1-＜2	1.050 (1.047-1.052)	1.053 (1.050-1.057)	1.043 (1.040-1.047)
≥2	1.079 (1.077-1.082)	1.100 (1.096-1.103)	1.053 (1.049-1.057)
Daily outdoor activity time /h (ref: ＜2)
≥2	0.986 (0.985-0.987)	0.973 (0.971-0.975)	1.010 (1.006-1.014)
Near-vision habits(ref: Good)
Poor	1.059 (1.058-1.060)	1.040 (1.038-1.043)	1.079 (1.079-1.079)
Rest interval after near work /h (ref: ＜0.5)
≥0.5-＜1	1.070 (1.069-1.070)	1.069 (1.069-1.069)	1.069 (1.069-1.070)
≥1	1.061 (1.060-1.062)	1.054 (1.053-1.055)	1.071 (1.068-1.074)
Daily eye exercises frequency (ref: 0 times)
1 time	0.891 (0.888-0.895)	0.908 (0.907-0.909)	0.863 (0.854-0.871)
≥2 times	0.920 (0.916-0.923)	0.931 (0.929-0.933)	0.899 (0.895-0.904)
Desk/chair height adjustment cycle (ref: ≤1 semester)
＞1 semester	1.006 (1.004-1.007)	1.022 (1.021-1.022)	0.993 (0.990-0.996)
Sleep adequacy (ref: Inadequate)
Adequate	0.925 (0.923-0.926)	0.931 (0.930-0.931)	0.918 (0.915-0.921)
Parental myopia (ref: Neither)
One parent	1.822 (1.820-1.824)	1.858 (1.853-1.864)	1.781 (1.771-1.792)
Both parents	2.412 (2.386-2.437)	2.483 (2.466-2.500)	2.336 (2.301-2.372)
School level
Urban-rural (ref: Urban)
Suburban	0.850 (0.847-0.854)	0.819 (0.816-0.823)	0.909 (0.907-0.911)
Blackboard reflectance ratio(ref: Unqualified)
Qualified	0.874 (0.872-0.876)	0.882 (0.880-0.884)	0.866 (0.866-0.867)
Blackboard illuminance uniformity(ref: Unqualified)
Qualified	0.973 (0.969-0.977)	0.981 (0.975-0.988)	0.981 (0.980-0.981)

表4

参考文献 33

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Items	Total (n=130 601)		Male (n=65 570)		Female (n=65 031)		χ²	P
Items	n	%	n	%	n	%	χ²	P
Urban and Rural							0.018	0.893
Urban	36 790	28.17	18 460	50.18	18 330	49.82
Suburban	93 811	71.83	47 110	50.22	46 701	49.78
Grade level							84.583	＜0.001
Primary school	50 308	38.52	25 810	51.30	24 498	48.70
Middle School	50 600	38.74	25 516	50.43	25 084	49.57
High School	29 693	22.74	14 244	47.97	15 449	52.03
Ethnicity							2.506	0.286
Han	90 469	69.27	45 552	50.35	44 917	49.65
Mongolian	33 676	25.79	16 790	49.86	16 886	50.14
Other	6 456	4.94	3 228	50.00	3 228	50.00

Category	Total (n=89 363)		Male (n=42 052)		Female (n=47 311)		χ²	P
Category	n	%	n	%	n	%	χ²	P
Urban-rural							642.74	＜0.001
Urban	27 089	73.63	13 002	70.43	14 087	76.85
Suburban	62 274	66.38	29 050	61.66	33 224	71.14
Grade level							1 122.47	＜0.001
Primary school	29 104	57.85	13 913	53.91	15 191	62.01
Middle school	36 852	72.83	17 401	68.20	19 451	77.54
High school	23 407	78.83	10 738	75.39	12 669	82.01
Ethnicity							973.05	＜0.001
Han	64 284	71.06	30 574	67.12	33 710	75.05
Mongolian	20 860	61.94	9 510	56.64	11 350	67.22
Other	4 219	65.35	1 968	60.97	2 251	69.73

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