目的 分析我国中学生近30年体质健康标准达标优秀率趋势,为国家制定学生体质健康干预措施提供依据.方法: 选取1985--2014年6次全国学生体质与健康调研中738 523 名13~18岁中学生,根据《全国学生体质与健康调研工作手册》分析身高,体质量,肺活量和身体素质指标.体质健康达标优秀依据《国家学生体质健康标准》(2014年修订)综合评分定义,≥90.0 分为优秀.采用χ ²检验比较不同性别,年龄,地区和年度学生体质健康达标优秀率的差异,绘制地图比较不同年度各省份体质健康达标优秀率的分布变化.结果: 1985--2014年,中国汉族13~18岁学生平均身高,体质量,体重指数(body mass index,BMI)不断增长,而平均肺活量和身体素质指标波动较大.总体体质健康达标优秀率从1985年的2.7%上升到1995 年的4.4%,然后持续下降至2005年的1.1%,2010年反弹了0.6 个百分点,2014年继续提高,达到2.2%.近30年来,男生体质健康达标优秀率一直高于女生(P<0.001), 13~15岁初中生优秀率始终高于16~18岁高中生(P<0.001),东部地区优秀率高于中部和西部地区(P<0.001).1985年仅个别地区中学生体质健康达标优秀率<1%, 2005年几乎一半省份(14/30)的达标优秀率<1%, 2014年有所好转,东部沿海部分地区中学生体质健康达标优秀率较高,中部省份和西部省份偏低.结论: 近30年来我国中学生体质健康达标优秀率呈波动趋势,距离健康中国2030规划纲要的目标差距较大,各地区需要积极采取措施促进学生体育锻炼,提高学生体质健康水平.

Objective: To analyze the trends of prevalence of excellent health status and physical fitness among Chinese Han students aged 13 to 18 years from 1985 to 2014.Methods: In the study, 738 523 students aged 13 to 18 years were extracted from the 1985 to 2014 Chinese National Survey on Students' Constitution and Health. Height, weight, vital capacity and indicators of physical fitness were measured for each student. According to National Standards for Students' Physical Health (2014 Revision), students meeting an overall score ≥ 90.0 were considered to be of excellent health status and physical fitness. We used the Chi-square test to compare the differences in prevalence of excellent health status and physical fitness among different subgroups and draw maps of regional distribution of prevalence by using ArcGIS.Results: From 1985 to 2014, the average height, weight, and BMI for Chinese Han students aged 13 to 18 years increased consistently, while the average vital capacity and indicators of physical fitness fluctuated largely. The overall prevalence of excellent health status and physical fitness increased from 2.7% in 1985 to 4.4% in 1995, dropped consistently to 1.1% in 2005, rebounded 0.6 percentage points in 2010, and increased to 2.2% in 2014. In each survey year, the prevalence for the boys was always higher than for the girls (P<0.001), the prevalence for middle school students aged 13 to 15 years was always higher than for high school students aged 16-18 years (P<0.001), and the prevalence for students in eastern region was higher than in western and central regions (P<0.001). In 1985 and 1995, the prevalence in certain provinces in eastern and central regions was <1%. In 2005, almost half provinces (14/30) had a prevalence <1%. In 2014, provinces in eastern coastal areas had relatively high prevalence of excellent health status and physical fitness in students aged 13 to 18 years, while provinces in central and western regions had relatively low prevalence.Conclusion: A fluctuating trend of the prevalence of excellent health status and physical fitness has been observed among Chinese Han students aged 13 to 18 years during the past three decades. There is great difference between the current prevalence of excellent health status and physical fitness and the goal of Outline of the Healthy China 2030 Plan, thus, the effective interventions and strategies for promoting students' physical activity and physical fitness are urgently needed in China.