目的调查中国某医学高校青年大学生的近视进展情况，探索影响近视进展的危险因素。
方法采用队列研究方法，于2019年对天津某医学高校16～22岁新生1 068人进行健康查体，最终共979例近视患者眼部资料纳入基线评估，812例参加了2年后的随访评估。在基线和2年随访时，采用裂隙灯显微镜检查眼前节情况，采用自动验光仪进行非睫状肌麻痹验光，采用Lenstar 900测量眼轴长度(AL)。将近视进展定义为等效球镜度(SE)变化≤-0.50 D/年或AL增长≥0.20 mm/年。采用广义估计方程模型进行多重线性回归分析，探索与近视进展相关的危险因素。
结果在2年随访期间，92.5%(751/812)SE保持稳定，96.1%(764/795)AL保持稳定。有7.5%(61/812)出现SE进展，3.9%(31/795)AL有增长，显示出近视进展趋势。多重线性回归分析显示，女性与AL增长显著相关( β＝0.064，95% CI：0.002～0.126； P＝0.042)；与基线为高度近视相比，基线处于中低度近视与AL增长显著相关( β＝0.083，95% CI：0.005～0.161； P＝0.037)。
结论超过92%的青年大学生近视趋于稳定。除高度近视外，仍需加强对女性和中低度近视者的随访和管理，有效防控高度近视。
ObjectiveTo investigate the myopia progression in Chinese young medical college students and explore the associated risk factors.
MethodsA cohort study was conducted.Among 1 068 freshmen aged 16 to 22 years receiving health checkups at a medical university in Tianjin, 979 myopes were ultimately included in the baseline assessment and 812 participated in the follow-up assessment after two years.The anterior segment examination with a slit lamp, non-cycloplegic autorefraction with an autorefractor and axial length (AL) measurements with Lenstar 900 were performed on participants at baseline and during the two-year follow-up.Myopia progression was defined as a spherical equivalent (SE) change of ≤-0.50 D/year or an AL increase of ≥0.20 mm/year.Multivariate regression analysis with the generalized estimating equation model was employed to identify risk factors associated with myopia progression.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Medical University Eye Hospital (No.2021KY-16).Informed consent was obtained from each subject.
ResultsDuring the two-year follow-up, 92.5%(751/812) of the participants had stable SE and 96.1%(764/795) had stable AL.However, 7.5%(61/812) showed SE progression and 3.9%(31/795) exhibited AL growth, demonstrating a tendency of myopia progression.Multivariate linear regression analysis revealed that females ( β=0.064, 95% CI: 0.002~0.126; P=0.042) and low to moderate myopia at baseline ( β=0.083, 95% CI: 0.005~0.161; P=0.037) were significantly associated with AL growth compared to high myopia at baseline.
ConclusionsMore than 92% of young college students have stable myopia.In addition to high myopia, there is still a need for better follow-up and management of females and those with low to moderate myopia to control the high prevalence of high myopia.
张红梅,朱云,宋德胜,等. 中国某医学高校青年大学生近视进展及危险因素分析：一项2年纵向研究[J]. 中华实验眼科杂志,2025,43(02)：153-157.
DOI:10.3760/cma.j.cn115989-20240626-00167版权归中华医学会所有。
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除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。
张红梅：酝酿和设计试验、实施研究、采集数据、分析/解释数据、文章撰写及修改；朱云、宋德胜：分析/解释数据、文章修改；张婕：酝酿和设计试验；魏瑞华：酝酿和设计试验、分析/解释数据、对文章的知识性内容作批判性审阅及定稿
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