青海省早发型与青少年型脊柱侧凸筛查现状及影响因素分析

郭海滨; 黄蛟灵; 金红芳; 陈楠; 周璇; 李欣; 谷双昱; 杜青

doi:10.11847/zgggws1138813

青海省早发型与青少年型脊柱侧凸筛查现状及影响因素分析

Prevalence of early-onset and adolescent scoliosis and its associates among primary and secondary school students in Qinghai province: a screening survey

摘要

摘要:
目的对比青海省儿童早发型与青少年型脊柱侧凸的筛查情况并探讨影响因素。
方法于2020年10月 — 2021年2月，采用分层整群抽样方法在青海省西宁和海东市随机抽取24所学校3 582名5～18岁儿童进行脊柱侧凸筛查横断面调查，比较早发型、青少年型筛查阳性率差异，建立多因素非条件logistic回归模型，分析脊柱侧凸的影响因素。
结果青海地区儿童脊柱侧凸整体检出率为5.6%（201/3 582）， < 10岁早发型检出率为2.9%（58/1 549），≥ 10岁青少年型为9.2%（143/2 033）（P < 0.05）；多因素非条件logistic回归模型结果显示，在青少年型中，年龄增长，父亲职业（相对农民）为牧民，母亲职业（相对农民）为牧民、商户、自由职业为危险因素，OR值分别为1.23、5.89、59.85、10.62、19.41；而BMI增大、母亲学历为保护因素，OR值分别为0.75、0.55。在早发型中，年龄增长为危险因素，OR值为1.88；胎次 ≥ 2（相对第1胎）、夏季和秋季出生（相对春季）为保护因素，OR值分别为0.27、0.27、0.19。
结论青海地区脊柱侧凸青少年型检出率高于早发型，其中生长发育指标之一的BMI、社会经济地位相关因素（母亲学历，父、母亲职业）仅影响青少年型，围产期相关因素（出生季节、胎次）则仅影响早发型。

Abstract:
Objective To explore the prevalence and influencing factors of early-onset scoliosis (EOS, which appears before the age of 10) and adolescent scoliosis (manifesting at the age of 10 and above) among primary and secondary school students in Qinghai province.
Methods Totally 3 582 students aged 5 – 18 years were recruited in 24 primary and secondary schools in 2 municipalities of Qinghai province with stratified cluster sampling. A scoliosis screening was conducted among the students during October 2020 – February 2021 using national standard method (GB/T 16133 – 2014); whole spine X-ray examination was recommended to the students with the angle of trunk rotation (ATR) of ≥ 5° measured with Bunnell Scoliometer. Relevant information of the students were collected from their guardians with a self-designed questionnaire. Detect rates of EOS and juvenile-type scoliosis among the students were compared in statistical analysis and unconditional multivariate logistic regression model was adopted to explore influencing factors of scoliosis.
Results The overall detection rate of scoliosis in the students was 5.6% (201/3 582) and the detection rate of EOS was significantly lower than that of adolescent scoliosis (2.9% 58/1 549 vs. 9.3% 143/2 033, P < 0.05). The results of unconditional multivariate logistic regression analysis showed that for adolescent scoliosis, age increment (odd ratio OR = 1.23), paternal occupation (herder versus farmer: OR = 5.89), maternal occupation compared to being farmer (herder: OR = 59.85, doing business: OR = 10.62, being self-employed: OR = 19.41) were significant risk factors; but higher body mass index (OR = 0.75) and higher maternal education (OR = 0.55) were significant protective factors against scoliosis; while for EOS, age increment was a significant risk factor (OR = 1.88) and significant protective factors including higher parity number ( ≥ 2 versus 1: OR = 0.27), being born in summer (OR = 0.27) and in autumn (OR = 0.19) in contrast to being born in spring.
Conclusion Among 5 – 18 years old primary and secondary school students in Qinghai province, the detection rate of adolescent scoliosis is higher than that of EOS; the prevalence of adolescent scoliosis is influenced significantly by body mass index, maternal education and parental occupation but that of EOS is affected by parity and birth season.

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