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Article(id=1311350274095149167, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202510391, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760976000000, receivedDateStr=2025-10-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579869054, onlineDateStr=2026-09-28, pubDate=1786291200000, pubDateStr=2026-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579869054, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579869054, creator=13701087609, updateTime=1790579869054, updator=13701087609, issue=Issue{id=1311350193946194882, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='15', pageStart='2689', pageEnd='2880', issueExtLink='null', onlineDate='null', pubDate='1786291200000', pubDateStr='2026-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790579849945, creator='13701087609', updateTime=1790588319569, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311385718195315029, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311385718195315030, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2733, endPage=2738, ext={EN=ArticleExt(id=1311350275307303024, articleId=1311350274095149167, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Effect of regional light climate levels on myopia in children and adolescents, columnId=1228016570660745413, journalTitle=Modern Preventive Medicine, columnName=Environmental and Occupational Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the influence of regional light climate levels (light levels) on myopia in children and adolescents and the differences among different populations.

Methods

Two kindergartens, two primary schools and two junior high schools were randomly selected from each of the 187 districts (counties) in Sichuan Province. In each school, students (at least 80 students) were selected from the entire class of each grade for vision examination, and questionnaires were conducted among primary school students in grades 4 to 6. The χ2 test was used for the differential comparison of myopia rates. The logistic regression model was used to study the influence of regional light climate levels on myopia.

Results

A total of 330 132 students were included. Among them, 5.9% were from Category II areas (45>Eq≥40klx）, 9.8% from Category III areas (40>Eq≥35klx）,15.1% from Category IV areas (35>Eq≥30klx), and 69.2% from Category V areas (Eq<30klx). The myopia rates of children and adolescents in Class II, Class III, Class IV and Class V areas were 30.4%, 29.0%, 33.9% and 43.1%, and increased with the decrease of light climate levels (the increase of type codes). After controlling for covariates, with the type II area (high light level) as the reference, the risk effect of myopia was observed in the type III, type IV, and type V areas (OR=1.433, 95% CI:1.331-1.543; OR=1.543, 95% CI: 1.437-1.656; OR=1.325, 95% CI: 1.238-1.418, all P<0.001). Stratified analysis showed that the same effect was observed in both male and female students, as well as in regions with good and poor economic levels (P<0.001).

Conclusion

The level of natural light in a region may affect the prevalence of myopia among children and adolescents.It is recommended to ensure adequate light intensity in reading and writing environments, provide supplementary artificial lighting when necessary, and further increase the duration of outdoor activities.

, authors=Liang ZHOU1, Qiao-qiao REN1, Ling ZENG2, Li ZHANG1, authorsList=Liang ZHOU, Qiao-qiao REN, Ling ZENG, Li ZHANG, authorCompany=null, correspAuthors=Li ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311350279933620337, articleId=1311350274095149167, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=地区光气候水平对儿童青少年近视影响的研究, columnId=1228016571273113811, journalTitle=现代预防医学, columnName=环境与职业卫生, runingTitle=null, highlight=null, articleAbstract=
目的

探索地区光气候水平（自然光照水平）对儿童青少年近视的影响及在不同人群中的差异。

方法

在四川省187个区（县）各随机抽取幼儿园2所、小学2所、初中2所，每个学校每年级以整班为单位抽取学生（至少80名）进行视力检查，并问卷调查小学4～6年级学生。使用χ2检验进行近视率的差异性比较，采用logistic回归模型研究地区光气候水平对近视的影响。

结果

330 132名学生纳入研究，Ⅱ类光气候地区（45>Eq≥40klx）学生占5.9%，Ⅲ类光气候地区（40>Eq≥35klx）学生占9.8%，Ⅳ类光气候地区（35>Eq≥30klx）学生占15.1%，Ⅴ类光气候地区（Eq<30klx）学生占69.2%；Ⅱ类、Ⅲ类、Ⅳ类、Ⅴ类光气候区儿童青少年近视率分别为30.4%、29.0%、33.9%、43.1%，随光气候水平降低（类型代码增大）而增高。控制协变量后，以Ⅱ类光气候地区（高光照水平）为参照，Ⅲ类、Ⅳ类、Ⅴ类光气候区均观察到近视的危险效应（OR=1.433,95%CI:1.331～1.543；OR=1.543,95%CI:1.437～1.656；OR=1.325,95%CI:1.238～1.418；P均<0.001）。分层分析，男生、女生、地区经济水平好和差中均观察到相同效应（P均<0.001）。

结论

地区自然光照水平可能会影响儿童青少年近视，建议关注读写环境光照强度，不足时予以人工照明补充，同时进一步增加户外活动时间。

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周亮（1988—），男，本科，副主任医师，研究方向：学校卫生

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张丽，E-mail：
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Relationship between Myopia and Light Exposure[J].Journal of Sichuan University: Medical Sciences, 2021, 52(6): 901-906.(In Chinese), articleTitle=Relationship between Myopia and Light Exposure, refAbstract=null), Reference(id=1311350293678354622, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[21], rfOrder=36, authorNames=国家疾病预防控制局, journalName=null, refType=null, unstructuredReference=国家疾病预防控制局. 儿童青少年近视防控公共卫生综合干预技术指南[EB/OL].[2026-05-30].https://www.ndcpa.gov.cn/jbkzzx/yqxxxw/common/content/content_1699314959781326848.html., articleTitle=儿童青少年近视防控公共卫生综合干预技术指南, refAbstract=null), Reference(id=1311350293770629311, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[21], rfOrder=37, authorNames=National Center for Disease Control and Prevention, journalName=null, refType=null, unstructuredReference=National Center for Disease Control and Prevention. Comprehensive Public Health Intervention Guidelines for the Prevention and Control of Myopia in Children and Adolescents[EB/OL]. [2026-05-30]. https://www.ndcpa.gov.cn/jbkzzx/yqxxxw/common/content/content_1699314959781326848.html.(In Chinese), articleTitle=Comprehensive Public Health Intervention Guidelines for the Prevention and Control of Myopia in Children and Adolescents, refAbstract=null), Reference(id=1311350293850321088, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, doi=null, pmid=null, pmcid=null, year=2016, volume=null, issue=1, pageStart=74, pageEnd=76, url=null, language=null, rfNumber=[22], rfOrder=38, authorNames=赵宏伟, 黄一飞, journalName=国际眼科杂志, refType=null, unstructuredReference=赵宏伟，黄一飞.光照与近视发生发展的关系[J].国际眼科杂志，2016，（1）：74-76., articleTitle=光照与近视发生发展的关系, refAbstract=null), Reference(id=1311350293934207169, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, doi=null, pmid=null, pmcid=null, year=2016, volume=null, issue=1, pageStart=74, pageEnd=76, url=null, language=null, rfNumber=[22], rfOrder=39, authorNames=Zhao HW, Huang YF, journalName=International Eye Science, refType=null, unstructuredReference=Zhao HW, Huang YF. Relationship between light and the development of myopia[J]. International Eye Science, 2016, (1): 74-76.(In Chinese), articleTitle=Relationship between light and the development of myopia, refAbstract=null), Reference(id=1311350294001316034, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=6, pageStart=521, pageEnd=524, url=null, language=null, rfNumber=[23], rfOrder=40, authorNames=《儿童青少年近视防控户外活动中的强光防护专家意见》专家组, journalName=中国眼耳鼻喉科杂志, refType=null, unstructuredReference=《儿童青少年近视防控户外活动中的强光防护专家意见》专家组.儿童青少年近视防控户外活动中的强光防护专家意见[J].中国眼耳鼻喉科杂志，2024，24(6)：521-524., articleTitle=儿童青少年近视防控户外活动中的强光防护专家意见, refAbstract=null), Reference(id=1311350294060036291, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, doi=null, pmid=null, pmcid=null, year=2024, volume=24, issue=6, pageStart=521, pageEnd=524, url=null, language=null, rfNumber=[23], rfOrder=41, authorNames=Expert Workgroup of the use of bright light protection during outdoor activities as a means of preventing and managing myopia in children and adolescents, journalName=Chinese Journal of Ophthalmology and Otorhinolaryngology, refType=null, unstructuredReference=Expert Workgroup of the use of bright light protection during outdoor activities as a means of preventing and managing myopia in children and adolescents. Expert guidance for the use of bright light protection during outdoor activities as a means of Preventing and managing myopia in children and adolescents[J]. Chinese Journal of Ophthalmology and Otorhinolaryngology, 2024, 24(6): 521-524.(In Chinese), articleTitle=Expert guidance for the use of bright light protection during outdoor activities as a means of Preventing and managing myopia in children and adolescents, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1311350281242243186, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, xref=1., ext=[AuthorCompanyExt(id=1311350281254826099, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, companyId=1311350281242243186, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1311350281263214708, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, companyId=1311350281242243186, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.四川省疾病预防控制中心，四川 成都 610041)]), AuthorCompany(id=1311350281330323573, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, xref=2., ext=[AuthorCompanyExt(id=1311350281581981814, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, companyId=1311350281330323573, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.德阳市疾病预防控制中心)])], figs=[ArticleFig(id=1311350287961518225, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=EN, label=Table 1, caption=

Myopia detection among 330 132 children and adolescents in Sichuan Province

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类人数构成比（%）近视检出
例数率（%）χ2值P值
性别男167 18650.661 93537.0905.458<0.001
女162 94649.468 71142.2
民族汉族255 66677.4108 56142.55 037.068<0.001
藏族40 11112.212 67831.6
彝族26 2888.06 01722.9
其他8 0672.43 39042.0
学段幼儿园大班31 7459.63 29610.463 795.148<0.001
小学1～3年级101 05730.616 50816.3
小学4～6年级99 87430.347 05947.1
初中97 45629.563 78365.4
城区/郊县城区110 78033.647 64843.0823.875<0.001
郊县219 35266.482 99837.8
地区经济水平好116 18835.250 55743.52 367.897<0.001
中117 76335.747 98940.8
差96 18129.132 10033.4
光气候区Ⅱ类19 3025.95 87330.44 043.599<0.001
Ⅲ类32 4619.89 40329.0
Ⅳ类49 83215.116 90833.9
Ⅴ类228 53769.298 46243.1
进行问卷调查是97 71030.347 05947.14 280.596<0.001
否232 42269.783 58736.0
合计330 132100130 64639.6
), ArticleFig(id=1311350288305451154, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=CN, label=表1, caption=

四川省330 132名儿童青少年近视检出情况

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类人数构成比（%）近视检出
例数率（%）χ2值P值
性别男167 18650.661 93537.0905.458<0.001
女162 94649.468 71142.2
民族汉族255 66677.4108 56142.55 037.068<0.001
藏族40 11112.212 67831.6
彝族26 2888.06 01722.9
其他8 0672.43 39042.0
学段幼儿园大班31 7459.63 29610.463 795.148<0.001
小学1～3年级101 05730.616 50816.3
小学4～6年级99 87430.347 05947.1
初中97 45629.563 78365.4
城区/郊县城区110 78033.647 64843.0823.875<0.001
郊县219 35266.482 99837.8
地区经济水平好116 18835.250 55743.52 367.897<0.001
中117 76335.747 98940.8
差96 18129.132 10033.4
光气候区Ⅱ类19 3025.95 87330.44 043.599<0.001
Ⅲ类32 4619.89 40329.0
Ⅳ类49 83215.116 90833.9
Ⅴ类228 53769.298 46243.1
进行问卷调查是97 71030.347 05947.14 280.596<0.001
否232 42269.783 58736.0
合计330 132100130 64639.6
), ArticleFig(id=1311350288393531539, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=EN, label=Table 2, caption=

The detection of myopia among children and adolescents in different light climate zones

, figureFileSmall=null, figureFileBig=null, tableContent=
项目Ⅱ类地区Ⅲ类地区
受检人数检出人数率（%）受检人数检出人数率（%）
幼儿园大班1 9941969.83 3801474.4
小学1～3年级6 32077512.39 8981 09511.1
小学4～6年级5 9212 11635.710 1443 61335.6
初中5 0672 78655.09 0394 54850.3
合计19 3025 87330.432 4619 40329.0
项目Ⅳ类地区Ⅴ类地区趋势χ2值P值
受检人数检出人数率（%）受检人数检出人数率（%）
幼儿园大班4 5093497.721 8622 60411.9126.755<0.001
小学1～3年级15 3792 06913.569 46012 56918.1450.722<0.001
小学4～6年级15 0206 21641.468 78935 11451.11 353.378<0.001
初中14 9248 27455.468 42648 17570.42 056.268<0.001
合计49 83216 90833.9228 53798 46243.13 574.078<0.001
), ArticleFig(id=1311350288460640404, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=CN, label=表2, caption=

不同光气候区儿童青少年近视检出情况

, figureFileSmall=null, figureFileBig=null, tableContent=
项目Ⅱ类地区Ⅲ类地区
受检人数检出人数率（%）受检人数检出人数率（%）
幼儿园大班1 9941969.83 3801474.4
小学1～3年级6 32077512.39 8981 09511.1
小学4～6年级5 9212 11635.710 1443 61335.6
初中5 0672 78655.09 0394 54850.3
合计19 3025 87330.432 4619 40329.0
项目Ⅳ类地区Ⅴ类地区趋势χ2值P值
受检人数检出人数率（%）受检人数检出人数率（%）
幼儿园大班4 5093497.721 8622 60411.9126.755<0.001
小学1～3年级15 3792 06913.569 46012 56918.1450.722<0.001
小学4～6年级15 0206 21641.468 78935 11451.11 353.378<0.001
初中14 9248 27455.468 42648 17570.42 056.268<0.001
合计49 83216 90833.9228 53798 46243.13 574.078<0.001
), ArticleFig(id=1311350288527749269, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=EN, label=Table 3, caption=

Correlation analysis of light climate levels and myopia detection among students under gender stratification

, figureFileSmall=null, figureFileBig=null, tableContent=
组别总体男生女生
人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值
单因素分析
Ⅱ类光气候区5 8271.0002 8501.0002 9771.000
Ⅲ类光气候区8 9841.075（1.004～1.151）0.0384 5321.165（1.054～1.288）0.0034 4521.011（0.920～1.111）0.817
Ⅳ类光气候区14 2331.281（1.203～1.365）<0.0017 0941.371（1.249～1.504）<0.0017 1391.218（1.117～1.329）<0.001
Ⅴ类光气候区68 6661.850（1.750～1.955）<0.00134 5392.013（1.855～2.186）<0.00134 1271.739（1.612～1.877）<0.001
多因素分析
Ⅱ类光气候区5 8271.0002 8501.0002 9771.000
Ⅲ类光气候区8 9841.433（1.331～1.543）<0.0014 5321.538（1.380～1.714）<0.0014 4521.346（1.215～1.490）<0.001
Ⅳ类光气候区14 2331.543（1.437～1.656）<0.0017 0941.629（1.469～1.806）<0.0017 1391.477（1.339～1.629）<0.001
Ⅴ类光气候区68 6661.325（1.238～1.418）<0.00134 5391.434（1.300～1.581）<0.00134 1271.231（1.120～1.354）<0.001
), ArticleFig(id=1311350288737464470, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=CN, label=表3, caption=

男女性别分层下光气候水平与学生近视检出的关联性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
组别总体男生女生
人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值
单因素分析
Ⅱ类光气候区5 8271.0002 8501.0002 9771.000
Ⅲ类光气候区8 9841.075（1.004～1.151）0.0384 5321.165（1.054～1.288）0.0034 4521.011（0.920～1.111）0.817
Ⅳ类光气候区14 2331.281（1.203～1.365）<0.0017 0941.371（1.249～1.504）<0.0017 1391.218（1.117～1.329）<0.001
Ⅴ类光气候区68 6661.850（1.750～1.955）<0.00134 5392.013（1.855～2.186）<0.00134 1271.739（1.612～1.877）<0.001
多因素分析
Ⅱ类光气候区5 8271.0002 8501.0002 9771.000
Ⅲ类光气候区8 9841.433（1.331～1.543）<0.0014 5321.538（1.380～1.714）<0.0014 4521.346（1.215～1.490）<0.001
Ⅳ类光气候区14 2331.543（1.437～1.656）<0.0017 0941.629（1.469～1.806）<0.0017 1391.477（1.339～1.629）<0.001
Ⅴ类光气候区68 6661.325（1.238～1.418）<0.00134 5391.434（1.300～1.581）<0.00134 1271.231（1.120～1.354）<0.001
), ArticleFig(id=1311350288812961943, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=EN, label=Table 4, caption=

Correlation analysis of light climate levels and myopia detection among students under stratification of regional economic levels

, figureFileSmall=null, figureFileBig=null, tableContent=
组别地区经济水平好地区经济水平中地区经济水平差
人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值
单因素分析
Ⅱ类光气候区2 5581.000—0——3 2691.000—
Ⅲ类光气候区0——9611.000—8 0231.325（1.215～1.445）<0.001
Ⅳ类光气候区1 6391.146（1.011～1.299）0.0337 2921.539（1.341～1.767）<0.0015 3020.952（0.866～1.046）0.307
Ⅴ类光气候区30 9311.595（1.470～1.731）<0.00126 3461.462（1.281～1.669）<0.00111 3892.176（2.004～2.364）<0.001
多因素分析
Ⅱ类光气候区2 5581.000—0——3 2691.000—
Ⅲ类光气候区0——9611.000—8 0231.516（1.366～1.682）<0.001
Ⅳ类光气候区1 6391.446（1.258～1.661）<0.0017 2921.262（1.082～1.473）0.0035 3021.371（1.216～1.546）<0.001
Ⅴ类光气候区30 9311.267（1.158～1.387）<0.00126 3461.033（0.870～1.226）0.71411 3891.437（1.259～1.641）<0.001
), ArticleFig(id=1311350288905236632, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350274095149167, language=CN, label=表4, caption=

地区经济水平分层下光气候水平与学生近视检出的关联性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
组别地区经济水平好地区经济水平中地区经济水平差
人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值人数OR值
（95%CI）		P值
单因素分析
Ⅱ类光气候区2 5581.000—0——3 2691.000—
Ⅲ类光气候区0——9611.000—8 0231.325（1.215～1.445）<0.001
Ⅳ类光气候区1 6391.146（1.011～1.299）0.0337 2921.539（1.341～1.767）<0.0015 3020.952（0.866～1.046）0.307
Ⅴ类光气候区30 9311.595（1.470～1.731）<0.00126 3461.462（1.281～1.669）<0.00111 3892.176（2.004～2.364）<0.001
多因素分析
Ⅱ类光气候区2 5581.000—0——3 2691.000—
Ⅲ类光气候区0——9611.000—8 0231.516（1.366～1.682）<0.001
Ⅳ类光气候区1 6391.446（1.258～1.661）<0.0017 2921.262（1.082～1.473）0.0035 3021.371（1.216～1.546）<0.001
Ⅴ类光气候区30 9311.267（1.158～1.387）<0.00126 3461.033（0.870～1.226）0.71411 3891.437（1.259～1.641）<0.001
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地区光气候水平对儿童青少年近视影响的研究
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周亮 1 , 任悄悄 1 , 曾玲 2 , 张丽 1
现代预防医学 | 环境与职业卫生 2026,53(15): 2733-2738
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现代预防医学 |环境与职业卫生 2026 , 53 (15) : 2733 -2738
地区光气候水平对儿童青少年近视影响的研究
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周亮1, 任悄悄1, 曾玲2, 张丽1
作者信息
  • 1.四川省疾病预防控制中心，四川 成都 610041
  • 2.德阳市疾病预防控制中心
通讯作者:
张丽，E-mail：
作者简介:

周亮（1988—），男，本科，副主任医师，研究方向：学校卫生

Effect of regional light climate levels on myopia in children and adolescents
Liang ZHOU1, Qiao-qiao REN1, Ling ZENG2, Li ZHANG1
Affiliations
  • Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China
出版时间: 2026-08-10 doi: 10.20043/j.cnki.MPM.202510391
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摘要
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目的

探索地区光气候水平（自然光照水平）对儿童青少年近视的影响及在不同人群中的差异。

方法

在四川省187个区（县）各随机抽取幼儿园2所、小学2所、初中2所，每个学校每年级以整班为单位抽取学生（至少80名）进行视力检查，并问卷调查小学4～6年级学生。使用χ2检验进行近视率的差异性比较，采用logistic回归模型研究地区光气候水平对近视的影响。

结果

330 132名学生纳入研究，Ⅱ类光气候地区（45>Eq≥40klx）学生占5.9%，Ⅲ类光气候地区（40>Eq≥35klx）学生占9.8%，Ⅳ类光气候地区（35>Eq≥30klx）学生占15.1%，Ⅴ类光气候地区（Eq<30klx）学生占69.2%；Ⅱ类、Ⅲ类、Ⅳ类、Ⅴ类光气候区儿童青少年近视率分别为30.4%、29.0%、33.9%、43.1%，随光气候水平降低（类型代码增大）而增高。控制协变量后，以Ⅱ类光气候地区（高光照水平）为参照，Ⅲ类、Ⅳ类、Ⅴ类光气候区均观察到近视的危险效应（OR=1.433,95%CI:1.331～1.543；OR=1.543,95%CI:1.437～1.656；OR=1.325,95%CI:1.238～1.418；P均<0.001）。分层分析，男生、女生、地区经济水平好和差中均观察到相同效应（P均<0.001）。

结论

地区自然光照水平可能会影响儿童青少年近视，建议关注读写环境光照强度，不足时予以人工照明补充，同时进一步增加户外活动时间。

儿童青少年  /  光气候  /  近视
Objective

To explore the influence of regional light climate levels (light levels) on myopia in children and adolescents and the differences among different populations.

Methods

Two kindergartens, two primary schools and two junior high schools were randomly selected from each of the 187 districts (counties) in Sichuan Province. In each school, students (at least 80 students) were selected from the entire class of each grade for vision examination, and questionnaires were conducted among primary school students in grades 4 to 6. The χ2 test was used for the differential comparison of myopia rates. The logistic regression model was used to study the influence of regional light climate levels on myopia.

Results

A total of 330 132 students were included. Among them, 5.9% were from Category II areas (45>Eq≥40klx）, 9.8% from Category III areas (40>Eq≥35klx）,15.1% from Category IV areas (35>Eq≥30klx), and 69.2% from Category V areas (Eq<30klx). The myopia rates of children and adolescents in Class II, Class III, Class IV and Class V areas were 30.4%, 29.0%, 33.9% and 43.1%, and increased with the decrease of light climate levels (the increase of type codes). After controlling for covariates, with the type II area (high light level) as the reference, the risk effect of myopia was observed in the type III, type IV, and type V areas (OR=1.433, 95% CI:1.331-1.543; OR=1.543, 95% CI: 1.437-1.656; OR=1.325, 95% CI: 1.238-1.418, all P<0.001). Stratified analysis showed that the same effect was observed in both male and female students, as well as in regions with good and poor economic levels (P<0.001).

Conclusion

The level of natural light in a region may affect the prevalence of myopia among children and adolescents.It is recommended to ensure adequate light intensity in reading and writing environments, provide supplementary artificial lighting when necessary, and further increase the duration of outdoor activities.

Children and teenagers  /  Light climate  /  Myopia
周亮, 任悄悄, 曾玲, 张丽. 地区光气候水平对儿童青少年近视影响的研究. 现代预防医学, 2026 , 53 (15) : 2733 -2738 . DOI: 10.20043/j.cnki.MPM.202510391
Liang ZHOU, Qiao-qiao REN, Ling ZENG, Li ZHANG. Effect of regional light climate levels on myopia in children and adolescents[J]. Modern Preventive Medicine, 2026 , 53 (15) : 2733 -2738 . DOI: 10.20043/j.cnki.MPM.202510391
正文
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近视是指人眼在调节功能处于放松状态时，外界光线经眼球屈光作用后，焦点落在视网膜前方的病理性屈光异常[1]。其发生与多种解剖或功能异常相关，主要包括眼球轴长过度延长、角膜曲率过大、晶状体屈光力增强等[2]，临床典型表现为远距视力减退[3]。有研究预测，至2050年，近视将累及全球近50%的人口[4-5]。作为近视高发地区，中国儿童青少年的近视患病率约达84%[6-7]，显著高于葡萄牙、美国等国家的同期水平[8]，形势不容乐观。研究表明，光照水平与近视的发生、发展有密切关系[9]。有研究指出，光线不足或日间户外活动减少会增加近视风险，增加户外活动时间能够延缓儿童近视发生，可能与户外环境的高强度光照有关[10]。动物实验也证实，增加光照强度能够延缓实验动物形觉剥夺性近视的进展[10]。因此，自然光线作为重要光源之一，对学生近视的发生、发展的影响不容忽视。目前，国内外虽然有针对自然光照水平与近视关系的相关研究报道，但四川省作为全国少数同时有4类光气候（Ⅱ、Ⅲ、Ⅳ、Ⅴ类）的省份，相关研究报道尚且较少。因此，本次以四川省187个区（县）的儿童青少年为研究对象，开展视力检查及视觉环境和用眼习惯调查，探究地区光气候水平（自然光照水平）对儿童青少年近视的影响。
1　对象与方法
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1.1　研究对象
2024年，在四川省187个区（县）各随机抽取幼儿园2所、小学2所、初中2所，每个学校每年级以整班为单位抽取学生（至少80名）进行视力检查。基于对幼儿园、小学低年级儿童无法独立完成问卷，初中生近视率已经较高，横断面调查的近期影响因素与近视结局关联性减弱等因素考虑，本研究问卷调查4～6年级小学生。本研究获四川省疾病预防控制中心伦理委员会批准（编号：SCCDCIRB第2025-020号），开展前获得学生及其家长的知情同意。
1.2　视力检查
由专业人员进行远视力检查和非睫状肌麻痹状态下的屈光检测，记录裸眼视力、等效球镜度数及戴镜情况。凡任意一眼裸眼视力<5.0且等效球镜度数<-0.50 D，则判定为近视；同时，角膜塑形镜佩戴者直接计为近视。本次共纳入330 132名学生进行近视率的分析。
1.3　问卷调查
由调查人员指导，学生自行填写近视专项问卷。内容包括个人基本信息、视觉环境状况、用眼习惯及父母近视状况等。最终收集97 710份问卷进行影响因素研究。
1.4　地区划分
依据《建筑采光设计标准》（GB 50033—2013）图A.0.1[11]，将各地光气候划分为Ⅰ类（Eq≥45klx）、Ⅱ类（40～<45klx）、Ⅲ类（35～<40klx）、Ⅳ类（30～<35klx）、Ⅴ类（<30klx），共5类水平，类型越靠后，自然光照水平越差，Eq代表天然光年平均总照度值。依据2024年四川统计年鉴中人均国内生产总值（gross domestic product,GDP）数据，将各地经济水平划分为好、中、差三类。
1.5　统计分析
用EXCEL建立数据库，采用R软件进行统计分析。使用χ2检验进行率的差异性比较；使用趋势χ2 检验分析近视检出率随学段和光气候水平的变化。使用二项分类logistic回归模型，在控制了学段、民族、性别、地区经济水平、城区/郊县、课桌椅高度调整频率、调换座位频率、日眼保健操次数、课间休息位置、家庭作业时长、文化类补习时长、看电视时长、近距离用眼时长、使用移动电子设备时长、躺着趴着看书/电子屏幕、走路或乘车看书/电子屏幕、阳光下看书/电子屏幕、休息眼睛时间间隔、父母近视18项因素后，研究光气候水平对近视的影响。双侧检验，检验水准α=0.05。
2　结果
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2.1　基本情况
2024年，共筛查330 132名学生。其中，男生167 186名（50.6%），女生162 946人（49.4%）；汉族255 666名（77.4%），藏族40 111名（12.2%），彝族26 288名（8.0%），其他民族8 067（2.4%）；幼儿园31 745名（9.6%），小学1～3年级101 057名（30.6%），小学4～6年级99 874名（30.3%），初中生97 456（29.5%）；城区110 780名（33.6%），郊县219 352名（66.4%）；经济水平好地区116 188名（35.2%），经济水平中等地区117 763名（35.7%），经济水平差地区96 181名（29.1%）；Ⅱ类光气候地区19 302名（5.9%），Ⅲ类光气候地区32 461名（9.8%），Ⅳ类光气候地区49 832名（15.1%），Ⅴ类光气候地区228 537名（69.2%）；问卷调查97 710名（30.3%）。见表1。
2.2　近视结果
330 132名儿童青少年中，近视者为130 646名，近视率为39.6%，幼儿园大班、小学1～3年级、小学4～6年级、初中学生近视率分别为10.4%、16.3%、47.1%、65.4%，呈现随学段增加而上升的趋势（趋势检验χ2=60 614.896，P<0.001），不同光气候水平也均观察到相同的结果（P均<0.001）。Ⅱ类、Ⅲ类、Ⅳ类、Ⅴ类光气候区儿童青少年近视率分别为30.4%、29.0%、33.9%、43.1%，呈现随光气候水平降低（类型代码增大）而上升的趋势（趋势检验χ2=3 574.078，P<0.001），不同学段也均观察到相同的结果（P均<0.001）。不同性别、民族、城区/郊县、光气候区的儿童青少年近视检出差异有统计学意义（P均<0.001）。见表1、2。
2.3　光气候水平与近视检出的关系
以小学4～6年级学生为研究对象，在控制了性别、民族等18项因素后，以Ⅱ类光气候区（高光照水平）为参照，Ⅲ类、Ⅳ类、Ⅴ类光气候区均观察到近视的危险效应（OR=1.433、1.543、1.325，P均<0.001）。分层分析发现，男、女生结果与总体结果相似（男生：OR=1.538、1.629、1.434；女生：OR=1.346、1.477、1.231，P均<0.001），地区经济水平好和差的学生中均观察到危险效应（好：OR=1.446、1.267；差：OR=1.516、1.371、1.437，P均<0.001）。鉴于没有地区经济水平中等且光气候区为Ⅱ类的学生，以Ⅲ类光气候区为参照，Ⅳ类光气候水平的近视风险是其1.262倍（P=0.003）。见表3、4。
3　讨论
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全国中小学生近视调查显示，2018—2022年中小学生近视率分别为53.6%、50.2%、52.7%、52.6%、51.9%[12-13]，均超过半数，呈现高发态势。该调查还显示，2018和2020年全国幼儿园大班（5.5～6.5岁）儿童近视率分别为14.5%[14]、14.3%[15]，接近15%，低龄化趋势明显。本次研究结果显示，幼儿园大班儿童近视率为10.4%，低于2018和2020年的全国平均水平，但高于刘光杰等[16]对腾冲市的研究。本次研究还发现，四川省幼儿园大班儿童、小学1～3年级、小学4～6年级、初中学生近视检出率分别为10.4%、16.3%、47.1%、65.4%，呈现随学段增加而上升的趋势，小学4～6年级与小学1～3年级近视率差值逾30%，增速较快，应予以重视。提示需进一步关注低年龄段学生，持续做好近视防控“关口前移”。
光照强度是影响儿童青少年近视发生与发展的关键环境因素之一，暴露于较高强度的光照环境有利于延缓眼轴过度增长，进而有效抑制近视的进展并降低其发生率[10,17]。有研究发现，每日接受不少于3 h的自然光照（光照强度≥10 000lux），能够对近视起到显著的预防作用[10]。反之，长期处于较低强度光照的环境下，则可能减少儿童的远视储备量[18]。本次研究发现，儿童青少年近视率随光气候水平的降低而呈明显上升趋势；回归分析结果显示，以高光气候水平的Ⅱ类地区为参照，Ⅲ类、Ⅳ类、Ⅴ类光气候区均观察到近视的危险效应。提示低自然光照水平是近视的重要危险因素。究其原因，可能与低自然光照水平环境下读写，光线不足容易引发视疲劳，长此以往引发近视有关[19]，也可能与低自然光照水平地区的紫外线强度也较低，户外活动时视网膜分泌多巴胺不足，导致其控制眼轴增长的作用减弱有关[20]。按性别、地区经济水平分层分析，得到的结果与整体结果相似，表明自然光照对近视的影响在不同人群中差异并不明显。
本次从生态学研究的角度运用地区自然光照水平来探索光照与近视的关系，非个体实际自然光暴露量，可能导致出现生态学谬误，未来可以综合自然光照暴露强度、时长、节律等因素进行进一步研究。另外，本研究通过问卷收集的学生视觉环境和用眼习惯等影响因素，存在回忆偏倚、报告偏倚的可能，同时未将户外活动时长、学业压力等因素纳入研究，可能进一步增加了导致效应估计偏移的风险。此外，国际公认的诊断近视的金标准是散瞳眼光，而本次屈光检测前未先进行散瞳处理，可能会出现等效球镜度数测量偏大，高估近视率。
综上所述，低自然光照水平为近视的危险因素，建议密切关注儿童青少年读写环境光照强度。同时，学校积极落实“上下午各安排一个30分钟的大课间”“保证学生课间走出教室，‘目’浴阳光”“保障学生每天校内1个小时体育活动”等防控要求[21]，低自然光照水平地区可进一步增加户外活动时间。此外，应避免室内外光强度过高导致的眼损伤效应[22-23]，切实保护好儿童青少年的眼睛。

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2026年第53卷第15期
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doi: 10.20043/j.cnki.MPM.202510391
  • 接收时间：2025-10-21
  • 首发时间：2026-09-28
  • 出版时间：2026-08-10
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  • 收稿日期：2025-10-21
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    1.四川省疾病预防控制中心，四川 成都 610041
    2.德阳市疾病预防控制中心

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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