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Article(id=1320438275941183573, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438244077056901, articleNumber=null, orderNo=null, doi=10.11847/zgggws1147563, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1743436800000, receivedDateStr=2025-04-01, revisedDate=1753113600000, revisedDateStr=2025-07-22, acceptedDate=1756310400000, acceptedDateStr=2025-08-28, onlineDate=1792746617541, onlineDateStr=2026-10-23, pubDate=1781020800000, pubDateStr=2026-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746617541, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746617541, creator=13701087609, updateTime=1792746617541, updator=13701087609, issue=Issue{id=1320438244077056901, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='6', pageStart='641', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='1781020800000', pubDateStr='2026-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746609943, creator='13701087609', updateTime=1792748036545, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444227734065468, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438244077056901, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444227734065469, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438244077056901, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=689, endPage=693, ext={EN=ArticleExt(id=1320438276150898774, articleId=1320438275941183573, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Trends and influencing factors of visual health status among children and adolescents in Macao: an analysis based on surveillance data from 2005 to 2020, columnId=1320438245473760135, journalTitle=Chinese Journal of Public Health, columnName=Special Report—Focus on Child and Adolescent Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the visual health status and its trends and influencing factors among children and adolescents in Macao.

Methods

Utilizing visual acuity data from the Macao Child and Adolescent Physical Fitness Surveillance (2005–2020), this study analyzed the visual health status of 16 688 participants aged 6–18 years. The trend χ2 test was conducted to assess changes in the detection rate of poor vision. Univariate analysis and multivariate logistic regression were employed to identify the factors associated with poor vision.

Results

The overall normal vision rate declined from 39.7% in 2005 to 29.2% in 2010 (trend χ2 = 108.3, P < 0.01) and then increased to 30.1% in 2015 and 30.7% in 2020. Concurrently, the severe poor vision rate exhibited a continuous upward trend, rising from 36.4% in 2005 to 46.3% in 2020 (trend χ2 = 79.0, P < 0.01). Results of the 2020 vision analysis revealed that the prevalence of normal vision in males (33.0%) was higher than that (28.0%) in females (χ2 = 9.9, P < 0.05). Multivariate analysis revealed that low-intensity physical education (PE) classes (OR = 1.92, 95%CI: 1.08–3.41), zero extracurricular physical activity sessions per week (OR = 2.52, 95%CI: 1.10–5.78), and sleep duration < 8 h per day (OR = 2.08, 95%CI: 1.03–4.21) were associated with an increased risk of poor vision. Conversely, limiting the daily electronic device use within 30 min (OR = 0.63, 95%CI: 0.41–0.97), moderate-intensity PE classes (OR = 0.51, 95%CI: 0.30–0.88), and shorter homework completion time (OR = 0.44, 95%CI: 0.25–0.78; reference: ≥ 180 min) were associated with a reduced risk of poor vision.

Conclusions

From 2005 to 2020, the visual health issues among children and adolescents in Macao were characterized by a declining normal vision rate and an increasing trend towards severity. These trends are primarily influenced by lifestyle factors, lack of physical activity, and academic pressure.

, authors=Jiaxin CHEN, Chunmiao WANG, Deqiang ZHAO, Yibei WANG, Yibo GAO, Lupei JIANG, Yanfeng ZHANG, authorsList=Jiaxin CHEN, Chunmiao WANG, Deqiang ZHAO, Yibei WANG, Yibo GAO, Lupei JIANG, Yanfeng ZHANG, authorCompany=null, correspAuthors=Yanfeng ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Yanfeng, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., 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=1320438276666798169, articleId=1320438275941183573, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=澳门儿童青少年视力健康状况变化趋势及影响因素分析：基于2005—2020年监测资料, columnId=1320438247243756426, journalTitle=中国公共卫生, columnName=专题报道——关注儿童青少年健康, runingTitle=null, highlight=null, articleAbstract=
目的

探究澳门儿童青少年视力健康状况、变化趋势以及影响因素。

方法

基于2005—2020年澳门儿童青少年体质监测视力数据，以澳门16 688名6～18岁儿童青少年为研究对象，通过趋势χ2检验分析视力不良检出率变化趋势，采用单因素分析与多元logistic回归探讨儿童青少年视力不良的影响因素。

结果

2005—2010年澳门儿童青少年总体视力正常率由39.7%下降至29.2%，呈现下降趋势（趋势χ2=108.3，P<0.01），随后总体视力正常率增加至2015年的30.1%和2020年的30.7%。重度视力不良率从2005年的36.4%持续上升至2020年的46.3%（趋势χ2=79.0，P<0.01），呈上升趋势。 2020年儿童青少年视力分析结果显示，男生视力正常率为33.0%，显著高于女生的28.0%， 差异有统计学意义（χ2=9.9，P<0.05）。多因素分析显示，体育课强度较低（OR=1.92，95%CI=1.08～1.41）、课外锻炼频率为0次/周（OR=2.52，95%CI=1.10～5.78）、睡眠时间<8 h/d（OR=2.08，95%CI=1.03～4.21）与视力不良风险升高相关；控制电子产品使用<30 min/d（OR=0.63，95%CI=0.41～0.97）、体育课中等强度运动（OR=0.51，95%CI=0.30～0.88）及合理控制完成功课时间（OR=0.44，95%CI=0.25～0.78）与视力不良风险降低相关。

结论

2005—2020年澳门儿童青少年视力健康问题呈现正常率下降及重度化趋势，主要受生活方式、锻炼缺失及学业压力影响。

, authors=陈佳鑫, 王春苗, 赵德强, 王艺蓓, 高艺博, 江露沛, 张彦峰*, *, authorsList=陈佳鑫, 王春苗, 赵德强, 王艺蓓, 高艺博, 江露沛, 张彦峰, authorCompany=null, correspAuthors=张彦峰, authorNote=

陈佳鑫（2001—），硕士，研究方向：体质与健康

, correspAuthorsNote=
张彦峰，E-mail：
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Visual health status of children and adolescents in Macao across different years

, figureFileSmall=null, figureFileBig=null, tableContent=
年份视力正常轻度视力不良中度视力不良重度视力不良
人数检出率/%人数检出率/%人数检出率/%人数检出率/%
2005年1 79439.73267.275216.71 64236.4
2010年1 26329.23909.073317.01 93844.8
2015年1 33230.13798.576717.31 95844.1
2020年1 04930.72557.553015.51 58046.3
), ArticleFig(id=1320438281020485771, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438275941183573, language=CN, label=表1, caption=

不同年份澳门儿童青少年视力状况分布

, figureFileSmall=null, figureFileBig=null, tableContent=
年份视力正常轻度视力不良中度视力不良重度视力不良
人数检出率/%人数检出率/%人数检出率/%人数检出率/%
2005年1 79439.73267.275216.71 64236.4
2010年1 26329.23909.073317.01 93844.8
2015年1 33230.13798.576717.31 95844.1
2020年1 04930.72557.553015.51 58046.3
), ArticleFig(id=1320438281100177548, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438275941183573, language=EN, label=Tab.2, caption=

Univariate analysis of influencing factors of poor vision among children and adolescents

, figureFileSmall=null, figureFileBig=null, tableContent=
因素视力正常轻度视力不良中度视力不良重度视力不良χ2值P值
人数占比/%人数占比/%人数占比/%人数占比/%
性别10.4<0.001
　男生61933.01357.228915.483444.4
　女生43028.01207.824115.774648.5
年龄/岁73.7<0.001
　 6～960651.616213.821818.518916.1
　10～1210024.2204.97417.921953.0
　13～1522422.4424.212812.860460.6
　16～1811914.4313.711013.356868.6
平均每天电子产品使用时间/min42.4<0.001
　<3018846.55714.16917.19022.3
　30～5924343.95710.39717.515728.3
　60～8913132.4358.66917.017042.0
　90～1196925.1165.84215.314853.8
　120～17912424.5295.77414.627955.2
　≥18022019.8454.014513.070563.2
近半年内参加兴趣班7.5<0.001
　没有15746.44413.07121.06619.6
　参加1项17146.85615.36517.87320.1
　参加2项18159.14113.45116.73310.8
　参加≥3项9858.32112.53118.51810.7
每周体育课次数/次29.1<0.001
　0316.7316.7316.7949.9
　140825.71016.323915.084253.0
　263835.31518.428815.972940.4
上体育课时的身体感受25.5<0.001
　呼吸平稳、与平常差不多、没有特别感觉17841.8378.77216.913932.6
　微微出汗、呼吸加快、心跳有点快72130.41787.836315.01 10846.8
　出汗较多、心跳明显加快、上气不接下气14724.5376.29215.332454.0
学校体育课外，体育锻炼频率/（次/周）8.4<0.001
　≥511232.2216.05616.115945.7
　3～422931.5527.211415.733145.6
　1～253733.71358.525716.166441.7
　017122.9699.310313.840254.0
学校体育课外，每次锻炼时长/min20.8<0.001
　<307919.1317.55713.824759.6
　30～5939335.4948.517716.044540.1
　60～9040635.5837.219316.946240.4
平均每天完成功课时间/min4.814<0.001
　<3016730.3417.48916.325246.0
　30～5932730.8999.316715.747044.2
　60～11932831.1908.620119.143441.2
　120～17914130.3398.58618.619842.6
　≥1806121.6227.94716.715153.8
平均每天睡眠时长/h70.16<0.001
　<835123.6906.123215.681354.7
　8～1064434.819710.634518.666736.0
　>102840.823.31217.62738.5
), ArticleFig(id=1320438281192452237, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438275941183573, language=CN, label=表2, caption=

儿童青少年视力不良影响因素单因素分析

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因素视力正常轻度视力不良中度视力不良重度视力不良χ2值P值
人数占比/%人数占比/%人数占比/%人数占比/%
性别10.4<0.001
　男生61933.01357.228915.483444.4
　女生43028.01207.824115.774648.5
年龄/岁73.7<0.001
　 6～960651.616213.821818.518916.1
　10～1210024.2204.97417.921953.0
　13～1522422.4424.212812.860460.6
　16～1811914.4313.711013.356868.6
平均每天电子产品使用时间/min42.4<0.001
　<3018846.55714.16917.19022.3
　30～5924343.95710.39717.515728.3
　60～8913132.4358.66917.017042.0
　90～1196925.1165.84215.314853.8
　120～17912424.5295.77414.627955.2
　≥18022019.8454.014513.070563.2
近半年内参加兴趣班7.5<0.001
　没有15746.44413.07121.06619.6
　参加1项17146.85615.36517.87320.1
　参加2项18159.14113.45116.73310.8
　参加≥3项9858.32112.53118.51810.7
每周体育课次数/次29.1<0.001
　0316.7316.7316.7949.9
　140825.71016.323915.084253.0
　263835.31518.428815.972940.4
上体育课时的身体感受25.5<0.001
　呼吸平稳、与平常差不多、没有特别感觉17841.8378.77216.913932.6
　微微出汗、呼吸加快、心跳有点快72130.41787.836315.01 10846.8
　出汗较多、心跳明显加快、上气不接下气14724.5376.29215.332454.0
学校体育课外，体育锻炼频率/（次/周）8.4<0.001
　≥511232.2216.05616.115945.7
　3～422931.5527.211415.733145.6
　1～253733.71358.525716.166441.7
　017122.9699.310313.840254.0
学校体育课外，每次锻炼时长/min20.8<0.001
　<307919.1317.55713.824759.6
　30～5939335.4948.517716.044540.1
　60～9040635.5837.219316.946240.4
平均每天完成功课时间/min4.814<0.001
　<3016730.3417.48916.325246.0
　30～5932730.8999.316715.747044.2
　60～11932831.1908.620119.143441.2
　120～17914130.3398.58618.619842.6
　≥1806121.6227.94716.715153.8
平均每天睡眠时长/h70.16<0.001
　<835123.6906.123215.681354.7
　8～1064434.819710.634518.666736.0
　>102840.823.31217.62738.5
), ArticleFig(id=1320438281280532622, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438275941183573, language=EN, label=Tab.3, caption=

Logistic regression analysis of influencing factors of poor vision among children and adolescents in Macao, 2020

, figureFileSmall=null, figureFileBig=null, tableContent=
视力不良程度及影响因素比较组参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
轻度视力不良
　学校体育课外体育锻炼频率/（次/周）0≥50.930.424.780.032.521.10～5.78
中度视力不良
　每次体育课的运动感觉呼吸心跳变化不大出汗较多、心跳明显加快、0.650.294.890.031.921.08～3.41
呼吸心跳略快，微微出汗上气不接下气−0.690.285.820.020.510.30～0.88
重度视力不良
　平均完成功课时间/min<30≥180−0.820.298.020.010.440.25～0.78
30～59−0.630.265.790.020.530.32～0.89
　平均每天睡眠时间/h<8>100.730.364.170.042.081.03～4.21
　平均每天使用电子产品时间/min<30≥180−0.460.224.420.040.630.41～0.97
), ArticleFig(id=1320438281360224399, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438275941183573, language=CN, label=表3, caption=

2020年澳门儿童青少年视力不良影响因素logistics回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
视力不良程度及影响因素比较组参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
轻度视力不良
　学校体育课外体育锻炼频率/（次/周）0≥50.930.424.780.032.521.10～5.78
中度视力不良
　每次体育课的运动感觉呼吸心跳变化不大出汗较多、心跳明显加快、0.650.294.890.031.921.08～3.41
呼吸心跳略快，微微出汗上气不接下气−0.690.285.820.020.510.30～0.88
重度视力不良
　平均完成功课时间/min<30≥180−0.820.298.020.010.440.25～0.78
30～59−0.630.265.790.020.530.32～0.89
　平均每天睡眠时间/h<8>100.730.364.170.042.081.03～4.21
　平均每天使用电子产品时间/min<30≥180−0.460.224.420.040.630.41～0.97
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澳门儿童青少年视力健康状况变化趋势及影响因素分析：基于2005—2020年监测资料
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陈佳鑫 , 王春苗 , 赵德强 , 王艺蓓 , 高艺博 , 江露沛 , 张彦峰 *, *
中国公共卫生 | 专题报道——关注儿童青少年健康 2026,42(6): 689-693
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中国公共卫生 |专题报道——关注儿童青少年健康 2026 , 42 (6) : 689 -693
澳门儿童青少年视力健康状况变化趋势及影响因素分析：基于2005—2020年监测资料
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陈佳鑫, 王春苗, 赵德强, 王艺蓓, 高艺博, 江露沛, 张彦峰*, *
作者信息
  • 国家体育总局体育科学研究所国民体质与科学健身研究中心，北京 100061
通讯作者:
张彦峰，E-mail：
作者简介:

陈佳鑫（2001—），硕士，研究方向：体质与健康

Trends and influencing factors of visual health status among children and adolescents in Macao: an analysis based on surveillance data from 2005 to 2020
Jiaxin CHEN, Chunmiao WANG, Deqiang ZHAO, Yibei WANG, Yibo GAO, Lupei JIANG, Yanfeng ZHANG
Affiliations
  • National Fitness and Scientific Exercise Research Center, China Institute of Sport Science, Beijing 100061, China
    • Corresponding Author:
    ZHANG Yanfeng, E-mail:
出版时间: 2026-06-10 doi: 10.11847/zgggws1147563
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摘要
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目的

探究澳门儿童青少年视力健康状况、变化趋势以及影响因素。

方法

基于2005—2020年澳门儿童青少年体质监测视力数据，以澳门16 688名6～18岁儿童青少年为研究对象，通过趋势χ2检验分析视力不良检出率变化趋势，采用单因素分析与多元logistic回归探讨儿童青少年视力不良的影响因素。

结果

2005—2010年澳门儿童青少年总体视力正常率由39.7%下降至29.2%，呈现下降趋势（趋势χ2=108.3，P<0.01），随后总体视力正常率增加至2015年的30.1%和2020年的30.7%。重度视力不良率从2005年的36.4%持续上升至2020年的46.3%（趋势χ2=79.0，P<0.01），呈上升趋势。 2020年儿童青少年视力分析结果显示，男生视力正常率为33.0%，显著高于女生的28.0%， 差异有统计学意义（χ2=9.9，P<0.05）。多因素分析显示，体育课强度较低（OR=1.92，95%CI=1.08～1.41）、课外锻炼频率为0次/周（OR=2.52，95%CI=1.10～5.78）、睡眠时间<8 h/d（OR=2.08，95%CI=1.03～4.21）与视力不良风险升高相关；控制电子产品使用<30 min/d（OR=0.63，95%CI=0.41～0.97）、体育课中等强度运动（OR=0.51，95%CI=0.30～0.88）及合理控制完成功课时间（OR=0.44，95%CI=0.25～0.78）与视力不良风险降低相关。

结论

2005—2020年澳门儿童青少年视力健康问题呈现正常率下降及重度化趋势，主要受生活方式、锻炼缺失及学业压力影响。

儿童青少年  /  视力健康  /  影响因素  /  变化趋势  /  澳门
Objective

To investigate the visual health status and its trends and influencing factors among children and adolescents in Macao.

Methods

Utilizing visual acuity data from the Macao Child and Adolescent Physical Fitness Surveillance (2005–2020), this study analyzed the visual health status of 16 688 participants aged 6–18 years. The trend χ2 test was conducted to assess changes in the detection rate of poor vision. Univariate analysis and multivariate logistic regression were employed to identify the factors associated with poor vision.

Results

The overall normal vision rate declined from 39.7% in 2005 to 29.2% in 2010 (trend χ2 = 108.3, P < 0.01) and then increased to 30.1% in 2015 and 30.7% in 2020. Concurrently, the severe poor vision rate exhibited a continuous upward trend, rising from 36.4% in 2005 to 46.3% in 2020 (trend χ2 = 79.0, P < 0.01). Results of the 2020 vision analysis revealed that the prevalence of normal vision in males (33.0%) was higher than that (28.0%) in females (χ2 = 9.9, P < 0.05). Multivariate analysis revealed that low-intensity physical education (PE) classes (OR = 1.92, 95%CI: 1.08–3.41), zero extracurricular physical activity sessions per week (OR = 2.52, 95%CI: 1.10–5.78), and sleep duration < 8 h per day (OR = 2.08, 95%CI: 1.03–4.21) were associated with an increased risk of poor vision. Conversely, limiting the daily electronic device use within 30 min (OR = 0.63, 95%CI: 0.41–0.97), moderate-intensity PE classes (OR = 0.51, 95%CI: 0.30–0.88), and shorter homework completion time (OR = 0.44, 95%CI: 0.25–0.78; reference: ≥ 180 min) were associated with a reduced risk of poor vision.

Conclusions

From 2005 to 2020, the visual health issues among children and adolescents in Macao were characterized by a declining normal vision rate and an increasing trend towards severity. These trends are primarily influenced by lifestyle factors, lack of physical activity, and academic pressure.

children and adolescents  /  visual health  /  influencing factors  /  trends  /  Macao
陈佳鑫, 王春苗, 赵德强, 王艺蓓, 高艺博, 江露沛, 张彦峰. 澳门儿童青少年视力健康状况变化趋势及影响因素分析：基于2005—2020年监测资料. 中国公共卫生, 2026 , 42 (6) : 689 -693 . DOI: 10.11847/zgggws1147563
Jiaxin CHEN, Chunmiao WANG, Deqiang ZHAO, Yibei WANG, Yibo GAO, Lupei JIANG, Yanfeng ZHANG. Trends and influencing factors of visual health status among children and adolescents in Macao: an analysis based on surveillance data from 2005 to 2020[J]. Chinese Journal of Public Health, 2026 , 42 (6) : 689 -693 . DOI: 10.11847/zgggws1147563
正文
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儿童青少年的视力健康问题已成为全球公共卫生领域重点关注的问题。随着电子产品的普及、学业压力的增加以及生活方式的改变，儿童青少年的近视率不断攀升，并呈现出低龄化和重度化趋势[1–2]，严重损害了儿童青少年的身心健康，影响其未来发展。WHO报告显示，我国青少年近视率高居世界第一，小学生的近视率也近40%[3]。既往儿童青少年视力的研究大多聚焦于中国内地，探讨电子产品使用、户外活动不足、睡眠时间缩短等因素与视力不良的关联[4–5]，但针对澳门儿童青少年的系统性研究较为匮乏。澳门作为中国特别行政区，城市化程度高，教育竞争激烈[6]，其独特的社会经济背景和教育环境，可能加剧儿童青少年视力健康不良风险，亟需本地化研究以揭示澳门儿童青少年视力健康现状及影响因素。自1999年澳门回归祖国以来，在国家体育总局的领导和支持下，国家体育总局体育科学研究所联合澳门特别行政区体育局工作组于2005、2010、2015、2020年顺利开展并完成了4次澳门市民体质监测工作，为精准把握澳门市民体质健康状况筑牢数据根基。本研究基于2005—2020年澳门儿童青少年体质监测视力数据，分析澳门儿童青少年视力健康状况及长期变化趋势，深入剖析视力不良的影响因素，旨在为澳门地区完善儿童青少年视力健康管理体系、遏制近视流行态势提供重要参考，助力实现“健康中国2030”目标。
1　对象与方法
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1.1　对象
以2005—2020年澳门6～18周岁的儿童青少年为研究对象，研究数据来源于2005、2010、2015、2020年澳门儿童青少年体质监测视力数据。采用分层随机整群抽样方法，根据澳门七大堂区进行分片，分为北片（花地玛堂区）、中片（花王堂区、望德堂区）、南片及离岛片（风顺堂区、大堂区、嘉模堂区、圣方济各堂区），在各片内随机抽取6所具有代表性的中小学作为抽样学校，在抽中的学校内，以班级为单位随机整群抽取72个班级学生参与调查，共调查16 688人。2005年、2010年、2015年、2020年分别调查4 514人（男生2 371人，女生2 143人）、4 324人（男生2 219人，女生2 105人）、4 436人（男生2 491人，女生1 945人）、3 414人（男生1 877人，女生1 537人）。本研究已通过国家体育总局体育科学研究所伦理委员会审查（批准文号：CISSLA20190607），所有研究对象及其监护人均签署知情同意书。
1.2　方法
聘用医生作为视力测试人员，需经过专业培训及考核，确保测试数据准确。本研究问卷由国家体育总局体育科学研究所国民体质调查工作组制定发布，内容包括基本信息（姓名、性别、年龄等）、运动习惯（体育课锻炼情况、课外体育锻炼情况等）、生活习惯（电子产品使用情况、参加兴趣班情况、完成功课情况、睡眠时长等）等，并邀请20余名相关领域专家（包括公共卫生、体育科学、儿童保健专业）对问卷内容进行修订与背对背评分，效度（KMO=0.87）及信度（Cronbach′s α=0.84）均达到心理学、测量学要求，适用于国民体质调查工作。问卷调查人员为国民体质测量的调查员，调查过程由专家进行监督，数据录入系统设定异常值范围并人工二次核验数据录入正确率，确保测试规范、数据准确无误。视力检查包括裸眼视力检查，参考《儿童青少年近视防控适宜技术指南》[7]，使用《标准对数视力表》进行裸眼视力检查。根据《标准对数视力表》（GB11533—2011）检查远视力，双侧裸眼视力均≥5.0为视力良好；只要有一只眼睛视力<5.0即为视力不良，视力4.9为轻度视力不良，4.6≤视力≤4.8为中度视力不良，视力≤4.5为重度视力不良。其中视力以双眼中较差者进行数据分析。
1.3　统计分析
采用EXCEL和SPSS 27.0统计软件进行数据收集、处理。计量资料采用Kolmogorov-Smirnov检验进行正态性分析。采用频数分析、描述性统计分析，对儿童青少年总样本进行汇总和整理；采用趋势χ2检验分析儿童青少年视力状况检出率随时间的变化趋势；单因素分析采用χ2检验探讨视力不良的可能影响因素。采用多元logistic回归进行儿童青少年视力不良的影响因素分析，分析各影响因素的影响效应。统计推断采用双侧检验，检验水准α=0.05。
2　结　果
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2.1　澳门2005—2020年儿童青少年视力状况变化趋势（表1）
澳门儿童青少年总体视力正常百分比从2005年的39.7%下降至2010年的29.2%，呈下降趋势（趋势χ2=108.3，P<0.01），2015年增加至30.1%，2020年增加至30.7%，但趋势检验差异无统计学意义；重度视力不良检出率从2005年的36.4%增加至2020年的46.3%，呈上升趋势（趋势χ2=79.0，P<0.01）。轻度视力不良检出率从2005年的7.2%增加至2020年的7.5%，中度视力不良检出率从2005年的16.7%下降至2020年的15.5%，但趋势检验差异均无统计学意义。
2.2　澳门2020年儿童青少年视力状况及视力不良影响因素单因素分析（表2）
2020年视力正常率为30.7%，其中男生视力正常率33.0%（619人）显著高于女生28.0%（430人）（χ2=9.9，P<0.05），各等级视力不良率的性别差异无统计学意义（P>0.05）。视力不良总体检出率为69.3%（2 365人），具体表现为轻度视力不良7.5%（255人）、中度视力不良15.5%（530人）、重度视力不良46.3%（1 580人）。本研究利用2020年数据对视力不良进行单因素分析，结果显示，平均每天电子产品使用时间、近半年（自调查日起向前推算6个月）内参加兴趣班、每周体育课次数、上体育课时的身体感受、学校体育课外每周体育锻炼频率、学校体育课外每次锻炼时长、平均每天完成功课时间、平均每天睡眠时长均是儿童青少年视力不良的影响因素，差异均有统计学意义（均P<0.05）。
2.3　澳门儿童青少年视力不良影响因素多元logistic回归分析（表3）
以视力状况为因变量（视力正常=0；轻度视力不良=1；中度视力不良=2；重度视力不良=3），单因素分析中具有统计学意义的因素（平均每天电子产品使用时间、近半年内参加兴趣班、每周体育课次数、上体育课时的身体感受、学校体育课外，每周体育锻炼频率、学校体育课外，每次锻炼时长、平均每天完成功课时间、平均每天睡眠时长）为自变量纳入多元logistic回归模型，以性别、年龄为协变量。结果显示，澳门儿童青少年课外体育锻炼频率为0次/周的人群轻度视力不良风险升高；体育课主观运动强度感受为“呼吸心跳变化不大”的人群中度视力不良风险升高，而“呼吸心跳略快并微微出汗”的人群中度视力不良风险降低；每日功课完成时间<30 min、每日电子产品使用时间<30 min的人群重度视力不良风险降低，而平均每日睡眠时长<8 h的人群重度视力不良风险升高。
3　讨　论
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本研究分析了2005—2020年澳门6～18岁儿童青少年的视力健康状况。从性别维度看，男生的视力正常率优于女生，可能是因为女生学习更加刻苦，长时间用眼学习所导致；另外女生户外锻炼频率、时长均低于男生[8]，本研究及相关研究[4]均表明体育活动对视力有保护作用。
本研究利用2005—2020年4次澳门儿童青少年体质监测视力数据进行分析。结果显示，2005—2020年，澳门儿童青少年视力正常率呈现“先降后升”的趋势，但总体仍低于2005年基线水平。“先降”的原因可能是学业压力及电子设备的普及，使儿童青少年用眼过多，“后升”的原因可能是在此期间国家《综合防控儿童青少年近视实施方案》的出台及家庭和学校对儿童青少年近视防控的重视。但是视力正常率上升的同时并非简单意味着视力不良率的下降。本研究显示，重度视力不良率持续攀升，提示视力问题呈现重度化趋势。
本研究结果显示，每日使用电子产品时间较长，视力不良率较高，反之视力不良率较低。这与内地学生使用电子产品对视力的不良影响结果一致[9]，因为长时间近距离用眼导致睫状肌持续痉挛，加速眼轴延长，眼压升高，易导致视力不良[10]。提示学生应该合理控制使用电子产品的时间，家长同时做好监督工作，多陪伴孩子进行户外活动，优化孩子娱乐方式。平均每天睡眠时间<8 h的儿童青少年重度视力不良率较高，结果与山东省视力调查结果一致[11]，大量研究也表明充足的睡眠有益于学生视力，夜间用眼加重眼疲劳累积[12–13]。建议学生建立规律生活作息，小学阶段睡眠时长达到9～11 h，中学阶段≥8 h，睡前1 h禁用电子设备[14–16]，保护视力健康。
课外不进行体育锻炼的儿童青少年轻度视力不良风险增加。体育课运动强度不足的儿童青少年，中度视力不良风险增加，体育课运动强度适中的儿童青少年，中度视力不良风险降低。课外额外锻炼和体育课运动强度的联合效应共同构成儿童青少年视力保护的关键环节，当儿童青少年既缺乏课外额外锻炼，体育课强度又不够时，视力不良风险均增加。静态生活方式与无效运动的双重作用会显著影响视力健康[17–18]。建议儿童青少年逐渐养成体育锻炼习惯，保障每日户外活动的时间；家长可以在周末组织家庭运动日，一起参加户外活动如爬山、打羽毛球等；学校优化课程设计、实施，确保达到合适的运动强度。
从学业压力维度分析，平均每天完成功课时间≥180 min的儿童青少年重度视力不良率高达53.8%，平均完成功课时间<30 min及30～59 min的儿童青少年重度视力不良风险均降低。长时间伏案学习容易导致睫状肌持续收缩，眼轴异常增长，加速近视发展。同时占用过多学生的户外活动及睡眠时长，加剧眼疲劳，影响视力[19–20]。建议学生注重学习效率，同时可以采用“20–20–20”护眼法则（每近距离用眼20 min，抬头注视6 m外的物体20 s），注重视力健康；学校努力落实“双减”政策，系统性减轻学业负担、优化学生校园活动，守护学生视力健康。
综上所述，澳门儿童青少年视力健康问题呈现出显著的性别差异及重度化趋势。2005—2020年，视力正常率虽然有所回升，但重度视力不良率仍然较高。多因素分析结果表明，生活方式、锻炼情况以及学业压力是影响儿童青少年视力健康的主要影响因素。本研究还存在一定局限性：研究仅纳入部分影响因素进行分析，实际生活中可能存在其他影响因素。未来研究可进一步纳入更多影响因素，并开展纵向研究以更好地揭示因果关系。

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2026年第42卷第6期
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doi: 10.11847/zgggws1147563
  • 接收时间：2025-04-01
  • 首发时间：2026-10-23
  • 出版时间：2026-06-10
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  • 收稿日期：2025-04-01
  • 修回日期：2025-07-22
  • 录用日期：2025-08-28
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    国家体育总局体育科学研究所国民体质与科学健身研究中心，北京 100061

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