目的：分析儿童散光患病率、散光程度和类型分布以及矫正情况，为防治儿童屈光不正提供科学依据。

方法：本研究为横断面调查研究，纳入陕西省西安市及蓝田县的29 153名6-12岁的儿童，测量视力及非睫状肌麻痹下屈光度，将右眼柱镜度绝对值≥0.5 D定义为散光，分析不同年龄、性别、地区时散光程度及分类构成比的差异以及屈光矫正情况。

结果：随着年龄增大，散光患病率呈上升趋势，11岁时散光患病率最高(62.88%)，男生散光患病率(57.10%)大于女生(54.86%)，市级地区散光患病率(58.29%)大于县级(51.75%)。散光程度以低度散光为主(63.82%)，中度散光随年龄增加呈上升趋势，高度散光儿童中以11岁儿童最多(9.68%)。散光类型以复合近视型散光(59.28%)及混合型散光(25.16%)较多，随着年龄增加，复合近视型散光增加，而单纯近视型散光、单纯远视型散光和复合远视型散光均呈下降趋势，混合型散光6-7岁时占比增加，7-12岁占比逐渐下降。散光轴向类型以顺规散光最多(81.06%)，且随年龄增加，顺规散光占比逐渐增加，11岁时达到最高峰(85.74%)，逆规散光呈下降趋势，斜轴散光则变化趋势不显著。不同性别及地区的各类型散光及散光轴向分布不同。不同年龄、性别及地区的散光程度、散光类型及散光轴向类型均有差异(均P<0.05)。此外，散光儿童总体戴镜矫正率仅为40.18%。

结论：陕西省6-12岁儿童散光总体患病率为56.02%，男生散光患病率大于女生，市级地区患病率大于县级地区，年龄、性别、地区均是散光的影响因素，而进行了屈光矫正的人数却不超过一半，需引起家长及相关部门更多的关注。

METHODS: This cross-sectional study included 29 153 children aged 6-12 years from Xi'an and Lantian County, Shaanxi Province, China. Visual acuity and non-cycloplegic refraction were measured. Astigmatism was defined as an absolute cylindrical power ≥0.5 D in the right eye. Differences in astigmatism severity, type distribution, and refractive correction were analyzed across age, gender, and region.

RESULTS:The prevalence of astigmatism increased with age, peaking at 11 years old(62.88%). Boys(57.10%)had a higher prevalence than girls(54.86%), and the municipal areas(58.29%)had a higher prevalence than county areas(51.75%). Mild astigmatism was the most common(63.82%), with moderate astigmatism increasing with age. The highest prevalence of high astigmatism was observed in 11-years-old children(9.68%). Compound myopic astigmatism(59.28%)and mixed astigmatism(25.16%)were the most frequent types. With increasing age, compound myopic astigmatism increased, while simple myopic, simple hyperopic, and compound hyperopic astigmatism decreased. Mixed astigmatism increased from ages 6 to 7, but declined from ages 7 to 12. For astigmatic axis types, with-the-rule astigmatism was the most prevalent(81.06%)and increased with age, peaking at 11 years(85.74%). Against-the-rule astigmatism showed a declining trend, while oblique astigmatism remained relatively stable. Distribution differences in astigmatism types and axes by gender and region were observed. Significant differences in astigmatism severity, types, and axis types across different ages, genders, and regions were observed(all P<0.05). The overall refractive correction rate for children with astigmatism was only 40.18%.

CONCLUSION: The overall prevalence of astigmatism among children aged 6-12 years in Shaanxi Province was 56.02%, with higher prevalence observed in boys and in municipal areas. Age, gender, and region significantly influenced the prevalence of astigmatism. Notably, less than half of the children with astigmatism received refractive correction, highlighting the need for increased attention from parents and relevant authorities.