目的：了解无锡市滨湖区中小学生近视伴脊柱侧弯患病率及影响因素。

方法：采用分层整群随机抽样的方法，抽取滨湖区10所中小学生进行视力检测、脊柱侧弯检查及相关因素问卷调查。使用单变量分析检测脊柱侧弯和近视之间的关系。应用二元多变量Logistic回归模型分析近视和脊柱侧弯共患病相关危险因素。

结果：共抽取17 951名学生，其中男生8 948名(49.85%)，女生9 003名(50.15%)； 小学生9 784名(54.50%)，初中生8 167名(45.50%)。近视、脊柱侧弯及共患病检出率分别为68.30%、2.95%和2.76%。女生的共患率(3.78%)高于男生(1.74%)。共患病检出率初中生(7-9年级为3.67%)高于小学生(4-6年级为2.00%； P<0.001)。Logistic回归分析显示，处于7-9年级(优势比\〖OR\〗=4.43，95%置信区间\〖CI\〗： 2.36-7.85)学生每天课后花费2-3 h(OR=1.46，95%CI： 1.02-2.16)或≥3 h(OR=1.5，95%CI： 1.21-2.55)进行家庭作业或每周>6 d且每次>60 min的中高强度体育活动(OR=1.39，95%CI： 1.08-1.7)，以及未根据学生身高调整书桌和椅子高度(OR=1.73，95%CI： 1.2-2.25)，均是近视与脊柱侧弯共患病的影响因素(P<0.05)。

结论：无锡市滨湖区小学及初中生中近视与脊柱侧弯共病的患病率逐渐受到关注。减少课后作业及读写时间，并每周至少3天进行≥60 min的中高强度体育活动，或有助于降低该人群罹患近视与脊柱侧弯共患病的风险。

METHODS:A stratified cluster random sampling method was used to select students from 10 primary and junior schools in Binhu District for visual acuity testing, scoliosis examination, and a questionnaire survey on related factors. The relationship between scoliosis and myopia was detected using univariate analysis. A binary multivariable logistic regression model was applied to analyze the risk factors associated with comorbid myopia and scoliosis.

RESULTS: A total of 17 951 students were selected, including 8948(49.85%)boys and 9003(50.15%)girls; 9784(54.50%)primary school students and 8167(45.50%)junior school students. The detection rates of myopia, scoliosis, and comorbidity were 68.30%, 2.95%, and 2.76%, respectively. The comorbidity rate was higher in girls(3.78%)than in boys(1.74%). Junior school students(3.67% in Grade 7-9)had a higher total comorbidity detection rate than primary school students(2.00% in Grade 4-6; all P<0.001). Logistic regression analysis showed that being in Grade 7-9 \〖odds ratio(OR)=4.43, 95% confidence interval(CI): 2.36-7.85\〗, spending 2-3 h(OR=1.46, 95%CI: 1.02-2.16)or ≥3 h(OR=1.5, 95%CI: 1.21-2.55)on homework or reading after school, engaging in >60 min of moderate-to-vigorous physical activity >6 days per week(OR=1.39, 95%CI: 1.08-1.7), and not adjusting desk and chair height to match the student's height(OR=1.73, 95%CI: 1.2-2.25)were positively associated with comorbidity(all P<0.05).

CONCLUSION: The prevalence of comorbid myopia and scoliosis among primary and junior school students in Binhu District of Wuxi is concerning. Reducing the time of

homework or reading and writing after school and engaging in ≥60 min of moderate-to-vigorous physical activity at least three days per week may help lower the risk of comorbid myopia and scoliosis in this population.