目的：探讨近视防控基地指导站模式对学龄儿童眼轴(AL)增长的影响。

方法：前瞻性队列研究。选取成都市青羊区2022年上半年就读于小学一至三年级并完成2022-2025年连续随访的学生，其中3所2023年实施近视防控基地指导站的学校为干预组，同区域3所未实施该指导站的学校为对照组。干预组采用学校-医院-家庭三位一体近视防控模式，对照组学校未实施该干预措施，仅按常规开展视力筛查。按2022年入学年级分为A组(一年级)、B组(二年级)、C组(三年级)三组。按年级分层进行比较：组间眼轴年变化量(ΔAL)采用独立样本t检验，干预组内不同时间点ΔAL比较采用重复测量方差分析(Bonferroni校正事后检验)。

结果：本研究共纳入学生3 404例，其中干预组1 709例(男897例，女812例，年龄7.64±0.88岁)，对照组1 695例(男902例，女793例，年龄7.75±0.97岁)。干预组中A组537例(男293例，女244例，年龄7.08±0.28岁)，B组721例(男369例，女352例，年龄8.03±0.29岁)，C组451例(男235例，女216例，年龄9.07±0.30岁)。对照组中A组559例(男295例，女264例，年龄7.05±0.28岁)，B组497例(男269例，女228例，年龄8.04±0.30岁)，C组639例(男338例，女301例，年龄9.08±0.30岁)。两组各年级组基线年龄、性别、ΔSE(2022-2023年)、ΔAL(2022-2023年)无差异(均P>0.05)。组间比较显示，干预第1 a(2023-2024年)，干预组与对照组的A、B、C三组ΔAL无差异(均P>0.05)。干预第2 a(2024-2025年)，A、B两组中干预组ΔAL均低于对照组(P<0.001、0.017)，C组ΔAL组间无差异(P=0.419)。组内比较：干预组内A、B、C三组中不同时间段ΔAL有差异(均P<0.001)，与干预前1 a相比，干预第2 a各组ΔAL均减少(均P<0.0167)。

结论：近视防控基地指导站这一三位一体模式的实施，与儿童AL增长减缓相关； 该关联呈现时间累积特征，且在低年级(1-2年级)儿童中更为显著。

METHODS:This was a prospective cohort study.Students enrolled in Grades 1 to 3 of primary schools in Qingyang District, Chengdu, in the first half of 2022 who completed continuous follow-up from 2022 to 2025 were included in this study. Among them, three schools that implemented the MPCGS in 2023 were assigned to the intervention group, and another three schools in the same district without MPCGS served as the control group. The intervention group received the school-hospital-family integrated model for myopia prevention and control,while the control group only received routine vision screening without such intervention measures.Students were categorized into three groups based on their grade in 2022: Group A(Grade 1), Group B(Grade 2), and Group C(Grade 3). Comparisons were stratified by grade, with independent samples t-tests used for intergroup analyses of annual axial elongation(ΔAL)between the intervention and control groups, and repeated-measures ANOVA(Bonferroni-corrected post-hoc test)used for intervention group comparisons across different time points.

RESULTS:Totally 3 404 students were enrolled in this study, including 1 709 in the intervention group(897 males and 812 females, aged 7.64±0.88 y)and 1 695 in the control group(902 males and 793 females, aged 7.75±0.97 y). In the intervention group, there were 537 students in subgroup A(293 males and 244 females, aged 7.08±0.28 y), 721 in subgroup B(369 males and 352 females, aged 8.03±0.29 y), and 451 in subgroup C(235 males and 216 females, aged 9.07±0.30 y). In the control group, there were 559 students in subgroup A(295 males and 264 females, aged 7.05±0.28 y), 497 in subgroup B(269 males and 228 females, aged 8.04±0.30 y), and 639 in subgroup C(338 males and 301 females, aged 9.08±0.30 y). No significant differences were observed between the intervention and control groups within each grade(A, B, and C)at baseline age, sex, SE, AL, ΔSE(2022-2023), and ΔAL(2022-2023)(all P>0.05). During the first intervention year(2023-2024), intergroup comparisons revealed no significant differences in ΔAL between the intervention and control groups within Groups A, B, and C(all P>0.05). During the second intervention year(2024-2025), the intervention group showed significantly lower ΔAL than the control group within Groups A and B(PSymbol|@@0.001 and P=0.017, respectively), while no significant difference in ΔAL was detected in Group C(P=0.419). In the intervention group, there were significant differences in ΔAL at different time points among Groups A, B and C(all P<0.001). Compared with the first year before intervention, the ΔAL of each subgroup significantly decreased in the second year of intervention(all P<0.0167).

CONCLUSION:The implementation of the school-hospital-family integrated MPCGS model was associated with slowed axial elongation. This association exhibited a time-dependent cumulative effect and was more pronounced in lower-grade children(grades 1-2).