摘要
目的调查渝东北学龄期青少年(3、5、7年级)扁平足患病率及流行病学特征,分析其影响因素,为选择干预方式提供科学依据。方法利用足底光学观测镜及问卷对重庆市万州区内10所城乡在校3、5、7年级学龄期青少年进行扁平足筛查,记录相关参数,纳入性别、遗传、BMI、运动时间、鞋具、足踝外伤史、对危害了解情况、有无就医、预防措施了解情况进行扁平足患病的单因素logistic回归分析。将单因素logistic回归分析中差异有统计学意义变量纳入多因素logistic回归分析。结果5058例学龄期青少年扁平足的患病人数为2163例,患病率为42.76%(2163/5058)。城乡患病率差异:城镇为43.70%(1444/3304),乡村为40.99%(719/1754),两者比较差异无统计学意义(χ^(2)=3.334,P=0.068)。性别患病率差异:男性为45.56%(1212/2660),女性为39.66%(951/2398),男性患病率高于女性,差异有统计学意义(χ^(2)=17.730,P<0.001)。年级患病率差异:3年级为50.48%(839/1662),5年级为42.55%(723/1699),7年级为35.42%(601/1697),不同年级比较差异有统计学意义(χ^(2)=77.912,P<0.001),3年级患病率明显高于5、7年级,且随着年级的增长患病率呈下降趋势(χ_(趋势)^(2)=77.840,P<0.001)。遗传阳性差异:非扁平足遗传阳性占比为7.98%(231/2895),扁平足遗传阳性占比为15.53%(336/2163),遗传对扁平足患病的影响差异有统计学意义(χ^(2)=70.232,P<0.001),且重度、中度、轻度扁平足遗传阳性占比逐渐减少,差异有统计学意义(χ_(趋势)^(2)=44.976,P<0.001)。BMI患病率差异:不同BMI分层扁平足严重程度比较,差异有统计学意义(χ_(趋势)^(2)=21.118,P=0.002),表明不同BMI对扁平足患病率有影响。多因素logistic回归分析结果显示性别、遗传、BMI(18.5~<25.0 kg/m^(2))是渝东北地区学龄期青少年扁平足患病的影响因素(P<0.05)。结论学龄期青少年扁平足患病率随年级增长而下降,女生低于男生,且存在遗传倾向,多数扁平足为轻度扁平足,BMI为高风险因素,对于青少年的扁平足应做到早期识别与干预。
Objective Investigate the prevalence and epidemiological characteristics of flatfoot among a sample of adolescents(grade 3,5 and 7)in the Northeastern Chongqing,analyze the influencing factors,to provide a scientific basis for selecting intervention strategies.Methods Utilizing plantar optical observation mirrors and questionnaires,a flatfoot screening was conducted among grade 3,5 and 7 school-aged adolescents from 10 urban and rural schools in Wanzhou District,Chongqing.Relevant parameters were recorded,and univariate logistic regression analysis was performed considering gender,genetics,BMI,exercise duration,footwear,history of ankle trauma,awareness of risks,medical consultation history,and knowledge of preventive measures for flatfoot prevalence.Variables with statistically significant differences in the univariate logistic analysis were included in the multivariate logistic regression analysis.Results In a sample of 5058 school-age adolescents,2163 were diagnosed with flatfoot,yielding a prevalence rate of 42.76%(2163/5058).Urban and rural areas difference:urban areas had a rate of 43.70%(1444/3304),while rural areas had a rate of 40.99%(719/1754),no statistically significant difference was found between the two(χ^(2)=3.334,P=0.068).Gender difference:males had a rate of 45.56%(1212/2660),and females had a rate of 39.66%(951/2398),the prevalence rate was higher in males than in females,with a statistically significant difference(χ^(2)=17.730,P<0.001).Grade difference:the prevalence rate in grade 3 was 49.45%(822/1662),in grade 5 was 42.78%(727/1699),and in grade 7 was 36.18%(614/1697),there was a statistically significant among different grades(χ^(2)=60.473,P<0.001),while the prevalence rate in grade 3 was significantly higher than that in grade 5 and 7,and it showed a decreasing trend with the increase of the students’grade level(χ_(trend)^(2)=24.223,P<0.001).Genetic differences:the proportion of individuals with a positive genetic predisposition to flat feet was 15.53%(336/2163),the influence of genetics on the occurrence of flat feet was statistically significant(χ^(2)=70.232,P<0.001);furthermore,there was a higher genetic tendency towards severe flatfoot,with statistically significant difference(χ_(trend)^(2)=44.976,P<0.001).BMI difference:comparison of flatfoot severity across different BMI strata showed a significant difference(χ_(trend)^(2)=21.118,P=0.002),indicating that varying BMI levels affect the prevalence of flatfoot.Multivariate logistic regression analysis showed that gender,genetics,and BMI(18.5-<25.0 kg/m^(2))were the influencing factors of flatfoot among adolescents in Northeastern Chongqing(P<0.05).Conclusion The incidence of flatfoot among school-age adolescents decreases with increasing grade,with lower rates among girls than boys,and there is a genetic predisposition.Most flatfoot are mild,and BMI is a high-risk factor.Early intervention should be implemented for flatfoot in adolescents.
作者
汤殷志
骆奇能
常兵
程绪刚
罗森
牟郭子锐
TANG Yinzhi;LUO Qineng;CHANG Bing;CHENG Xugang;LUO Sen;MOU Guozirui(Department of Orthopedics Ward Ⅲ,Chongqing Wanzhou District Institute of Orthopedics/Chongqing Three Gorges Medical College Affiliated Traditional Chinese Medicine Hospital,Chongqing 404151,China;Department of Quality Management,Chongqing Wanzhou District Institute of Orthopedics/Chongqing Three Gorges Medical College Affiliated Traditional Chinese Medicine Hospital,Chongqing 404151,China;School of Pediatrics,Chongqing Medical University,Chongqing 400016,China)
出处
《重庆医学》
2025年第8期1835-1840,1847,共7页
Chongqing Medical Journal
基金
重庆市卫生健康委医学科研项目(2024WSJK038)。
关键词
渝东北
青少年
扁平足
筛查
回归分析
Northeastern Chongqing
adolescent
flatfoot
screening
regression analysis
