目的：调查湘潭市中小学生视力不良、屈光不正患病状况及近视主要影响因素，为中小学生近视防控提供科学依据。

方法：采取整群随机抽样。2018-09/12，在湘潭市区随机抽取5所全日制小学和3所中学，共6 164名学生作为调查对象，进行裸眼视力、矫正视力、眼位检查，双眼中任一眼裸眼远视力低于5.0者，进一步测量双眼屈光度数。自制调查问卷以了解近视发生相关因素。

结果：在6 164名学生中日常生活视力不良男生检出率为40.3%(1 249/3 099)，女生检出率为43.8%(1 343/3 065)(P<0.01)。中小学男生近视患病率59.1% ，女生近视患病率68.7%(P<0.01)。小学生近视患病率为44.1%，远视患病率为3.0% 。初中生近视患病率为71.3%，远视患病率为 1.7%。多因素回归分析显示，年级(初中)、性别(女)、每天写作业时间(>2h)、平均每天睡眠时间(≤8h)、父母为近视是中小学生近视发生的独立危险因素(OR=1.48、1.55、1.26、1.58、2.13，均P<0.05)。

结论：湘潭市中小学生视力不良检出率高，近视发病率高，学生近视与多因素综合作用有关，需进行针对性的综合干预。

METHODS:Cluster random sampling was performed. 6 164 samples were randomly chosen to be tested for uncorrected visual acuity, corrected visual acuity and eye position, and among those whose uncorrected far visual acuity of either eyes below 5.0, refractive power of both eyes were further tested. Self-questionnaire was designed to understand the influencing factors of myopia.

RESULTS: Among 6 164 samples, the rate of presenting visual acuity below 5.0 is 40.3%(1 249/3 099)for male and 43.8%(1 343/3 065)for female respectively(P<0.01). The prevalence of myopia is 59.1% for male and 68.7% for female respectively(P<0.01). The prevalence of myopia is 44.1% for primary school students and 71.3% for secondary school students; the prevalence of hyperopia is 3% for primary school students and 1.7% for secondary school students. Multivariate regression analysis showed that, homework time(>2h), average sleeping time(≤8h)and myopic parents are independent risk factors(OR=1.48, 1.55, 1.26, 1.58, 2.13,all P<0.05)for myopia of primary and secondary school students.

CONCLUSION: The prevalence of visual impairment and myopia for primary and secondary school students in Xiangtan are high, which is influenced by many factors, by which should be intervened comprehensively.