目的：调查湖北省恩施州不同硒含量地区初中生的近视情况，分析血硒和发硒含量与近视发生的相关性。

方法：横断面研究。以随机抽样方法分别抽取2020-09/2021-09富硒(土壤硒含量≥1.28mg/kg)及缺硒(土壤硒含量<1.28mg/kg)地区初中1～3年级学生共600名，各年级学生100名。检测血硒和发硒含量及谷胱甘肽过氧化物酶浓度和近视情况。

结果：近视组学生244名(40.7%)血硒含量为75.14±11.16μg/L，发硒含量为0.51±0.01μg/g，非近视组学生356名(59.3%)血硒含量为110.24±12.14μg/L，发硒含量为0.68±0.02μg/g，两组血硒和发硒含量均有差异(均P<0.01)。低硒地区300名学生血硒含量为76.74±11.25μg/L，发硒含量为0.45±0.01μg/g，近视人数154名(51.3%)； 富硒地区300名学生血硒含量为102.31±10.26μg/L，发硒含量为0.71±0.02μg/g，近视人数90名(30.0%)，与低硒地区学生比较，富硒地区学生血硒和发硒含量明显较高，近视发病率明显减少(均P<0.01)。富硒地区学生的GSH-Px活力含量为114.65±12.12U/L，低硒地区为75.34±13.20U/L(Z=37.994，P<0.01)。血硒和发硒含量与近视发病率负相关(r=-0.542、-0.621，P<0.05)。

结论：恩施地区初中生血硒和发硒含量与近视的发生显著相关，有可能为临床上防治近视提供新思路。

METHODS:A cross-sectional study. A total of 600 students from grades 1-3 of junior high schools(100 students in each grade)in selenium-rich(selenium in soil ≥1.28mg/kg)and selenium-deficient(selenium in soil <1.28mg/kg)areas were randomly selected from September 2020 to September 2021, respectively. The level of serum selenium, hair selenium, glutathione peroxidase(GSH-Px)and myopia condition were determined.

RESULTS:The serum and hair selenium of myopic group(n=244, 40.7%)were 75.14±11.16μg/L and 0.51±0.01μg/g, respectively. Those in the non-myopic group(n=356, 59.3%)were 110.24±12.14μg/L and 0.68±0.02 μg/g, respectively. The serum selenium and hair selenium in the two groups were different(all P<0.01). The serum selenium of 300 students in the selenium-deficient area was 76.74±11.25μg/L, the hair selenium was 0.45±0.01 μg/g, and the number of myopia cases was 154(51.3%); The serum selenium of 300 students in selenium-rich areas was 102.31±10.26 μg/L, the hair selenium was 0.71±0.02 μg/g, and the number of myopia cases was 90(30.0%), the serum and hair selenium in the selenium-rich areas were significantly higher than those compared with the students in selenium-deficient areas, and the myopic incidence was significantly reduced(all P<0.01). The level of GSH-Px of the two areas was 114.65±12.12U/L vs 75.34±13.20U/L(Z=37.994, P<0.01). There is a negative correlation between serum and hair selenium and the myopic incidence(r=-0.542, -0.621, P<0.05).

CONCLUSION:Serum and hair selenium is significantly associated with myopia of junior high school students in Enshi, which may provide new ideas for the clinical prevention and treatment of myopia.