摘要目的:追踪调查青海省西宁市湟中区小学生的视力、屈光状态变化情况。方法:队列研究。首都医科大学附属北京儿童医院眼科于2020年9月和2021年7月对青海省西宁市湟中区16所小学及教学点一至五年级学生的视力、屈光状态进行普查。对视力<1.0的儿童使用复方托比卡胺滴眼液（0.5%托吡卡胺和0.5%盐酸去氧肾上腺素）散瞳验光，近视定义为睫状肌麻痹后等效球镜（spherical equivalent，SE）≤-0.5 D。计量资料数据分析行 t检验，计数资料行χ 2检验，影响因素分析采用多元线性回归分析。 结果:两年重复受检的2 489人被纳入研究。2020年近视患病率为26.24%（653/2 489），2021年近视患病率为32.94%（820/2 489）。一至五年级一学年近视发病率依次为11.19%（47/420），5.44%（21/386），6.39%（25/391），11.52%（44/382）和11.67%（30/257）。各年级儿童双眼平均SE均较前一年向负值增大（一至五年级分别增加：0.40 D、0.69 D、0.62 D、0.52 D和0.37 D）。结论:青海省西宁市湟中区小学生近视患病率较高。一年级和四、五年级是小学阶段两次近视发病高峰，女生、年级、基线SE是近视进展的相关影响因素。

abstractsObjective:To determine the characteristics and progress of the visual acuity and refractive state of schoolchildren in Huangzhong District, Xining City, Qinghai Province in China.Methods:Cohort study. Department of Ophthalmology, Beijing Children′s Hospital carried out a cohort study by collecting the visual acuity and refractive state of Grade 1-5 schoolchildren among 16 primary schools in Huangzhong District, Xining City, Qinghai Province in September 2020 and July 2021. Cycloplegic retinoscopy with eye drop which contained tropicamide (0.5%) and phenylephrine hydrochloride (0.5%) was performed in children with low vision(<1.0). Myopia was defined as the spherical equivalent (SE) ≤-0.5 D after cycloplegic retinoscopy. Measurement data was analyzed by t-test and enumeration data was analyzed by χ 2 test. Multiple linear regression was used to analyze the influencing factors. Results:The 2 489 individuals with repeated tests in two years were included in the follow-up study, among whom the prevalence of myopia was 26.24%(653/2 489) in 2020, while 32.94% (820/2 489)respectively in 2021. The incidence of myopia in one school year from grades 1 to 5 was 11.19%(47/420), 5.44%(21/386), 6.39%(25/391), 11.52%(44/382) and 11.67%(30/257). The average SE of children in all grades in 2021 increased negatively from the previous year (Grade 1 to Grade 5 increased respectively: 0.40 D, 0.69 D, 0.62 D, 0.52 D and 0.37 D).Conclusions:The prevalence of myopia among schoolchildren in Huangzhong District, Xining City, Qinghai Province was relatively high. There were two peaks of myopia incidence in the first, fourth and fifth grades. Female, age, and the baseline of SE were the related influencing factors for myopia progression.