中国青少年特发性脊柱侧弯的学校筛查：中山市一项为期五年的评估研究
School screening for adolescent idiopathic scoliosis in China: a five-year evaluating the evaluation in Zhongshan city.
摘要(中文译文)
青少年特发性脊柱侧凸（AIS）的早期发现对于防止其进展为严重病例至关重要。以学校为基础的脊柱侧凸筛查项目可有效识别疑似脊柱侧凸的学生并促进及时干预。本研究旨在评估中国中山市以学校为基础的脊柱侧凸筛查（SSS）项目的有效性和准确性，并评估病例严重程度的趋势，为改进未来筛查方案提出建议。本研究为纵向队列研究，于2017年至2021年每年开展一次，纳入中国广东省中山市多所学校三个年级的初中学生。SSS流程包括视诊、临床评估以及对疑似病例进行确诊性X线检查。分析了阳性检测率（PTR）、进一步检测率（FTR）、诊断率（DR）和严重程度构成比等关键指标，并评估了灵敏度、需筛查人数（NNS）和阳性预测值（PPV）。在五年研究期间，共有7，764名学生筛查为疑似脊柱侧凸阳性，其中51.6%（n=4，376）接受了进一步诊断评估。在接受评估者中，85.5%经影像学确诊为AIS。五年间AIS的估计患病率为1.08%。PPV较高，且确诊患者的严重程度在研究期间有所下降。女生的阳性率和PPV均高于男生，且重症病例比例更高。阳性筛查率随年级升高而增加。中山市的SSS项目识别出了高危学生，并在接受影像学评估者中取得了较高的诊断率。研究期间观察到确诊AIS病例严重程度分布的时间变化。性别和年级相关模式可能有助于完善未来筛查策略，并支持更有针对性的早期发现和干预方法。
Abstract
Early detection of Adolescent Idiopathic Scoliosis (AIS) is crucial to prevent progression to severe cases. School-based scoliosis screening programs can be effective in identifying students with suspected scoliosis and facilitating timely intervention. This study aimed to evaluate the effectiveness and accuracy of a school-based scoliosis screening (SSS) program in Zhongshan, China, and assess trends in case severity, with recommendations for improving future screening protocols. A longitudinal cohort study was conducted annually from 2017 to 2021, involving middle school students from three grade levels across multiple schools in Zhongshan, Guangdong Province, China. The SSS process included visual inspections, clinical assessments, and confirmatory X-rays for suspected cases. Key metrics such as Positive Test Rate (PTR), Further Testing Rate (FTR), Diagnosis Rate (DR), and severity proportions were analyzed. Sensitivity, number needed to screen (NNS), and positive predictive value (PPV) were also assessed. Over the five-year study period, 7,764 students screened positive for suspected scoliosis, of whom 51.6% (n = 4,376) underwent further diagnostic evaluation. Of those evaluated, 85.5% were radiographically confirmed as AIS. The estimated prevalence of AIS over the five years was 1.08%. The PPV was high, and the severity of confirmed cases decreased over the study period. Girls had higher positivity and PPV than boys and a greater proportion of severe cases. Positive screening rates increased across grade. The SSS program in Zhongshan identified students at risk and achieved a high diagnostic yield among those undergoing radiographic evaluation. Temporal changes in the severity distribution of confirmed AIS cases were observed over the study period. Sex- and grade-related patterns may help refine future screening strategies and support more targeted approaches to early detection and intervention.
如何引用
AMA
Zifang Huang, Sizhe Huang, Zhijun Fei, Lingling Zheng, Dongling Yang, Wenjuan Qi, et al. School screening for adolescent idiopathic scoliosis in China: a five-year evaluating the evaluation in Zhongshan city.. Scientific reports. 2026; doi:10.1038/s41598-026-60458-1.
APA
Zifang Huang, Sizhe Huang, Zhijun Fei, Lingling Zheng, Dongling Yang, Wenjuan Qi, et al (2026). School screening for adolescent idiopathic scoliosis in China: a five-year evaluating the evaluation in Zhongshan city.. Scientific reports. https://doi.org/10.1038/s41598-026-60458-1
GB/T 7714
Zifang Huang, Sizhe Huang, Zhijun Fei, Lingling Zheng, Dongling Yang, Wenjuan Qi, et al. School screening for adolescent idiopathic scoliosis in China: a five-year evaluating the evaluation in Zhongshan city.[J]. Scientific reports, 2026 doi:10.1038/s41598-026-60458-1.
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