Objective: Using the Chinese National Survey on Students' Constitution and Health data from 1985 to 2014 to analyze the trend of excellent and good physical fitness and health status among Chinese Han students aged 13 to 18 years and the related influencing factors. Methods: 738 523 students aged 13 to 18 years with completed data of gender, age, urban and rural, physical form, vital capacity and physical fitness were selected from the six Chinese National Surveys on Students' Constitution and Health. According to National Standards for Students' Physical Health (2014 revision), the comprehensive scores and the prevalence of excellent and good physical fitness and health status were calculated (90.0-120.0 was classified as excellent, and 80.0-89.9 was classified as good). The trend of prevalence of excellent and good physical fitness and health status in different years and the corresponding differences among students with different characteristics were analyzed and compared. The log-binomial regression model was used to analyze related factors of physical fitness and health status. Results: From 1985 to 2014, the overall prevalence of excellent and good physical fitness and health status increased from 27.6% in 1985 to 35.6% in 1995, and then declined to 13.9% in 2005. In the 2010 and 2014 cycles, the prevalence increased steadily, at 16.5% and 19.1% respectively. Except for 1995 and 2014, the prevalence of boys was higher than that of girls (P<0.001). The prevalence of students aged 13 to 15 was higher than that of students aged 16 to 18 (P<0.001). Log-binomial regression model analysis showed that girls ［PR（95%CI）=1.03（1.00-1.05）, P=0.021］, rural area ［PR（95%CI）=1.09（1.07-1.12）, P<0.001］, 13-15 years old［PR（95%CI）=1.89（1.84-1.94）, P<0.001］, eastern region［PR（95%CI）=1.94（1.88-2.00）, P<0.001］, middle region［PR（95%CI）=1.15（1.11-1.20）, P<0.001］, Exercise time ≥1 h/d［PR（95%CI）=1.41（1.37-1.45）, P<0.001］, parents support participation in sports activities after school［PR（95%CI）=1.10（1.06-1.15）, P<0.001］, TV time ≤1 h/d［PR（95%CI）=1.26（1.21-1.30）, P<0.001］, playing video games, watching videos or e-books ≤1 h/d［PR（95%CI）=1.05（1.02-1.09）, P<0.001］ were all related to the high prevalence of excellent and good physical fitness and health status. Conclusion: The prevalence of excellent and good physical fitness and health status among students aged 13 to 18 was changing between 1985 and 2014. Gender, age, area, physical exercise time, screen time for non-learning purposes, and parents' attitudes toward students' participation in physical activities were all related to the excellent and good physical fitness and health status of students.
目的： 利用1985—2014年全国学生体质与健康调研数据，分析中国近30年来汉族13~18岁学生体质健康达标优良率的流行变化趋势及相关因素。 方法： 从1985—2014年6次全国学生体质与健康调研原始数据库中，选取性别、年龄、城乡、身体形态、肺活量和身体素质指标完整的738 523名13~18岁学生作为研究对象。根据《国家学生体质健康标准》（2014年修订）计算体质健康综合得分和优良率（90.0~120.0分为优秀，80.0~89.9分为良好）。分析不同年份学生体质健康达标优良率的变化趋势以及不同特征学生优良率的差异，并采用log-binomial回归模型分析学生体质健康的相关因素。 结果： 1985—2014年间，中国汉族13~18岁学生体质健康达标优良率从1985年的27.6%上升到1995年的35.6%，随后持续下降至2005年的13.9%，在2010和2014年，优良率稳步上升，分别为16.5%和19.1%。男生优良率除1995、2014年外，均高于女生（P<0.001）；13~15岁学生优良率始终高于16~18岁学生（P<0.001）；农村学生优良率在1995、2000、2014年高于城市学生（P<0.05）。log-binomial回归模型分析结果显示，女生［PR（95%CI）=1.03（1.00~1.05），P=0.021］、农村［PR（95%CI）=1.09（1.07~1.12），P<0.001］、13~15岁［PR（95%CI）=1.89（1.84~1.94），P<0.001］、东部［PR（95%CI）=1.94（1.88~2.00），P<0.001］和中部地区［PR（95%CI）=1.15（1.11~1.20），P<0.001］、体育锻炼≥1 h/d［PR（95%CI）=1.41（1.37~1.45），P<0.001］、父母支持课余时间参加体育活动［PR（95%CI）=1.10（1.06~1.15），P<0.001］、看电视时间≤1 h/d［PR（95%CI）=1.26（1.21~1.30），P<0.001］、玩电子游戏、看视频或电子书等≤1 h/d［PR（95%CI）=1.05（1.02~1.09），P<0.001］是学生体质健康达标优良率高的相关因素。 结论： 1985—2014年，中国汉族13~18岁学生体质健康达标优良率呈波动趋势；性别、年龄、地区、体育锻炼时间、非学习目的屏幕时间及父母对学生参加体育活动的态度均与学生体质健康有关联。.
Keywords: Body constitution; Factor analysis; Health status; Students; Trend.