重症早产儿视网膜病变的高危因素分析

目的探讨重症早产儿视网膜病变(ROP)的发生率及高危因素分析对临床筛查的指导意义。方法回顾性分析2013年1月至2015年12月756例早产儿临床资料,记录其孕周、出生体重、吸氧时间、吸氧浓度、APgar评分(1分钟in)、APgar评分(5 min)、败血症、呼吸暂停、机械通气、输血等。应用t检验、卡方检验以及Logistic回归分析分析重症ROP与孕周(GA)、出生体重(BW)、吸氧时间、吸氧浓度、APgar评分(1 min)、APgar评分(5 min)、败血症、呼吸暂停、机械通气、输血等因素之间的关系。结果 756例早产儿,严重ROP发生3.3%。各因素中,孕周较少、低出生体重、长时间吸氧、高浓度吸氧、APgar评分(5 min)<4分,机械通气、输血是重症ROP的高危因素,统计学有显著差异。结论严重ROP的发生受孕周较少、低出生体重、长时间吸氧、高浓度吸氧、APgar评分(5 min)<4分,机械通气、输血影响。特别是GA≤28周或BW≤1000 g早产儿患严重ROP的危险性显著增加,建议重点对此类早产儿进行及时筛查。

Analysis of risk factors of severe retinopathy of prematurity

Objective To analyze the risk factors of severe retinopathy of prematurity(ROP)and provide consult-able evidence for the rational establishment of screening standard. Methods The clinical data of 756 premature infants who was diagnosed in our department from Jan 2013 to Dec 2015 was analyzed retrospectively. Gestational age (GA),birth weight (BW),duration of oxygen therapy pressure of dissolved arterial oxygen,1,5-min Apgar scores,septicemia,apnea, mechanical ventilation and blood transfusion ,etc. were recorded. Logistic regression was applied to analyze the relationship of ROP and gender,BC,GA,BW and oxygen therapy. Results The overall incidence of severe retinopathy of prematurity was 3. 3% (25 of 756). In all of the factors,GA,BW,duration of oxygen therapy,pressure of dissolved arterial oxygen, 5 ~ min Apgar scores,mechanical ventilation and blood transfusion were found to have a significant impact on severe ROP. Statistic analysis of subgroup showed that the risk of severe ROP in premature infants would increase significantly when GA≤28 weeks,BW≤1000g. Conclusions Severe ROP relates to GA,BW,the time of oxygen therapy ≥ 7 days,pressure of dissolved arterial oxygen≥40%,5 - min Apgar scores < 4 scores,mechanical ventilation and blood transfusion. The risk of occurrence of severe ROP in premature infants increases significantly when GA≤28 weeks,BW≤1000g,so it is recom-mended to screen such premature infants carefully.