早产儿视网膜病变的调查

目的 评价早产儿视网膜病变发病高危因素。方法 对我院2003年9月～2005年12月产科接生的1365例新生儿进行广泛普查，其中205例早产翼均进行眼底检查及早产儿视网膜病变风险评估。结果 确诊早产儿视网膜病变患儿31例。结论 孕龄小于32w；出生体重小于2000g；多胎儿；吸氧浓度大于40％的早产低出生体重儿视网膜病变的高危因素。     

济南地区高危新生儿及高危因素探讨

本文依据全国标准对我院自１９９６年１月－１１月活产新生儿２２６８例分析，高危新生儿３８３例（１６．９％），死亡１８例（４．７％）。在高危因素中阿氏评分＜７，出生体重＜２５００ｇ、产时感染、先天畸形、产伤、出生体重＜２５００ｇ评分＞７，６项中分别例数为１１２（２９．２％）、８４（２１．９％）、１２９（３３．７％）、３２（８．４％）、５（１．３％）和４７（１２．３％）。高危新生儿与母亲高危妊娠有密切关系，与产科因素也有重要关系。文中提出预防高危新生儿应从孕母抓起。     

早产儿颅内出血的高危因素分析

目的研究早产儿颅内出血的高危因素,探讨早产儿颅内出血的预防措施。方法选择湖南省儿童医院新生儿重症监护病房（NICU）2009年1月-2009年12月134例颅内出血早产儿作为研究组,同期130例无颅内出血的早产儿作为对照组,对23个临床因素进行单因素分析,筛选早产儿颅内出血的高危因素。结果单因素分析发现胎龄、出生体重、妊高征、前置胎盘、胎膜早破、产时窒息、脐带绕颈、宫内窘迫、呼吸暂停、代谢性酸中毒、低氧血症、高碳酸血症、机械通气、吸入高浓度氧等14项与早产儿颅内出血有关（P〈0.05）。再对这些相关因素进行Logistic回归分析确定胎龄、出生体重、产时窒息、宫内窘迫、代谢性酸中毒、低氧血症、高碳酸血症、机械通气、吸入高浓度氧等9项为早产儿颅内出血的高危因素（P〈0.05）。结论早产儿颅内出血的高危因素较多,在早产儿的诊治过程中应予足够重视,从而提高预见性并在早期采取相应干预措施。     

早产儿智力发育及影响因素研究

对２８３名４～９岁的早产儿进行智力发育追踪调查，随机选择２８３名足月正常体重儿做对照。结果显示：早产儿组智商（ＩＱ）值明显低于足月儿组（Ｐ＜０．０００１）。在孕周＜３０周的早产儿中ＩＱ＜７０者占８０％；孕周３０～３２周中占４３．７％；出生体重＜１５００克的早产儿ＩＱ＜７０者占４０．７％。对影响早产儿智力发育的因素作多元逐步回归分析，提示出生孕周、体重、早期教育、新生儿疾病、孕期营养、父母受教育年限、儿童头围、婴儿期喂养方式、窒息、喂养时间，师资水平为主要危险因素。     

妊娠高血压疾病与早产儿视网膜病风险关系的Meta分析

目的 探讨妊娠高血压疾病与早产儿视网膜病风险关系。方法 计算机检索中国知网、维普、万方、PubMed、Cochrane Library数据库中以“早产儿视网膜病”“妊娠高血压”为检索词的相关文献,检索时限从各数据库建库至2022年5月31日,按照纳入及排除标准筛选、提取并评价纳入文献的质量。采用RevMan5.3统计学软件进行Meta分析。结果 最终纳入33篇文献,共计47164例研究对象。Meta分析结果显示：在病例对照研究中,妊娠高血压疾病会增加早产儿视网膜病发生的风险[OR=1.52,95%CI(1.16～1.98),P=0.002];在队列研究中,妊娠高血压疾病与早产儿视网膜病没有显著相关性,[OR=1.07,95%CI(0.79～1.46),P=0.66]。亚组分析结果显示：不同统计模型、妊娠期高血压、发达国家、高质量和2015—2021年发表文献提示妊娠高血压疾病会增加早产儿视网膜病的发生率;先兆子痫、发展中国家、中等质量和2000—2014年发表文献无统计学意义。结论 当前证据显示,妊娠高血压疾病与早产儿视网膜病的发生具有相关性,可能是早产儿视网膜病的危险因素。     

早产儿视网膜病变发病情况筛查分析

早产儿视网膜病变（retinopthy of premature,ROP）是一种未成熟或低出生体重婴儿的视网膜增殖性病变,主要是由于未成熟儿视网膜发育不完善,在多种因素的影响下,使视网膜缺血,造成新生儿血管形成,导致增殖性视网膜病变,牵引视网膜脱离,可并斜视、弱视、白内障、青光眼、视网膜变性甚至失明,是导致婴儿视力损伤和失明的主要原因,随着我国早产低出生体重儿治疗需求和生存率的不断提高,ROP的发生率及严重程度逐渐上升。约占儿童致盲原因的6％～18％。随着我国早产低出生体重儿治疗需求和生存率的不断提高,ROP的发生率及严重程度逐渐上升．预防和治疗ROP已成为提高早产低出生质量儿生活质量的重要问题。     

早产儿视网膜病变的研究进展

目的早产儿视网膜病变(ROP)原称晶体后纤维增生症,是一种增殖性视网膜病变.其特征是早产儿视网膜血管发育异常,新生血管形成,纤维增殖及视网膜脱离,可导致包括终生失明在内的多种严重并发症.近年来由于新生儿重症监护病房(NICU)医疗水平的不断提高,早产儿的存活率明显提高,本病的发病率呈显著增加趋势,目前已成为世界范围内儿童致盲的主要原因.因此,对BOP的早期防治应引起高度重视.     

早产儿视网膜病变发病率的临床研究

目的 研究以人群为基础的早产儿视网膜病变发病率。方法 对我院2003年9月至2005年12月产科接生的1365例新生儿进行广泛普查，特别是早产儿，均对其进行眼底检查及早产儿视网膜病变风险评估。结果 在205例早产儿中，确诊为早产儿视网膜病变患儿为31人。结论 在普查的1365例新生儿中，早产儿视网膜病变发病率为2．27％，1-3期病变患儿占早产儿百分比为12％，4—5期患儿占早产儿百分比为3％。     

1183例高危孕妇因素及高危管理分析

目的提高我区高危管理质量,降低孕产妇死亡率。方法对我区2010年分娩的1183例高危孕妇情况及分娩方式进行分析。结果高危因素中首位因素为妊娠合并贫血;有高危因素的孕产妇剖宫产率为74.64%,无高危因素孕产妇剖宫产率为58.05%,两者比较有显著性差异（P〈0.01）结论提高我区各级妇保门诊对高危孕产妇筛查能力与管理水平,对保障母婴安全与健康起着至关重要的作用。     

心血管常见病的高危发病因素分析及社区预防研究

目的 总结心血管常见病高危发病因素,探讨社区性预防途径及方法.方法 选择2013年1月～2014年1月我市所属25家卫生服务站中登记的150例心血管疾病患者作为观察对象,将患者分为观察组(75例)和对照组(75例).对观察组患者实施健康教育,包括疾病预防、不良生活习惯干预及不良情绪指导,对照组仅给予常规干预模式,比较两组患者TC、TG、LDL-C、HDL-C、血压及生活质量改善情况.结果 所有患者均获得随访,随访时间6个月,随访期间无死亡案例出现;社区预防性干预后,观察组患者血压、血脂水平改善程度显著优于对照组,差异具有统计学意义(P＜0.05);观察组干预后生活质量评分显著高于干预前及对照组干预后,P＜0.05.结论 在社区内对心血管患者开展健康教育,可扩大相关疾病普及率,为患者预后提供良好指导,进一步提高患者生存质量.     

高氧诱导早产新生鼠视网膜病变的实验研究

目的探讨高浓度氧对新生鼠视网膜的影响及其机制。方法将新生鼠放入含氧80%的氧箱中连续饲养14d,再置于空气中饲养5d,以一直在空气中饲养的同龄鼠为对照组。分别检测14d、19d龄鼠血管灌注及密度计数检测鼠视网膜血管主干直径及周边血管覆盖率:HE染色观察并计数突破视网膜内界膜的内皮细胞核数目,检测鼠视网膜新生血管。结果持续高浓度氧使幼鼠视网膜血管收缩、分支闭塞,视网膜血管主干直径、周边血管覆盖率明显降低(P<0.01);相对低氧使视网膜血管扩张、增生,两组比较差别有显著性意义(P<0.01)。结论高浓度氧能短时间内有效诱导W istar新生鼠视网膜新生血管的生长,成功构建(retinopathy of prem aturity,ROP)动物模型,可进行定量研究,是研究ROP发病机制及治疗对策较合适的模型。     

新生儿硬肿症的高危因素分析

１９８５－１９９３年我院儿科收治新生儿硬肿症１１９例，存活６５例，自动出院９例，死亡４５例．经统计学分析认为该病发病的高危因素依次为：环境温度低、体温低、出生体重低、围产期异常、早产、感染。经存活组与死亡组对比分析认为该病死亡的高危因素依次为：呼吸衰竭（主要是肺出血引起）、ＤＩＣ、硬肿面积大、心脏损害、颅内出血、重要脏器先天畸形、肾损害、休克、低钠血症、酸中毒。     

Oral glucose for pain relief during examination for retinopathy of prematurity: a masked randomized clinical trial

OBJECTIVE:

Ophthalmologic examination for retinopathy of prematurity is a painful procedure. Pharmacological and non-pharmacological interventions have been proposed to reduce pain during eye examinations. This study aims to evaluate the analgesic effect of 25% glucose using a validated pain scale during the first eye examination for retinopathy of prematurity in preterm infants with birth weight ≤1,500 g and/or gestational age ≤32 weeks.

METHODS:

A masked, randomized clinical trial for one dose of 1 ml of oral 25% glucose solution 2 minutes before the first ophthalmologic examination for retinopathy of prematurity was conducted between March 2008 and April 2010. The results were compared to those of a control group that did not receive oral glucose solution. Pain was evaluated using a Neonatal Infant Pain Scale immediately before and immediately after the ophthalmologic examination in both groups. Clinicaltrials.gov: {"type":"clinical-trial","attrs":{"text":"NCT00648687","term_id":"NCT00648687"}}NCT00648687

RESULTS:

One hundred and twenty-four patients who were examined for the first time for retinopathy of prematurity were included. Seventy were included in the intervention group and 54 in the control group. The number of patients with pain immediately before the procedure was similar in both groups. The number of patients with pain after ophthalmologic examination was 15.7% in the intervention group and 68.5% in the control group (p<0.001).

CONCLUSIONS:

One ml of oral 25% glucose solution given 2 minutes before an ophthalmologic examination for retinopathy of prematurity was an effective measure for pain relief.     

Serum concentrations of cytokines in infants with retinopathy of prematurity

Retinopathy of prematurity (ROP) is the leading cause of blindness in preterm infants. In this study, we investigated the cytokine levels in cord blood of normal preterm neonates and preterm infants developed ROP. Serum levels of 10 cytokines in umbilical cord blood were measured by multiplex protein arrays from 62 healthy preterm neonates and 30 preterm neonate cases who developed ROP at later stage. Results showed that serum levels of cytokines including interleukin 7 (IL‐7), monocyte chemotactic protein‐1 (MCP‐1), macrophage inflammatory protein 1 alpha (MIP‐1α), and macrophage inflammatory protein 1 beta (MIP‐1β) were significantly increased in cases who developed ROP than in healthy preterm neonates (3.5‐fold, 3.2‐fold, 3.4‐fold, and 2.1‐fold, respectively), whereas levels of these four cytokines did not reveal any significant differences between healthy preterm infants and normal infants. When comparing the expression of cytokines in ROP patients with different clinical parameters, ROP cases whose gestational age at delivery earlier than 29.0 weeks demonstrated increased levels of MCP‐1 and MIP‐1β than those later than 29.0 weeks (p < 0.05). Also, ROP cases with birth weight less than 1.28 kg revealed significantly higher level of MIP‐1β than those who were heavier than 1.28 kg (p < 0.05). These data indicated that levels of IL‐7, MCP‐1, MIP‐1α, and MIP‐1β were associated with increased risk of ROP, in which MIP‐1β may be further correlated with the severity of ROP.     

Motor asymmetries in preterm infants: Effects of prematurity and illness

Two types of motor asymmetry, postural asymmetry and lateral head turning, were assessed in 3 groups of preterm infants, one of which had experienced respiratory distress syndrome (RDS) in the postnatal period. Results reveal that maintenance of a right postural asymmetry is present as early as 34 weeks conceptional age and is not disrupted by postnatal illness. Lateral head turning after midline placement was evident as early as 36 weeks conceptional age but was disrupted by physiologic condition. Infants who had experienced RDS had poor muscle tonus and did not assume the head right position even at 39 weeks conceptional age. These data argue that lateral responding may be affected by illness and that studies of preterm populations must evaluate postnatal medical condition when assessing both the short- and long-term outcomes of lateral asymmetries.     

早产儿甲状腺功能影响因素分析

目的研究早产儿甲状腺功能三碘甲状腺原氨酸（triiodothyronine,T3）、甲状腺素（thyroxine,T4）、促甲状腺激素（thyroid stimulating hormone,TSH）的影响因素。方法对353例早产儿生后第14天的甲状腺功能进行检测,并收集可能相关的14种因素,运用多元线性回归分析T3、T4、TSH的影响因素。结果在分析的14种因素中对早产儿生后第14天T3有影响的有胎龄、呼吸窘迫综合征（respiratory distress syndrome,RDS）、糖耐量异常,对T4有影响的有胎龄、性别,对TSH有影响的有出生体重比例、性别。结论早产是早产儿暂时性低甲状腺素血症（transient hypothyroxinemia of preterm infant,THOP）的根本原因。胎龄越小,早产儿甲状腺功能越低下。母糖耐量异常、性别、出生体重比值、呼吸窘迫综合征可能影响早产儿的甲状腺功能。     

Insertion and deletion mutations in the dinucleotide repeat region of the Norrie disease gene in patients with advanced retinopathy of prematurity

Retinopathy of prematurity (ROP) is a leading cause of blindness in premature children. It is a multifactorial disorder which causes fibrovascular tissue changes that affect the retina in low birth-weight and short gestational age infants. To determine the prevalence of Norrie disease (ND) gene mutations, clinical examination and molecular genetic analyses were performed in 100 pre-term babies of different ethnic backgrounds who developed advanced ROP. The leukocyte DNA was extracted, amplified by the polymerase chain reaction (PCR), and analyzed by single-strand conformation polymorphism (SSCP), G/T and C/A scanning, and by DNA sequencing. All three exons, including splice sites and the 3′-untranslated region, were screened. Of the 100 patients analyzed, 2 patients with advanced ROP showed a mobility shift in the DNA. In 1 patient, this mobility shift was caused by the insertion of an additional 12-bp CT repeat in exon 1, and in the second patient, there was a 14-bp deletion in the same exon of the ND gene, as evidenced by direct sequencing of the amplified products. Similar analyses of exons 2 and 3 and the 3′-untranslated region failed to detect additional mutations in the gene. None of the 130 normal, unrelated controls revealed similar changes. Taking into account the above results, as well as those of other studies, it appears that the ND gene mutations can account for 3% of cases of advanced ROP. Although the ND gene is not frequently involved in advanced ROP, the present large-scale study further supports the hypothesis that genetic influences may play an important role in the development of severe ROP in some premature infants. Received: December 1, 2000 / Accepted: January 5, 2001     

Prevalence and associated factors of diabetic retinopathy in rural Korea: the Chungju metabolic disease cohort study

This study was aimed to investigate the prevalence of diabetic retinopathy and its associated factors in rural Korean patients with type 2 diabetes. A population-based, cross-sectional diabetic retinopathy survey was conducted from 2005 to 2006 in 1,298 eligible participants aged over 40 yr with type 2 diabetes identified in a rural area of Chungju, Korea. Diabetic retinopathy was diagnosed by a practicing ophthalmologist using funduscopy. The overall prevalence of diabetic retinopathy in the population was 18% and proliferative or severe non-proliferative form was found in 5.0% of the study subjects. The prevalence of retinopathy was 6.2% among those with newly diagnosed type 2 diabetes and 2.4% of them had a proliferative or severe non-proliferative diabetic retinopathy. The odds ratio of diabetic retinopathy increased with the duration of diabetes mellitus (5-10 yr: 5.2- fold; > 10 yr: 10-fold), postprandial glucose levels (> 180 mg/dL: 2.5-fold), and HbA1c levels (every 1% elevation: 1.34-fold). The overall prevalence of diabetic retinopathy in rural Korean patients was similar to or less than that of other Asian group studies. However, the number of patients with proliferative or severe non-proliferative diabetic retinopathy was still high and identified more frequently at the time of diagnosis. This emphasizes that regular screening for diabetic retinopathy and more aggressive management of glycemia can reduce the number of people who develop diabetic retinopathy.     

Intraocular pressure in very low birth weight preterm infants and its association with postconceptional age

OBJECTIVE:

To evaluate intraocular pressure in very low birth weight preterm infants and correlate it with postconceptional age.

METHODS:

The intraocular pressure in a prospective cohort of very low birth weight premature infants (defined as a birth weight ≤1,500 g and gestational age ≤32 weeks) admitted to Hospital de Clínicas de Porto Alegre, Brazil was evaluated weekly. The evaluated outcome was the variation in the intraocular pressure following changes in the postconceptional age (defined as the gestational age at birth plus the age in weeks at the time of examination) in the weeks following preterm birth. Mixed-effects models were used for the statistical analysis to determine the intraocular pressure variation according to postconceptional age, and means and 10^th and 90^th percentiles were calculated for the intraocular pressure values.

RESULTS:

Fifty preterm infants with a mean gestational age of 29.7±1.6 weeks and a mean birth weight of 1,127.7±222.7 g were evaluated. The mean intraocular pressure for the entire cohort considering both eyes was 14.9±4.5 mmHg, and 13.5% of all recorded intraocular pressure values were greater than 20 mmHg. The analysis revealed a mean reduction in the intraocular pressure of 0.29 mmHg for each increase in postconceptional age (p = 0.047; 95% CI: −0.58 to −0.0035). The mean intraocular pressure (P10–P90) decreased from 16.3 mmHg (10.52–22.16) at 26.3 weeks to 13.1 mmHg (7.28–18.92) at 37.6 weeks of postconceptional age.

CONCLUSIONS:

The mean intraocular pressure in very low birth weight preterm infants was 14.9±4.5 mmHg. This value decreased 0.29 mmHg per week as the postconceptional age increased.