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H. S. Niranjan K. R. Bharath Kumar Reddy Naveen Benakappa Krishna Murthy Shivananda Shivananda Vishwanath Veeranna 《Indian journal of pediatrics》2013,80(9):726-730
Objectives
To study the role of hematological parameters in predicting retinopathy of prematurity (ROP) in preterm neonates.Method
Two hundred forty eight babies less than 34 wk and/or with a birth weight of less than 2,000 g were evaluated. Peripheral blood smear and complete blood count were done on day one of life. Ophthalmological examination was done as per guidelines and grades of ROP classified and followed up till 40 wk of gestation for complete vascularisation. Cases were matched with similar number of controls (n?=?67) and the sensitivity, specificity and positive predictive value of different parameters were assessed.Results
The incidence of ROP on screening was found to be 27 %. Sixty seven cases were matched with 67 controls as per birth weight and gestational age. Significant risk factors for ROP included longer duration of ventilation, higher FiO2, culture proven sepsis and apnea requiring pharmacotherapy. The incidence of Stage I was 10.5 % (n?=?7), Stage II 58.2 % (n?=?39) and Stage III was 31.3 % (n?=?21). The absolute nucleated RBC (ANRBC) count was found to be the only parameter which was significantly higher in babies with ROP (p?<?0.001). The ANRBC was higher with increasing severity of ROP (p?=?0.003). The sensitivity, specificity and positive predictive value of ANRBC with ROP was higher than other parameters.Conclusions
Increase in ANRBC count correlated with intrauterine hypoxia. Hence, an increase in ANRBC count could be used as a screening tool for the early prediction of ROP in babies. 相似文献2.
Objective
To assess the changing spectrum of ROP, and to compare the siblings of multiple gestations with regard to incidence and severity of ROP. 相似文献4.
Retinopathy of Prematurity 总被引:2,自引:0,他引:2
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Chawla D Agarwal R Deorari A Paul VK Chandra P Azad RV 《Indian journal of pediatrics》2012,79(4):501-509
Retinopathy of prematurity (ROP) occurs due to abnormal proliferation of retinal vessels. The most important risk factors
which predispose to development of ROP include oxygen therapy, anemia needing blood transfusion, sepsis and apnea. Very low
birth weight neonates, those born at ≤32 week of gestation and other preterm neonates with risk factors must be screened for
ROP. As a general rule first screening should be done at 1 month of postnatal age. If screening detects ROP not needing treatment
follow up should be planned according to location and stage of ROP. Better visual outcomes are observed with earlier treatment
at lower threshold. Peripheral retinal ablation with diode laser under adequate analgesia and sedation is the preferred method
for treatment of severe ROP. Guidelines regarding the procedure of dilatation, ophthalmic examination and treatment (if required)
have been provided in the protocol. Close co-operation between the ophthalmologist and neonatologist is essential for successful
management of ROP. 相似文献
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影响早产儿视网膜病变的多因素分析 总被引:4,自引:0,他引:4
目的探讨早产儿视网膜病变(ROP)发病的相关因素。方法对东南大学医学院附属盐城医院NICU完成整个诊疗随访过程的早产儿308例行眼底检查,对各相关因素进行临床分析。结果对308例早产儿行单因素分析得出,出生体质量、胎龄、蓝光照射时间、黄疸程度、吸氧时间、低碳酸血症、低氧血症、颅内出血与ROP发病呈明显相关性(P<0.05)。Logistic回归分析结果显示低胎龄、酸中毒、低碳酸血症及感染是影响ROP发生的显著因素,治疗过程规范用氧后,ROP仅发生在1、2期病变。结论预防早产、防治早产儿各种并发症发生、规范用氧是预防ROP的关键。 相似文献
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Bozdag S Oguz SS Gokmen T Tunay Z Tok L Uras N Erdeve O Dilmen U 《Indian journal of pediatrics》2011,78(12):1503-1509
Objective
To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants.Methods
One hundred sixty seven premature infants who had a birth weight of <1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants’ eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first.Results
Corrected fructosamine was 319.6?±?59.6 and 272.8?±?50.6 mmol/l for group1 on 1st and 30th day respectively; 320?±?61.7 and 268.2?±?47.3 mmol/l for groups 2?+?3 on 1st and 30th day respectively which did not differ between groups (p?=?0.766 and p?=?0.665), whereas duration of hyperglycemia was 1.69?±?1.1 day in group 1 compared with 3.05?±?2.4 day in groups 2?+?3 which was significantly different (p?=?0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09–9.80; p?=?0.035).Conclusions
Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants. 相似文献9.
吴本清 《中国当代儿科杂志》2003,5(6):500-502
目的:早产儿视网膜病(ROP)是儿童视觉损害及致盲的重要原因之一。众多的研究表明低出生体重和低胎龄是ROP发病的主要危险因素。该文旨在探讨除出生体重和胎龄外,影响ROP发生的其他危险因素。方法:根据胎龄、出生体重进行配对,合并ROP的早产儿和未合并ROP的早产儿各32例进行对照研究,对20种可能的危险因素进行Logistic回归性分析。结果:氧疗时间(DOT)、最高动脉氧分压(MaxPaO2)、妊娠高血压(PIH)、生后3 d内最低pH值(MinpH)的比值比(OR)值分别为2.764、2.175、1.935、2.417(P<0.01)。建立的早产儿ROP危险因素主效应模型是Logit(P)=β0+1.265 DOT+1.034MaxPaO2+0.936 PIH-1.273 MinpH (χ2=25.634,P<0.01)。结论:氧疗时间长、高氧血症、妊娠高血压和酸中毒为ROP的高危因素。 相似文献
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Objective
This study was conducted to determine the distribution and risk factors of retinopathy of prematurity (ROP) in premature infants referred to neonates intensive care unit (NICU) of central hospital of Kerman University of Medical Sciences, to obtain primary information on ROP in Kerman, Iran.Methods
In a cross sectional prospective study, data of premature infants screened for ROP including possible risk factors and eye examination results were recorded during 2006-2008 and analyzed by using logistic regression and chi-square tests.Findings
Out of 83 premature infants, 24 (29%) had different stages of ROP (CI 95%: 0.19-0.39). The infants’ mean gestational age (GA) and mean birth weight (BW) in ROP group were 30.17±1.8 weeks and 1247.92±237.1 grams (g), respectively. Logistic regression analysis showed a significant relation between GA and BW with ROP (P<0.001). Indication for treatment was set in 6 (25%) infants.Conclusion
The results of this study illustrate a relatively high prevalence of ROP in this series. GA and BW were independent ROP determinants. 相似文献14.
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Podraza W Podraza H Jezierska K Szwed J Modrzejewska M Rudnicki J Kordek A Domek H 《Indian journal of pediatrics》2011,78(12):1498-1502
Objective
To conduct tests of relationships between different factors that could influence the course of retinopathy of prematurity (ROP) and ROP, particularly the role of hemoglobin variant replacement in adult blood transfusions. 相似文献18.
早产儿视网膜病的影响因素 总被引:3,自引:2,他引:1
目的 探讨早产儿视网膜病(ROP)的影响因素.方法 选择本院患ROP早产儿为观察组,32周以下的早产儿为对照组,对2组患儿胎龄、出生体质量、出生方式、性别、多胎、使用呼吸机时间、休克、呼吸暂停、新生儿寒冷损伤综合征、肺透明膜病(Ⅲ级以上)、严重感染、肺出血及并发症合计数等临床资料进行单因素分析,并对有意义的因素进行多因素Logistic分析.结果 本资料共有早产儿358例,胎龄均小于32周.ROP 34例,其中Ⅰ期13例,Ⅱ期18例,Ⅲ期3例.二组患儿窒息、呼吸暂停、新生儿寒冷损伤综合征、肺透明膜病、严重感染、肺出血等并发症的发生率比较差异均有统计学意义(Pa<0.05),并发症合计数(OR=2.152,P=0.048)、使用呼吸机时间(OR=1.514,P=0.009)是危险因素.结论 早产儿ROP的发生率和发生并发症的多少及使用呼吸机的时间长短有关.在临床工作中要更多关注并发症的情况. 相似文献
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血管内皮生长因子在早产儿视网膜病发病中的作用 总被引:1,自引:0,他引:1
血管内皮生长因子(VEGF)是内皮细胞特异性有丝分裂原,是促使血管发育和新生血管形成的最重要物质。VEGF在早产儿视网膜病的发病中起重要作用,并受多因素的调控和影响。氧浓度可进行多环节的调控,高氧抑制VEGF的表达,低氧促进VEGF的表达。胰岛素样生长因子-1的允许作用使VEGF能最大程度地诱导视网膜新生血管的生长。此外,雌激素、转化生长因子-β、血小板源性生长因子、胎盘生长因子和血管紧张素II等均对VEGF有一定的影响。随着对VEGF与早产儿视网膜病研究的不断深入,针对VEGF的一些内科治疗方法已开始动物实验研究,为早产儿视网膜病的早期干预提供了可能。 相似文献
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Luca Filippi Giacomo Cavallaro Patrizio Fiorini Marta Daniotti Valentina Benedetti Gloria Cristofori Gabriella Araimo Luca Ramenghi Agostino La Torre Pina Fortunato Liliana Pollazzi Giancarlo la Marca Sabrina Malvagia Paola Bagnoli Chiara Ristori Massimo Dal Monte Anna Rita Bilia Benedetta Isacchi Sandra Furlanetto Francesca Tinelli Giovanni Cioni Gianpaolo Donzelli Silvia Osnaghi Fabio Mosca 《BMC pediatrics》2010,10(1):1-11