严重早产儿视网膜病变相关因素分析(英文)

目的评估严重早产儿视网膜病变(ROP)的发生率及相关危险因素分析。方法回顾性分析2008年5月～2011年5月期间我院957例早产儿的临床资料和出生后4-6周或矫正胎龄32周行ROP筛查的结果。结果 957例早产儿中,发生不同程度ROP病变者86例(8.99%),其中轻度ROP 60例(6.27%),重度ROP26例(2.72%)。发生重度ROP病变的早产儿平均出生体质量为(1420.40±328.6)g,平均出生胎龄为(29.88±1.67)周,而轻度病变患儿的平均出生体质量和出生胎龄分别为(1593.28±339.3)g和(31.78±2.53)周,两组相比具有显著差异(P<0.005)。各因素中,出生胎龄、出生体质量、出生后1min、5 min Apgar评分、输血次数、呼吸暂停史及视网膜出血对严重ROP的发生有影响(P值分别为0.001、0.035、0.001、0.005、0.032、0.04、0.000,a=0.05)。经logistic回归分析,仅出生胎龄与网膜出血与严重ROP的发生有相关性(OR=0.353,95%CI 0.163-0.763,P=0.008;OR=26.133,95%CI 3.042-224.501,P=0.035)。结论严重ROP发病率呈下降趋势并且更多发生在较成熟的早产儿中,受累患儿具有第一次流行的特征。出生胎龄、网膜出血都是预测严重ROP发生的相关因素。

Risk factors for severe retinopathy of prematurity in premature infants: a single-center study

Objective To evaluate the incidence and risk factors for severe retinopathy of prematurity (ROP) in preterm infants.Methods Between May,2008 and May,2011,a total of 957 preterm infants at 4-6 weeks of chronological age or 32 weeks of postmenstrual age underwent retinal evaluation by RetCamⅡ in our center,and the data of infants with ROP in any stage were analyzed.Results Among the 957 preterm infants,we found 86 (8.99％) infants to have ROP in different stages,including 60(6.27％) with mild ROP and 26 (2.72％) with severe ROP.The birth weight and gestational age of the infants with severe ROP averaged 1 420.40+328.64 g and 29.88+1.67 weeks,as compared to 1 593.28±339.30 g and 31.78±2.53 weeks in those with mild ROP,respectively,showing a significant difference between the two groups (P＜0.005).The significant variables for severe ROP included gestational age (P=0.001),birth weight (P=0.035),1 min Apgar score (P=0.001),5 min Apgar score (P=0.005),number of blood transfusions (P=0.032),and the presence of apnea (P=0.04) and retinal hemorrhage (P=0.000).Gestational age and retinal hemorrhage were the independent risk factors for severe ROP (OR=0.353,95％CI 0.163-0.763,P=0.008; OR=26.133,95％CI 3.042-224.501,P=0.035).Conclusion Severe (R)OP tends to have a decreasing incidence and occurs more often in more mature preterm infants.The affected infants have the characteristics of the first epidemics.Gestational age and retinal hemorrhage are independent predictive factors for severe ROP.