616例早产儿视网膜病变筛查分析

目的 探讨早产儿视网膜病变(ROP)的发病情况及该病发生的高危因素。 方法 选择2015年11月-2017年6月于安徽省立医院住院且符合2014版早产儿视网膜病变筛查标准的616例早产儿为研究对象,所有研究对象均完成早产儿眼底疾病筛查,根据筛查结果分为ROP组和非ROP组,对ROP组进行分级并计算ROP的发生率。统计所有研究对象的临床资料,比较2组患儿的一般情况、临床诊疗情况、并发症及孕母相关情况,采用单因素分析和Logistic回归分析ROP发生的高危因素。 结果 616例早产儿,发生ROP 47例,发生率为7.7%,其中按国际ROP分类标准,Ⅰ区病变3例,Ⅱ区病变27例,Ⅲ区病变17例。1期病变21例,2期病变13例,3期病变12例,4A期1例,Ⅱ区附加病变1例,病变AP-ROP 1例。2组胎龄、出生体重、头围、5 min Apgar评分、窒息比较差异有统计学意义(均P<0.05);临床诊疗情况的吸氧及吸氧时间、肺表面活性物质(PS)、EPO、输血、氨茶碱和咖啡因的使用在2组的差异存在统计学意义(P<0.05);并发症中支气管肺发育不良、动脉导管未闭、脑室出血的发生在2组间差异有统计学意义(P<0.05);孕母情况的激素和硫酸镁的使用在2组的差异存在统计学意义(P<0.05)。多因素Logistic回归分析结果显示胎龄(OR=0.730,95%CI:0.658~0.815,P<0.001)、吸氧(OR=0.159,95%CI:1.050~37.468,P=0.044)、颅内出血(OR=0.018,95%CI:0.001~0.621,P=0.026)和咖啡因的使用(OR=0.049,95%CI:0.003~0.754,P=0.031)在ROP组与非ROP组间的差异具有统计学意义。 结论 ROP发病率为7.7%,胎龄、吸氧、咖啡因的使用以及重要并发症(颅内出血)与ROP的发生有关。 

Screening and analysis of 616 cases of retinopathy of prematurity

Objective To investigate the incidence of retinopathy of prematurity (ROP) in our hospital and the risk factors of the disease. Methods A total of 616 preterm infants who were admitted to our hospital from November, 2015 to June, 2017 and met the 2014 screening criteria for retinopathy of prematurity were selected. All the subjects were screened for fundus diseases in preterm infants. The results were divided into ROP group and non-ROP group. The ROP group was graded and the incidence of ROP was calculated. The clinical data of all subjects were collected. The general conditions, clinical diagnosis and treatment status, complications, and maternal related conditions were compared between the two groups. Univariate analysis and Logistic regression analysis were used to analyze the risk factors for ROP. Results In 616 preterm infants, there were 47 patients with ROP and the incidence was 7.7%. According to the international ROP classification criteria, 3 cases were in zone Ⅰ, 27 cases were in zone Ⅱ, 18 cases were in zone Ⅲ. And 21 cases were in stage 1, 13 cases in stage 2, 12 cases in stage 3, 1 case in stage 4A, 1 case in additional lesions of zone Ⅱ and 1 case in aggressive posterior RO (AP-ROP). The general gestational age, birth weight, head circumference, 5 min Apgar score, and asphyxia were statistically significant between the two groups (P<0.05); oxygen and oxygen inhalation time, PS, EPO, blood transfusion, the use of aminophylline and caffeine showed statistical significance between the two groups (P<0.05); among the complications, bronchopulmonary dysplasia, patent ductus arteriosus, and intraventricular hemorrhage were statistically different between the two groups (P<0.05); the use of hormones and magnesium sulfate in the maternal condition was statistically significant between the two groups (P<0.05). Multivariate Logistic regression analysis showed the differences between ROP and non-ROP groups in gestational age (OR=0.730, 95% CI:0.658-0.815, P<0.001), oxygen intake (OR=0.159, 95% CI:1.050-37.468, P=0.044), intracranial hemorrhage(OR=0.018, 95% CI:0.001-0.621, P=0.026) and the use of caffeine (OR=0.049, 95%CI:0.003-0.754,P=0.031) were statistically significant. Conclusion The incidence of ROP is 7.7%. The gestational age, oxygen consumption, use of caffeine, and important complications (intracranial hemorrhage) are related to the occurrence of ROP.