论文部分内容阅读
目的分析严重早产儿视网膜病变(ROP)的危险因素,为合理制定ROP筛查标准提供参考依据。方法回顾性分析2002年12月至2004年4月期间我院眼科就诊的168例孕龄<37周的早产儿临床资料。记录其性别、胎数(BC)、孕龄(GA)、出生体重(BW)、氧疗时间以及双眼充分散瞳后双目间接检眼镜检查所见的视网膜血管发育情况。按ROP国际分类法(ICROP)记录检查结果,1、2、3期为轻度ROP,阈值病变、4期和5期为严重ROP。应用多元Logistic回归分析分析ROP与性别、BC、GA、BW、氧疗时间等因素之间的关系。结果168例早产儿336只眼中,严重ROP47例91只眼,分别占患儿例数和眼数的28.0%、27.1%。其中,阈值病变20只眼,占6.0%;4期病变11只眼,占3.3%。4期病变中,4A期2只眼,占0.6%;4B期9只眼,占2.7%。5期60只眼,占17.8%。各因素中,GA、BW和氧疗时间对严重ROP的发生有影响(P值分别为0.000、0.000和0.015,α=0.05),性别和BC与ROP无关(P值分别为0.640和0.084,α=0.05)。亚变量统计分析显示,当GA≤30周或BW≤1500g或氧疗时间>4d时早产儿患严重ROP的危险性显著增加。结论严重ROP的发生受GA、BW和氧疗时间的影响,而与性别和BC无关。GA≤30周或BW≤1500g或氧疗时间>4d的早产儿患严重ROP的危险性显著增加,建议重点对此类早产儿进行筛查。
Objective To analyze the risk factors of retinopathy of prematurity (ROP) and provide reference for the rational development of ROP screening criteria. Methods Retrospective analysis of 168 cases of gestational age <37 weeks of premature infants clinical data from December 2002 to April 2004 in our hospital ophthalmology. Record their gender, number of births (BC), gestational age (GA), birth weight (BW), duration of oxygen therapy, and binocular indirect ophthalmoscopy after retinal dilation. According to the ROP International Classification (ICROP) records the results of the examination, 1,2,3 for the mild ROP, threshold lesions, 4 and 5 for the serious ROP. Multivariate logistic regression analysis was used to analyze the relationship between ROP and sex, BC, GA, BW, oxygen therapy time and other factors. Results Among the 168 eyes of 168 preterm infants, 91 eyes were severe ROP and 91 eyes, accounting for 28.0% and 27.1% of the total number of children and eyes, respectively. Among them, the threshold lesion 20 eyes, accounting for 6.0%; 4 lesions 11 eyes, accounting for 3.3%. Stage 4 lesions, 4A 2 eyes, accounting for 0.6%; 4B 9 eyes, accounting for 2.7%. Stage 5 60 eyes, accounting for 17.8%. The factors of GA, BW and duration of oxygen therapy had significant effects on the occurrence of severe ROP (P = 0.000,0.000 and 0.015, respectively, α = 0.05), sex and BC were independent of ROP (P = 0.640 and 0.084, respectively = 0.05). Sub-variables statistical analysis showed that when GA≤30 weeks or BW≤1500g or oxygen therapy time> 4d, the risk of severe ROP in preterm infants was significantly increased. Conclusions The occurrence of severe ROP is affected by GA, BW and oxygen therapy time, but not with gender and BC. Preterm infants with GA ≤30 weeks or BW ≤1500g or oxygen therapy> 4 days have a significantly increased risk of developing severe ROP and it is advisable to screen these preterm infants.