足月新生儿眼生物学参数与屈光度的相关性

Correlation between Ocular Biological Parameters and Refractive Status in Term Infants

目的:探讨足月新生儿的眼部生物学参数与屈光状态的相关关系。方法:横断面研究。采用简单随机抽样的方法纳入2022年1—10月于北京市海淀区妇幼保健院出生的足月新生儿379例(758眼)。通过检影验光获得新生儿睫状肌麻痹后的屈光度并计算等效球镜度(SE),采用眼科A型超声测量仪测量眼轴长度(AL),手持电脑验光仪测定角膜曲率(Km),计算轴率比(AL/CR)。采用秩和检验、t检验或方差分析比较不同性别、眼别、孕周(GA)、日龄、出生体质量(BW)以及父母高度近视新生儿间AL、Km、AL/CR、SE的差异。采用Spearman分析各参数之间的相关性,并用多元线性回归分析建立回归分析方程。结果:足月新生儿AL为(17.09±0.54)mm,Km为47.1(45.6,48.6)D,AL/CR为2.38±0.13,SE为3.00(1.75,4.00)D。男婴的AL较女婴长、Km较女婴低,差异均有统计学意义(t=4.48,P<0.001;Z=-4.39,P<0.001)。婴儿的左眼Km、SE高于右眼,差异均有统计学意义(Z=-3.20,P=0.001;Z=-2.70,P=0.007)。GA越大,AL越长、Km越低(均P<0.001);日龄越大,AL越长、AL/CR越大、SE越低(均P<0.01);BW越高,AL越长、Km越低、AL/CR越小、SE越高(均P<0.01);父母有高度近视者AL更长、SE更低(均P<0.05)。SE与AL、Km、AL/CR均呈负相关(r=-0.49、-0.19、-0.48,均P<0.001)。以SE为因变量,AL、Km为自变量,建立SE线性回归方程:SE=52.24-2.19AL-0.25 Km(R 2=0.35,F=190.19,P<0.001)。结论:足月新生儿的AL较短、Km较高,AL/CR低于正视眼的水平,屈光状态为轻中度远视。日龄越大和父母高度近视者AL越长,远视度越低;BW越大者AL/CR越小,远视度越高。

Objective:To investigate the correlation between ocular biological parameters and refractive status in term infants.Methods:This cross-sectional study included a total of 379 full-term infants(758 eyes)from Beijing Haidian Maternal and Child Health Hospital,selected through simple random sampling.Diopter was assessed by retinoscopy after cycloplegia,from which the spherical equivalent(SE)was calculated.Axial length(AL)was measured by A-type ultrasound,and the keratometric power(Km)was obtained using a handheld auto-keratometer.The axial length/corneal radius ratio(AL/CR)was calculated from AL and Km.Differences in AL,Km,AL/CR and SE across gender,eye,age,gestational age(GA),birth weight(BW),and parental history of high myopia were examined using t-tests,ANOVA or rank sum tests.The correlations between parameters were analyzed using Spearman's correlation analysis.A multiple linear regression model was developed to establish a regression equation.Results:AL of the infants was 17.09±0.54 mm,with Km at 47.1(45.6,48.6)D,AL/CR at 2.38±0.13,and SE at 3.00(1.75,4.00)D.AL in males was significantly higher than in females,while Km was significantly lower in males(t=4.48,P<0.001,Z=-4.39,P<0.001).The Km and SE in the left eye were significantly higher than that in the right eye(Z=-3.20,P=0.001,Z=-2.70,P=0.007).Increased GA was associated with longer AL and lower Km(both P<0.001).Older age correlated with longer AL,bigger AL/CR,and lower SE(all P<0.01).Higher BW was linked to longer AL,lower Km,smaller AL/CR,and higher SE(all P<0.01).Infants with parents having high myopia showed longer AL and lower SE(all P<0.05).SE was negatively correlated with AL,Km,and AL/CR(r=-0.49,-0.19,-0.48,all P<0.001).Regression analysis demonstrated that SE could be predicted by the equation SE=52.24-2.19AL-0.25Km(R 2=0.35,F=190.19,P<0.001).Conclusions:The term infants exhibited shorter AL,higher Km and smaller AL/CR,correlating with the refractive state of mild to moderate hyperopia.Infants of older age or those with highly myopic parents demonstrated longer AL and lower SE.Additionally,infants with higher BW had smaller AL/CR and higher SE.