早产儿视网膜病变的筛查及其相关因素分析

Incidence and risk factor analysis of retinopathy of prematurity

目的 探讨发生早产儿视网膜病变(ROP)的全身高危因素。方法 对2002年7月1日至2003年6月30日在北京妇产医院出生的胎龄≤34周或体重≤2000g的早产儿进行眼部检查,并分析发生ROP的相关因素。结果 北京妇产医院98例早产儿中,有17例发生ROP,ROP发生率为17 .3%。出现阈值病变需进行激光治疗者4例(7只眼),占4. 1%。ROP组与正常眼底组早产儿在胎龄、出生体重、吸氧时间( >5d)和最高氧分压及发生败血症方面的差异均有统计学意义(均P<0. 05)。Logistic回归分析结果表明小胎龄、低出生体重等是发生ROP的基本因素,长时间吸氧是发生ROP的危险因素。结论 小胎龄、低出生体重、长时间吸氧等因素与ROP的发生有关。

Objective Retinopathy of prematurity (ROP) is a leading cause of infant blindness. This study was designed to screen the high-risk premature infants and investigate the incidence and risk factors associated with the development of ROP. Methods From July 1 2002 to June 30 2003, all premature infants born in Beijing Maternal and Children Healthcare Hospital with birth body weight (BBW) less than 2000 gm or gestational age (GA) less than 34 weeks were enrolled and underwent ophthalmologic examination. The perinatal variables were analyzed to evaluate their correlation with the development of ROP. Results In 98 premature infants, the incidence of ROP was 17.3% (17 in 98 patients). Four cases with 7 eyes (4.1%) developed threshold ROP. There was significant difference in birth body weight, gestational age, maximal oxygen tension, oxygen use for more than 5 days and sepsis between ROP and Non-ROP groups. Logistic regression analysis indicated that long time use of oxygen was a significant risk factor associated with the development of ROP. GA and BBW were protective factors of ROP. Conclusion Low birth body weight, young gestational age and long time oxygen usage are the most important risk factors in the development of ROP.