不同胎龄新生儿视网膜发育情况及其影响因素

Development of Amphiblestrodes in Newborn Infants with Different Gestational Age and Its Related Factors

目的观察不同胎龄的新生儿视网膜发育情况,探讨胎龄与早产儿视网膜病变(ROP)的关系及ROP的影响因素。方法 78例不同胎龄新生儿(胎龄28～30周8例,30+1～32周16例,32+1～34周18例,34+1～37周13例,37+1～41周23例),于出生第1-3天检查视网膜血管发育情况,并于出生后4～6周复查眼底,观察ROP发生情况,并分析胎龄、出生体质量、氧疗时间、出生窒息、HIE、颅内出血、呼吸窘迫、高胆红素脑病、母亲产前使用激素、出生后应用肺表面活性物质及母亲妊娠高血压病等因素与ROP发生的关系。结果胎龄28～30周8例中7例(占87.5%)视网膜发育不成熟,30+1～32周16例中9例(占56.3%)视网膜发育不成熟,32+1～34周18例中3例(占16.7%)视网膜发育不成熟,34+1～37周13例中仅1例(占7.6%)视网膜发育不成熟,37+1～41周23例均发育成熟。出生时视网膜发育不成熟的20例新生儿中,8例(占60%)于出生后4～6周复查时发现ROP,而出生时视网膜发育良好的新生儿无一例发生ROP。胎龄、出生体质量、氧疗时间、母亲产前应用皮质激素、呼吸窘迫、使用肺表面活性物质与ROP的发生有关。而出生窒息、HIE、颅内出血、高胆红素脑病等与ROP的发生无明显相关性。结论胎龄、出生体质量、氧疗时间、母亲产前应用皮质激素、呼吸窘迫、使用肺表面活性物质与ROP的发生有关。胎龄越小、出生体质量越低,视网膜发育越不成熟,ROP发生率越高。

Objective To observe the development of amphiblestrodes in newborn infants with different gestation age,and explore the relationship between retinal vascularization and retinopathy of prematurity（ROP） and the related factors.Methods Retinal vascularization was screened and evaluated in 78 newborns in different periods of gestation and birth weights.In this study,infants with 28-30 weeks of gestation were 8 cases,30^＋1-32 weeks of gestation were 16 cases,32^＋1-34 weeks were 18 cases,34^＋1-37 weeks were 13 cases,and 37^＋1-41 weeks were 23 cases.Retinal vascular development was checked at the 1-3 days after birth and were recheched at 4-6 weeks after birth.The perinatal variables including gestational age,birth weight,oxygen use time,birth asphyxia,hypoxic-ischemic encephalopathy,intracranial hemorrhage,respiratory distress,hyperbilirubinemia,anemia,pulmonary surfactant and pregnancy hypertension were analyzed to evaluate their correlations with the occurrence of ROP.Results In this study,7 cases of 8 infants（87.5%） whose gestational age were 28-30 weeks had immature retina,9 cases of 16 infants（56.3%） whose gestational age were 30＋1-32 weeks had immature retina,3 cases of 18 infants（16.7%） whose gestational age were 32＋1-34 weeks had immature retina and 1 case of 13 babies（7.6%） whose gestational age were 34＋1-37 weeks had immature retina,none of 23 babies whose gestational age were 37^＋1-41 weeks had immature retina.There were 8 cases of 20 infants（60%）with immature retina at birth developing ROP.However,none of 58 babies with mature retina had ROP.There was significant relationships between birth body weight,gestational age,time of oxygen use,anemia,respiratory distress,pulmonary surfactant and ROP.There was no relationship between birth asphyxia,hypoxic ischemic encephalopathy,intracranial hemorrhage,hyperbilirubinemia and ROP.Conclusions There was significant relationship between birth body weight,gestational age,oxygen use time,anemia,respiratory distress,pulmonary surfactant and ROP.Young gestational age,low birth body weight and long time oxygen usage are the most important risk factors in the development of ROP.