低体重儿P-VEP改变及影响因素的研究

The tentative investigation of associated factors of P VEP changes in low birth weight children

为研究低体重儿（ＬＢＷＩ）视功能发育状态及影响因素，用日本ＮｅｕｒｏｐａｃｋⅡ电生理仪，对３～１０岁１３８例ＬＢＷＩ进行图形视诱发电位（Ｐ—ＶＥＰ）检查，３１例３～１０岁足月正常体重儿作对照组，记录１４６’、７３’、３６．５’三种空间频率的Ｐ１００潜伏期和Ｎ１—Ｐ１振幅。结果：ＬＢＷＩ三种空间频率Ｐ１００潜伏期均较对照组延长，其中中、高空间频率组与对照组比较差异有显著性（Ｐ＜０．０５）；三种空间频率的振幅值明显低于对照组，差异有非常显著性（Ｐ＜０．００１）；潜伏期延长和振幅降低主要集中在胎龄＜３２周、体重＜２．０ｋｇ组。多元回归分析示Ｐ－ＶＥＰ改变与出生体重、胎龄及围产期窒息、脑损害和眼部病变等因素有关。无眼、脑合并症的早产ＬＢＷＩ组的振幅与对照组比较仍存在统计学差异（Ｐ＜０．０５）。结论：ＬＢＷＩ具有视觉发育障碍的高风险，应给予视功能发育的早期监测及随访。

Abstract To study the developmental state of visual function and its associated factors in the Low birth weight infant.The P VEPs were tested in 138 LBWI aged 3～10 years and 31 mature and normal birth weight children of the same age(the control group)using Neuropack Ⅱ made in Japan.The P 100 latencies and N 1 P 1 amplitudes of 146’,73’ and 36 5’ spatial frequencies were recorded.Results:The P 100 latencies of the three spatial frequencies in the LBWI were longer than those in the control group,and a significant difference was seen in the middle and high spatial frequencies(P<0 05);the amplitudes of the three spatial frequencies were obviously lower than those in the control group,indiating greatly significant difference(P<0 001);the increase in the P VEPs latencies and the decrease in their amplitudes occurred inainly in the extremely premature or LBWI(gestational age<32 weeks,birth weight<2 0kg).Multiple linear regression analysis show that the changes of P VEPs latencies and amplitudes were found to be associated with birth weight,gestational age,perinatal asphyxia and brain damage and so on.Conclusions:The LBWI have a high risk for delayed visual development.The care of their vision should be started from the perinatal period and followed up as early as possible.