正常早产儿与足月儿视网膜电图特征分析

Characteristics of normal preterm and full-term infants ' electroretinograms

目的了解正常早产儿与足月儿视网膜功能发育的特点。方法选取健康无眼病出生孕周小于37周的早产儿组63例(126只眼),其中孕周小于34周(含34周)早产儿1组28例(56只眼)和出生孕周大于34周早产儿2组35例(70只眼),足月组30例(60只眼)在出生后4～6周进行闪光视网膜电图(ERG)检测,记录视杆细胞反应、视锥细胞反应及最大混合反应。对比分析三组婴儿的ERG的a、b波反应的潜伏期、振幅。结果与足月组婴儿比较,早产组在视杆反应、最大混合反应、视锥反应中b波的潜伏期延长,幅值降低,差异有统计学意义(P=0.044,P=0.030,P=0.001,P=0.025,P=0.040,P=0.024),而a波除了在混合反应中的幅值差异有统计学意义外(P=0.012),其余潜伏期与幅值在视杆反应、最大混合反应、视锥反应中差异均无统计学意义(P=0.100,P=0.186,P=0.379,P=0.861,P=0.059)。而2组早产儿之间,早产1组视杆细胞反应、最大混合反应、视锥细胞反应a波、b波潜伏期较早产儿2组轻度延长,幅值轻度降低,但差异均无统计学意义(P=0.637,P=0.619,P=0.706,P=0.141,P=0.098,P=0.782;(P=0.635,P=0.059,P=0.125,P=0.606,P=0.348,P=0.634)。结论确定了正常足月儿和早产儿1个月龄时F-ERG的3个标准反应的正常值,并比较了各反应值与孕周的关系,发现早产儿视网膜发育程度较足月产婴儿稍低,且出生孕周越低,视网膜的发育程度越差。

Objective To investigate the retinal function development characteristics in normal preterm and full- term infants. Methods Flash electmretinography （ EBG ） was performed on 63 healthy preterm infants （ 126 eyes ） and 35 full-termones（70 eyes）, and the preterm infants were divided two gmupe, including gestational weeks less than 34 weeks （ including 34 weeks ） premature 1 group of 28 cases （ 56 eyes ） and birth 8eatational weeks more than 34 weeks premature 2 group of 35 patients （ 70 eyes）, rmpome d rod cedis and cone cells and maximal mixed responses were recorded. The delitescenee and amplitudes of a-and b-waves and the ratio of amplitudes were analyzed. Results Compared with the full - term infants, The deliteaeenee of b-wave responses of rod cells, maximum mixed respmmes and cone cells in pretenn in- fants was statistically longer ,and the amplitude of b-wave was lower,the differenee were statistically significant（ P =0. 044, P =0.030, P =0.001, P =0.025, P =0.040, P =0.024） ,but except the amplitude of a-wave in the response of maximum mixed responses, there were no significant differences of the deliteacence and amplitude of a-wave,b-wave in all the raspollses. Compared with the preterm group 2, The delitescence of a-wave, b-wave responses of rod cells, maximum mixed responses and cone ceils in preterm group 1 was statistically longer ,and the amplitude of a-wave,b-wave was lower, the difference were statiically significant （ P =0.637, P =0.619, P =0.706, P =0.141, P =0.098, P =0.782; （ P =0.635, P =0.059, P =0.125,P =0.606, P =0.348, P =0.634）. Conclusions Determine the standerd reactlon of ERG in normal preterm and full-term infants, and compared the reaction value with gestational weeks, found pretexm in- fants i-etinal development degree is lower than ful-term infants, and the gestational weeks was lower, the retina was worse.