阈值期和阈值前期早产儿视网膜病变的远期视网膜电图特征

Full-field flash electroretinogram following up for children with history of pre-threshold or threshold retinopathy of prematurity

目的观察阈值期和阈值前期早产儿视网膜病变（ROP）的远期视网膜电图特征。方法诊断为阈值期或阈值前期ROP的24例患儿48只眼（ROP组）纳入研究。选择出生年龄、体重与之匹配的未发生ROP的早产儿10例20只眼为对照组。经过湖南省儿童医院医学伦理委员会批准并取得所有受检者父母的知情同意后，所有受检儿行全视野闪光视网膜电图（F-ERG）检查，记录视杆反应、最大混合反应以及视锥反应。结果与对照组比较，ROP组患儿的视杆反应b波潜伏期明显延长，差异有统计学意义（t=5．643，P％0．05）；振幅明显降低，差异也有统计学意义（t=7．068，P％0．05）。与对照组比较，ROP组患儿的最大混合反应a、b波潜伏期均延长，差异有统计学意义（t=3．099、2．886，P％0．05）；振幅均降低，差异也有统计学意义（t=5．614、2．850，P％0．05）。与对照组比较，R（）P组患儿的视锥细胞反应a、b波潜伏期（t=0．819、0．948）及振幅（t=0．904、0．850）无明显变化，差异均无统计学意义（P〉0．05）。结论阈值期和阈值前期ROP患儿远期视网膜视杆反应b波及最大混合反应a、b波潜伏期延长，振幅降低；视锥反应a、b波无明显变化。

Objective To evaluate the characteristics of electroretinagram （EGR） in children with history of pre-threshold or threshold retinopathy of prematurity （ROP）. Methods A total of 24 children （48 eyes） with history of pre-threshold ROP or threshold ROP received F-ERG examination. Ten age and body weight-matched children with a history of premature birth （20 eyes） but without ROP were recruited as control group. The rod response, maximal rod-cone response and cone response of F-ERG were recorded respectively following the international Standard Protocal of ISCEV （2000 version）. The latency and amplitude of a-wave and b-wave of various responses were analyzed. The trial was approved by the Ethic Committee of Hunan Children＇s Hospital and informed consent was obtained from the parents of patients prior to any medical procedure. Results There was significant difference between ROP and control group in rod response,the latency was longer （t=5. 643＂,P^0.05） and the amplitude was lower in ROP group（t= 7. 068,P^0.05）. In maximal rod-cone response both in a and b wave, the latency wave was longer（t= 3. 099, 2. 886;P^0. 05） and the amplitude was lower（t=5. 614, 2. 850~P^0. 05） in ROP group. But there is no difference between ROP and control group in cone response latency（t=0. 819, 0. 948）and amplitude （t=0. 904, 0. 850）. Conclusion ERG in ROP children with history of pre-threshold or threshold ROP is abnormal, which mainly in rod response,but the cone response remains normal.