早产儿视网膜病变筛查及相关因素分析

Screening of retinopathy of prematurity and risk factor analysis

目的：分析我院早产儿视网膜病变（ retinopathy of prematurity，ROP）的发病情况，探讨其相关因素。方法回顾性分析2013年9月至2014年9月我院新生儿科住院的182例早产儿（出生体重〈2000 g或胎龄〈37周）的临床资料。于生后第4~6周或纠正胎龄32周进行ROP筛查，并定期随访。结果182例早产儿中筛查出不同程度ROP患儿32例，占17.6％，其中单眼10例，双眼22例。ROP患儿平均出生胎龄为（29.3±1.5）周，平均出生体重为（1280±240）g，其中ROP 1期11例，2期5例，3期16例，附加病变5例，住院期间18例患儿行视网膜激光光凝手术，2例行Lucentis球内注射。ROP组患儿与非ROP组在出生体重、胎龄、吸氧、肺表面活性物质应用、感染、窒息、输血方面比较，差异有统计学意义（P〈0.05）。 Logistic回归分析显示胎龄、吸氧、机械通气、肺表面活性物质应用对ROP的发生有明显影响（ P〈0.05）。结论胎龄、出生体重、吸氧、呼吸暂停、感染等因素与ROP的发生有关，出生体重及胎龄越低，ROP发病率越高。

Objective To investigate the present incidence and the risk factors of retinopathy of pre-maturity（ ROP） . Methods The clinical data of 182 premature infants who were born in our hospital from Sep 2013 to Sep 2014 with birth weight 〈2 000 g and gestational age〈37 weeks were analyzed retrospec-tively,and were divided into ROP group and without ROP group. They were screened for ROP from 4 to 6 weeks of chronological age or 32 weeks of postmenstrual age. Results In 182 cases, there were 32 cases with ROP,the incident rate was 17. 6%. Among them,10 cases were monocular and 22 cases were binocular with ROP. In ROP groups,the mean gestational age was（29. 3 ± 1. 5） weeks and the birth weight was（1 280 ± 240）g. Eleven cases developed to stage 1 of ROP,5 cases developed to stage 2 of ROP,16 cases developed to stage 3 of ROP and 5 cases with plus lesions. Eighteen cases were treated by laser photocoagulation and 2 cases received intravitreal ranibizumab injections. Compared with the infants without ROP,the development of ROP was correlated with birth weight,gestational age,oxygen supplement,use of pulmonary surfactants,in-fection,apnea,and blood transfusions（P〈0. 05）. Logistic regression analysis suggested that gestational age, oxygen inhalation,use of pulmonary surfactant,and mechanical ventilation were significant risk factors associ-ated with the development of ROP（P〈0. 05）. Conclusion The factors associated with ROP are gestational age,birth weight,oxygen inhalation,apnea and infection. The lower of the birth weight and gestational age, the incidence of ROP is higher.