围生期感染对早产儿视网膜病影响的研究

Influence of perinatal infection on retinopathy of premature infants

目的探讨围生期感染对早产儿视网膜病(ROP)的影响。方法采用回顾性分析法,选取2015年4月-2017年3月在我院出生的313例早产儿(胎龄≤32周),收集其围生期病历和眼底检查结果,发现患有视网膜病的早产儿103例为研究对象,按照早产儿眼底病变程度分为轻度ROP组(62例)、重度ROP组(24例)、手术治疗的ROP组(17例),进行危险因素的单因素分析及多因素回归分析。结果在围生期产妇单因素分析中,轻度ROP组的妊娠期贫血比例最高、手术治疗ROP组的产妇围生期有感染性疾病比例最高、重度ROP组的宫颈分泌物支原体阳性比例最高(P<0.05);在围生期早产儿单因素分析中,手术治疗ROP组的平均孕周最短、轻度ROP组的出生时体质量和吸氧天数最少;轻度ROP组及重度ROP组与产妇宫颈分泌物支原体阳性、早产儿的孕周、出生时体质量、吸氧时间有相关性(P<0.05);手术治疗ROP与产妇围生期感染性疾病、早产儿的孕周、出生时体质量有相关性(P<0.05)。结论产妇围生期感染、宫颈分泌物支原体阳性、早产儿孕周小、出生时体质量低、吸氧时间长与ROP的发生发展具有相关性,是ROP发生发展的危险因素。

OBJECTIVE To explore the influence of perinatal infection on retinopathy（ROP）of premature infants.METHODS By means of retrospective survey,totally 313 premature infants（with the gestational age no more than32 weeks）who were born in the hospital from Apr 2015 to Mar 2017 were enrolled in the study,103 of whom were diagnosed with retinopathy according to the perinatal records and result of fundus examination and were recruited as the study objects.The study objects were divided into the mild ROP group with 62 cases,the severe ROP group and the surgical ROP group according to the severity of fundus lesions.The univariate analysis and multivariate regression analysis were performed for the risk factors.RESULTS The univariate analysis showed that among the perinatal puerpera,the proportion of the puerpera with gestational anemia was the highest in the mild ROP group,the proportion of the puerpera with perinatal infectious diseases was the highest in the surgical ROP group,and the proportion of the puerpera whose cervical secretions were tested positive for Mycoplasma was the highest in the severe ROP group（P〈0.05）.The univariate analysis indicated that among the perinatal premature infants,the average gestational age was shortest in the surgical ROP group,the birth weight and oxygen inhalation duration were the least in the mild ROP group;the mild ROP and severe ROP and severe ROP were associated with the positive test of Mycoplasmain cervical secretions,gestational age,birth weight and oxygen inhalation duration（P〈0.05）.The surgical ROP was associated with the perinatal infectious diseases,gestational age and birthweight（P〈0.05）.CONCLUSIONS The incidence of ROP is associated with the perinatal infection in the puerpera,positive test of Mycoplasmain cervical secretions,short gestational age,low birth weight and oxygen inhalation duration,which are the risk factors for progression of ROP.