四川省早产儿视网膜病变初步筛查结果及危险因素分析

Preliminary results and risk factors of retinopathy screening for premature infants in Sichuan Province

目的:了解四川盆地地区早产儿视网膜病变(ROP)的发病特点及其相关的高危因素。方法:2017-07/2018-08对出生胎龄≤34周或出生体质量≤2 500g早产儿的238例476眼采用RetCamⅢ进行ROP筛查。根据筛查结果分为ROP组和无ROP组,筛查同时评估并记录受检儿全身情况和母孕期健康状况,分析ROP发生的高危因素。结果:ROP组35例70眼,ROP检出率为14.7%,其中1期14例28眼,2期11例22眼,3期8例16眼,4期2例4眼,5期0例。需接受激光光凝治疗者12例24眼。非ROP组出生胎龄、出生体质量均明显高于ROP组(P<0.01);不同胎龄组、不同出生体质量组ROP发病情况均有差异(P<0.01);两组持续吸氧>72h、缺血缺氧性脑病及机械通气者所占比例均有差异(P=0.034、0.001、0.004);两组患儿其他全身疾病、母孕期健康状况均无差异(P>0.05)。结论:2017-07/2018-08四川盆地地区ROP检出率为14.7%;出生胎龄、出生体质量、持续吸氧>72h、缺血缺氧脑病、机械通气是影响ROP发病率的重要危险因素。

AIM:To investigate the incidence and risk factors of retinopathy of prematurity (ROP) in Sichuan Province. METHODS: From July 2017 to Augest. 2018, 238 premature infants (476 eyes) with gestational age of 34wk or less, or birth weight of 2500g or less, were examined by RetCamⅢ for ROP screening. The infants were divided into ROP group and non-ROP group according to the results of screening. Meanwhile, the general condition of the premature infants and maternal health during pregnancy were assessed and recorded to determine the risk factors of ROP. RESULTS: In 238 infants (476 eyes), ROP developed in 35 infants and the incidence of ROP was 14.7%, which including 14 cases (28 eyes) suffering from stage 1, 11 cases (22 eyes) from stage 2, 8 cases (16 eyes) from stage 3, 2 cases (4 eyes) from stage 4, 0 cases from stage 5. 12 cases (24 eyes) received laser therapy. The gestation age and birth weight in non-ROP group were higher than ROP group, significant difference was found between the two groups ( P <0.01). The incidence of ROP was statistically significant between different gestational age groups and different birth weight groups ( P <0.01). The ratios of oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation in non-ROP group and ROP group were statistically significant ( P =0.034;P =0.001;P =0.004). However, the significant difference had not been found with other systemic diseases of the premature infants sand maternal health during pregnancy between the two groups ( P >0.05). CONCLUSION: The incidence of ROP in Sichuan Province is 14.7% from July 2017 to Augest 2018. The gestation age, birth weight, oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation are high risk factors for the occurrence of ROP.