极低出生体质量早产儿视网膜病变临床分析

Clinical analysis of retinopathy of prematurity in preterm infants with very low birth weight

目的:分析极低出生体质量早产儿视网膜病变(ROP)的临床特点。方法:回顾分析2009-12/2018-06在我院眼科门诊及新生儿科住院并接受眼底检查的早产儿3121例,男1862例,女1259例,其中出生体质量低于1500g的极低出生体质量早产儿400例,男191例,女209例;出生体质量≥1500g的早产儿2721例,男1671例,女1050例。比较不同出生体质量早产儿中ROP的检出率、出生胎龄、性别比例、ROP的诊断时间、ROP的严重程度及其他眼病的患病率。结果:本研究筛查3121例早产儿,ROP检出率8.2%(255/3121),出生体质量小于1500g的极低出生体质量早产儿400例,ROP检出率23.8%(95/400),其中无需治疗的1~2期病变93.7%(89/95),阈值前及阈值病变3.2%(3/95),4~5期病变3.2%(3/95)。出生体质量<1000,1000~1499,≥1500g,ROP检出率分别为25.0%、23.7%、5.9%。不同体质量组男女性别比例、ROP检出率、出生胎龄、ROP诊断时间、ROP严重程度均有差异(P<0.001)。出生体质量<1000g组与出生体质量1000~1499g组,以及出生体质量<1000g组与出生体质量≥1500g组的ROP严重程度比较有差异(χ2=28.90,P<0.01;χ2=34.64,P<0.01),但是出生体质量1000~1499g组与出生体质量≥1500g组的ROP严重程度无差异(P>0.05)。不同出生体质量组其他眼病的发生率无差异(P>0.05)。结论:出生体质量越低,ROP的发生率越高。出生体质量<1000g的ROP严重程度明显高于出生体质量≥1000g的早产儿。眼科应联合产科、新生儿科,降低极低出生体质量早产儿ROP的发生率,提高极低体质量ROP筛查、随访的依从性,是降低ROP致盲的重要手段。

·AIM:To analyze the clinical characteristics of retinopathy of prematurity(ROP)in preterm infants with very low birth weight.·METHODS:A retrospective analysis was made of 3121 premature infants who were admitted to the ophthalmic clinic and neonatal department of our hospital from December 2009 to June 2018 and underwent fundus examination.There were 1862 males and 1259 females.Among them,there were 400 premature infants with very low birth mass whose body mass was less than 1500g.191 males and 209 females.To compare the detection rate of ROP,gestational age,gender ratio,diagnosis time of ROP,severity of ROP and prevalence of other eye diseases,among different birth quality groups in preterm infants with extremely low birth mass.·RESULTS:In this study,3121 premature infants were screened,and the ROP detection rate was 8.2%(255/3121).There were 400 premature infants with very low birth mass with a body mass less than 1500g,ROP detection rate was 23.8%(95/400),stage 1-2 lesions that do not require treatment were 93.7%(89/95),pre-threshold and threshold lesions were 3.2%(3/95),stage 4-5 lesions were 3.2%(3/95).ROP detection rates of birth weight(g)<1000,1000-1499,≥1500,were:25.0%,23.7%,5.9%,respectively.There were statistically significant differences in gestational age,ROP diagnostic time,between different birth weight groups(P<0.001).There were significant differences in the severity of ROP among the groups with birth weight<1000g,1000-1499g and≥1500g.But,there was no significant difference in the severity of ROP between the group with birth weight 1000-1499g and the group with birth weight≥1500g(P>0.05).There was no statistical difference in the incidence of other eye diseases in different birth weight groups(P>0.05).·CONCLUSION:The lower of birth weight,with the higher of incidence of ROP.The severity of ROP in preterm infants with birth weight<1000g was significantly higher than that of preterm infants with birth weight≥1000g.Ophthalmology should combine obstetrics and neonatology to reduce the incidence of very low birth weight premature infants,and improve the compliance of screening and follow-up of retinopathy of very low birth weight premature infants,which is an important way to reduce the blindness caused by ROP.