早产儿出生后早期屈光系统发育及其影响因素

Ocular Biometry Parameters and Factors in Early Stages of Premature Infants

目的:探讨早产儿矫正胎龄32~40周的屈光系统发育情况,评估早产儿眼轴长度与出生体质量及出生孕龄的相关性。方法:系列病例研究。选取2018年3─12月在浙江大学医学院附属妇产科医院以及温州医科大学附属眼视光医院接受早产儿视网膜病变筛查的早产儿为研究对象,在矫正胎龄32~40周时右眼行A超检查并记录,得到前房深度、晶状体厚度、玻璃体长度、眼轴长度等数据。记录早产儿的出生体质量、出生孕龄及接受检查时的矫正胎龄。分别根据出生孕龄(出生孕龄<30周,出生孕龄≥30周)及出生体质量(出生体质量<1500 g,出生体质量≥1500 g)对早产儿进行分组并评估其与眼轴长度的相关性。采用Pearson相关性分析研究屈光系统参数与矫正胎龄的关系,2组间眼轴长度的比较采用独立样本t检验。结果:共496例早产儿纳入研究,收集屈光系统参数1385次。前房深度(r=0.384,P<0.001),晶状体厚度(r=0.295,P<0.001),玻璃体长度(r=0.723,P<0.001),眼轴长度(r=0.782,P<0.001)均与矫正胎龄呈正相关。出生孕龄<30周以及出生孕龄≥30周的早产儿眼轴差异无统计学意义。出生体质量<1500 g的早产儿较出生体质量≥1500 g的早产儿在矫正胎龄38~40周时眼轴更短,差异有统计学意义(t=2.195,P=0.030;t=2.504,P=0.015;t=1.989,P=0.048)。结论:早产儿出生后早期,出生孕龄对眼轴影响不大,极低出生体质量早产儿有较短的眼轴。

Objective:To study the development of the ocular biometry parameters and evaluate the relationship between axial length with gestational age and birth weight during 32 to 40 weeks of postnatal age.Methods:Premature infants screened for retinopathy of prematurity at Women's Hospital School of Medicine Zhejiang University and Eye Hospital,Wenzhou Medical University were included from March to December 2018.Infants were divided into groups based on age,gestational age(GA)<30 weeks and GA≥30 weeks,and birth weight,birth weight(BW)<1500 g and BW≥1500 g.They were examined between 32 to 40 weeks of postnatal age(PA).Anterior chamber depth(ACD),lens thickness(LT),vitreous length(VL)and axial length(AL)were measured with an A-scan biometer.BW and GA were recorded.Pearson correlation analysis was used to study the relationship between refractive system parameters and GA.The independent-samples t test was used to compare the AL between the two groups.Results:A total of 1385 readings were recorded from 496 infants.The ACD(r=0.384,P<0.001),LT(r=0.295,P<0.001),VL(r=0.723,P<0.001)and AL(r=0.782,P<0.001)were all positively correlated with PA.There were no statistically significant differences in AL in the two groups from 32 to 40 weeks of PA(P>0.05).The average AL differed significantly from 38 to 40 weeks of PA in the two groups based on birth weight(t=2.195,P=0.030;t=2.504,P=0.015;t=1.989,P=0.048).Conclusions:In the early postnatal period of premature infants,gestational age has little effect on AL,however infants with low birth weight have a shorter AL.