双胎极低出生体重早产儿ROP筛查结果及相关因素分析

Screening results and related factors of retinopathy of prematurity in twins with very low birth weight

目的 探讨双胎极低出生体重早产儿视网膜病变(ROP)的筛查结果及其相关因素。方法 选取2016年1月至2020年12月在嘉兴市妇幼保健院行ROP筛查的134例(67对)双胎极低出生体重早产儿的临床资料和治疗方案及伴随疾病。双胎中体重较轻者入体重轻组(67例),体重较重者入体重重组(67例);依据ROP筛查情况分为正常组74例和ROP组60例,收集观察数据,并进行统计分析。结果 早产儿中ROP发生率为44.78%(60/134)。体重轻组与体重重组患儿出生体重比较有显著性差异(t=-5.371,P<0.05),其ROP发生率差异无统计学意义(P>0.05)。正常组与ROP组的胎龄、出生体重、5min Apgar评分,以及受孕方式、分娩方式、机械通气、持续呼吸道正压通气(CPAP)、输血、低蛋白血症、败血症、支气管肺发育不良分布比较均有显著性差异(t=2.624~4.611、χ^(2)=5.312~28.611,P<0.05),其1min Apgar评分及鼻导管吸氧、肺泡表面活性物质使用、贫血、呼吸窘迫、先天性心脏病、颅内出血、肺出血分布差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,胎龄越大,ROP发生风险越小(OR=0.398,95%CI:0.225~0.702,P<0.05)。结论 胎龄小是双胎极低出生体重早产儿ROP发生的危险因素,而体重并非其ROP发生的危险因素。

Objective To explore the screening results and related factors of retinopathy of prematurity(ROP) in twins with very low birth weight.Methods The clinical data, treatment measures and concomitant diseases of 134 cases(67 pairs) of premature twins with very low birth weight who underwent ROP screening in Jiaxing Maternity and Child Health Care Hospital from January 2016 to December 2020 were selected.Lighter weight in the twins was included in the light weight group(67 cases),and heavier weight was included in the weight recombination group(67 cases);According to the ROP screening situation, 74 cases were divided in the normal group and 60 cases were divided in the ROP group.Observation data were collected and statistical analysis was performed.Results The incidence of ROP in premature was 44.78%(60/134).Birth weight was different between the light weight group and the recombinant group(t=-5.371,P<0.05),and there was no significant difference in the incidence of ROP between the light weight group and the recombinant group(P>0.05).There were significant differences between gestational age, birth weight, 5 min Apgar score, delivery, mechanical ventilation, continuous positive airway pressure(CPAP),blood transfusion, hypoproteinemia, septicemia, and bronchial pulmonary dysplasia between normal and ROP group(t value ranged from 2.624 to 4.661,χ^(2) value ranged from 5.312 to 28.611,P<0.05).There were no significant differences in 1 min Apgar score, nasal catheter oxygen inhalation, use of alveolar surfactant substances, anemia, respiratory distress, congenital heart disease, intracranial hemorrhage, and pulmonary hemorrhage(P>0.05).The results of the multivariate Logistic regression indicated that, the older the gestational age, the smaller the risk of ROP occurrence(OR=0.398,95%CI:0.225-0.702,P<0.05).Conclusion Gestational age instead of body weight is a risk factor for ROP in very low birth weight premature twins.