血/尿代谢产物检测在早产儿视网膜病早期预测中的价值研究

The Value of Blood/Urine Metabolite Detection in Early Prediction of Retinopathy in Premature Infants

研讨血/尿代谢产物检测在早产儿视网膜病早期预测中的价值。选取2020年1月—2021年12月佛山复星禅诚医院收治的100例妊娠27~34周出生的早产儿为研究对象。根据住院期间间接眼底镜和透镜检查结果,选取50例发生视网膜病变的早产儿为研究组,50例未发现视网膜病变的早产儿为对照组。应用气相色谱-质谱和液相色谱-串联质谱联用技术测定两组新生儿足跟血和尿液中代谢物质/产物(氨基酸、脂肪酸和有机酸等)。结果显示,两组ROP筛查一致性较高(Kappa=0.955,95%CI:0.93~0.97)。两组不良事件发生率差异无统计学意义(P>0.05)。本文金标准结果为间接眼底镜,对比金标准,血/尿代谢产物检测敏感性与特异性为100%、99.38%,阳性预测率为96.43%,假阳性为3.57%。研究发现,早产儿视网膜疾病筛查中,血/尿代谢产物检测一致性及安全性较高,且操作简单、学习周期短,可用于替代临床双目间接眼底镜筛查。

Discuss the value of blood/urine metabolic product detection in early prediction of retinopathy in premature infants.We selected 100 premature infants born at 27 to 34 weeks of gestation who were admitted to Foshan Fuxing Chancheng Hospital from January 2020 to December 2021 as the research subjects.Based on the results of indirect fundoscopy and lens examination during hospitalization,50 premature infants with retinopathy were selected as the study group,and 50 premature infants without retinopathy were selected as the control group.Gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry were used to determine metabolic substances/products(amino acids,fatty acids,and organic acids)in the heel blood and urine of two groups of newborns.The results showed that there was high consistency in ROP screening between the two groups(Kappa=0.955,95%CI:0.93~0.97).There was no statistically signifi cant diff erence in the incidence of adverse events between the two groups(P>0.05).The gold standard result of this article is indirect fundoscopy.Compared with the gold standard,the sen-sitivity and specifi city of blood/urine metabolites detection are 100%and 99.38%,the positive predictive rate is 96.43%,and the false positive rate is 3.57%.Research has found that in the screening of retinal diseases in premature infants,the consistency and safety of blood/urine metabolites detection are high,and the operation is simple and the learning cycle is short,which can be used as a substitute for clinical binocular indirect fundoscopic screening.