301例早产儿视网膜病变筛查结果及其高危因素分析
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摘要
目的:调查早产儿视网膜病变(ROP)的发生情况并分析其高危因素。方法:选取2017年6月至2018年6月在我院进行眼底检查的301例早产儿,依据《早产儿治疗用氧和视网膜病变防治指南》和《中国早产儿视网膜病变筛查指南》对早产儿进行筛查和随诊,同时收集早产儿及其母亲的相应病历信息,采用多因素Logistic回归分析分析ROP的高危因素。结果:301例早产儿中,共检出ROP患儿43例,其中须接受治疗的患儿13例,所有患儿经过2-6个月的治疗和随诊后均好转。围产因素中,胎龄小、出生体重低、吸氧、输血、有急性呼吸窘迫综合征(ARDS)的早产儿ROP检出率更高(均P<0.05);母体因素中,多胎分娩的早产儿ROP检出率高于单胎分娩的早产儿(P<0.05)。Logistic回归分析显示,胎龄小、出生体重低、吸氧、输血和有ARDS为早产儿ROP的高危因素(P<0.05)。结论:早产儿ROP发病率较高,胎龄小、出生体重低、吸氧、输血和有ARDS是其高危因素,在临床实践中应给予重视,及早发现ROP并规范治疗,以降低早产儿ROP的发病率。
Objective: To investigate the incidence of retinopathy of prematurity(ROP) in premature infants and analyze the risk factors. Methods: 301 cases of preterm infants who were received fundus examination in our hospital from June 2017 to June 2018 were selected. The preterm infants were screened and followed up according to and . At the same time, the corresponding medical records of premature infants and their mothers were collected. Multivariate Logistic regression analysis was used to analyze the high risk factors of ROP. Results: Among 301 premature infants, 43 cases of preterm infants were diagnosed with ROP,among them, 13 cases were required to receive treatment, and all premature infants were improved 2-6 months after treatment and follow-up. Among the perinatal factors, the ROP detection rate was higher in infants with small gestational age, low birth weight, oxygen inhalation, blood transfusion and acute respiratory distress syndrome(ARDS)(all P<0.05). Among the maternal factors, the detection rate of ROP in premature infants with multiple births was higher than that in premature infants with single birth(P<0.05). Logistic regression analysis showed that small gestational age, low birth weight, oxygen inhalation, blood transfusion and ARDS were risk factors for ROP in premature infants(P<0.05). Conclusion: The incidence of ROP is higher in premature infants, and its risk factors are small gestational age, low birth weight, oxygen inhalation, blood transfusion and ARDS. Attention should be paid to clinical practice, early detection of ROP and standardized treatment, so as to reduce the incidence of ROP in premature infants.
Objective: To investigate the incidence of retinopathy of prematurity(ROP) in premature infants and analyze the risk factors. Methods: 301 cases of preterm infants who were received fundus examination in our hospital from June 2017 to June 2018 were selected. The preterm infants were screened and followed up according to
引文
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[16]Moreton RB,Fleck BW,Fielder AR,et al.The effect of oxygen saturation targeting on retinal blood vessel growth using retinal image data from the BOOST-II UK Trial[J].Eye(Lond),2016,30(4):577-581
[17]Tereshchenko AV,Belyi魧IuA,Isaev SV,et al.Retinal vessels in retinopathy of prematurity[J].Vestn Oftalmol,2014,130(3):26-31
[18]Bee CR,Burris CKH,Potter HAD,et al.Histopathological analysis of retinopathy of prematurity after intravitreal bevacizumab[J].JAAPOS,2017,21(2):159-160
[19]魏明,陈长征,廖婷婷,等.复方血栓通用于早期糖尿病视网膜病变的临床效果及对血清VEGF,IGF-1,NSE水平的影响[J].现代生物医学进展,2017,17(20):3901-3904
[20]郭佃强,韩梅,单若冰,等.多胎与单胎早产儿视网膜病变的发病率及危险因素的比较[J].眼科新进展,2017,37(4):348-350
[21]Wu T,Zhang L,Tong Y,et al.Retinopathy of Prematurity Among Very Low-Birth-Weight Infants in China:Incidence and Perinatal Risk Factors[J].Invest Ophthalmol Vis Sci,2018,59(2):757-763
[22]Kim SJ,Port AD,Swan R,et al.Retinopathy of prematurity:a review of risk factors and their clinical significance[J].Surv Ophthalmol,2018,63(5):618-637
[23]Slidsborg C,Jensen LB,Rasmussen SC,et al.Early postnatal hyperglycaemia is a risk factor for treatment-demanding retinopathy of prematurity[J].Br J Ophthalmol,2018,102(1):14-18
[24]高宏程,陈晨,张迎秋,等.早产儿视网膜病变的危险因素研究进展[J].国际眼科杂志,2018,18(1):80-83
[25]Ali AA,Gomaa NAS,Awadein AR,et al.Retrospective cohort study shows that the risks for retinopathy of prematurity included birth age and weight,medical conditions and treatment[J].Acta Paediatr,2017,106(12):1919-1927
[26]Vesoulis ZA,Lust CE,Liao SM,et al.Early hyperoxia burden detected by cerebral near-infrared spectroscopy is superior to pulse oximetry for prediction of severe retinopathy of prematurity[J].JPerinatol,2016,36(11):966-971
[27]Yau GS,Lee JW,Tam VT,et al.Incidence and Risk Factors of Retinopathy of Prematurity From 2 Neonatal Intensive Care Units in a Hong Kong Chinese Population[J].Asia Pac J Ophthalmol(Phila),2016,5(3):185-191
[28]Stutchfield CJ,Jain A,Odd D,et al.Foetal haemoglobin,blood transfusion,and retinopathy of prematurity in very preterm infants:a pilot prospective cohort study[J].Eye(Lond),2017,31(10):1451-1455
[29]Zepeda-Romero LC,Lundgren P,Gutierrez-Padilla JA,et al.Oxygen Monitoring Reduces the Risk for Retinopathy of Prematurity in a Mexican Population[J].Neonatology,2016,110(2):135-140
[30]朱赟,潘家华.172例早产儿视网膜病变高危因素分析[J].安徽医学,2017,38(8):976-978
[2]Prakalapakorn SG,Freedman SF,Hutchinson AK,et al.Re al-World Simulation of an Alternative Retinopathy of Prematurity Screening System in Thailand:A Pilot Study[J].J Pediatr Ophthalmol Strabismus,2018,55(4):245-253
[3]Babaei H,Alibabrdel M,Asadian S,et al.Increased circulation mobilization of endothelial progenitor cells in preterm infants with retinopathy of prematurity[J].J Cell Biochem,2018,119(8):6575-6583
[4]Gerull R,Brauer V,Bassler D,et al.Incidence of retinopathy of prematurity(ROP)and ROP treatment in Switzerland 2006-2015:a population-based analysis[J].Arch Dis Child Fetal Neonatal Ed,2018,103(4):F337-F342
[5]Arnold RW,Jacob J,Matrix Z.Toward Achieving 100%Adherence for Retinopathy of Prematurity Screening Guidelines[J].J Pediatr Ophthalmol Strabismus,2017,54(6):356-362
[6]Ludwig CA,Chen TA,Hernandez-Boussard T,et al.The Epidemiology of Retinopathy of Prematurity in the United States[J].Ophthalmic Surg Lasers Imaging Retina,2017,48(7):553-562
[7]Jung JL,Wagner BD,Mc Court EA,et al.Validation of WINROP for detecting retinopathy of prematurity in a North American cohort of preterm infants[J].J AAPOS,2017,21(3):229-233
[8]中华医学会.早产儿治疗用氧和视网膜病变防治指南[J].中华眼科杂志,2005,41(4):375-376
[9]中华医学会眼科学分会眼底病学组.中国早产儿视网膜病变筛查指南(2014年)[J].中华眼科杂志,2014,50(12):933-935
[10]Fagerholm R,Vesti E.Retinopathy of prematurity-from recognition of risk factors to treatment recommendations[J].Duodecim,2017,133(4):337-344
[11]Dogra MR,Katoch D.Retinopathy of Prematurity:An emerging and evolving challenge[J].Indian J Ophthalmol,2017,65(9):782-784
[12]Darlow BA,Vento M,Beltempo M,et al.Variations in Oxygen Saturation Targeting,and Retinopathy of Prematurity Screening and Treatment Criteria in Neonatal Intensive Care Units:An International Survey[J].Neonatology,2018,114(4):323-331
[13]Quinn GE,Barr C,Bremer D,et al.Changes in Course of Retinopathy of Prematurity from 1986 to 2013:Comparison of Three Studies in the United States[J].Ophthalmology,2016,123(7):1595-600
[14]Hutchinson AK,Melia M,Yang MB,et al.Clinical Models and Algorithms for the Prediction of Retinopathy of Prematurity:AReport by the American Academy of Ophthalmology[J].Ophthalmology,2016,123(4):804-816
[15]Solans Pérez de Larraya AM,Ortega Molina JM,Fernández JU,et al Retinal vascular speed<0.5 disc diameter per week as an early sign of retinopathy of prematurity requiring treatment[J].Eur J Ophthalmol,2018,28(4):441-445
[16]Moreton RB,Fleck BW,Fielder AR,et al.The effect of oxygen saturation targeting on retinal blood vessel growth using retinal image data from the BOOST-II UK Trial[J].Eye(Lond),2016,30(4):577-581
[17]Tereshchenko AV,Belyi魧IuA,Isaev SV,et al.Retinal vessels in retinopathy of prematurity[J].Vestn Oftalmol,2014,130(3):26-31
[18]Bee CR,Burris CKH,Potter HAD,et al.Histopathological analysis of retinopathy of prematurity after intravitreal bevacizumab[J].JAAPOS,2017,21(2):159-160
[19]魏明,陈长征,廖婷婷,等.复方血栓通用于早期糖尿病视网膜病变的临床效果及对血清VEGF,IGF-1,NSE水平的影响[J].现代生物医学进展,2017,17(20):3901-3904
[20]郭佃强,韩梅,单若冰,等.多胎与单胎早产儿视网膜病变的发病率及危险因素的比较[J].眼科新进展,2017,37(4):348-350
[21]Wu T,Zhang L,Tong Y,et al.Retinopathy of Prematurity Among Very Low-Birth-Weight Infants in China:Incidence and Perinatal Risk Factors[J].Invest Ophthalmol Vis Sci,2018,59(2):757-763
[22]Kim SJ,Port AD,Swan R,et al.Retinopathy of prematurity:a review of risk factors and their clinical significance[J].Surv Ophthalmol,2018,63(5):618-637
[23]Slidsborg C,Jensen LB,Rasmussen SC,et al.Early postnatal hyperglycaemia is a risk factor for treatment-demanding retinopathy of prematurity[J].Br J Ophthalmol,2018,102(1):14-18
[24]高宏程,陈晨,张迎秋,等.早产儿视网膜病变的危险因素研究进展[J].国际眼科杂志,2018,18(1):80-83
[25]Ali AA,Gomaa NAS,Awadein AR,et al.Retrospective cohort study shows that the risks for retinopathy of prematurity included birth age and weight,medical conditions and treatment[J].Acta Paediatr,2017,106(12):1919-1927
[26]Vesoulis ZA,Lust CE,Liao SM,et al.Early hyperoxia burden detected by cerebral near-infrared spectroscopy is superior to pulse oximetry for prediction of severe retinopathy of prematurity[J].JPerinatol,2016,36(11):966-971
[27]Yau GS,Lee JW,Tam VT,et al.Incidence and Risk Factors of Retinopathy of Prematurity From 2 Neonatal Intensive Care Units in a Hong Kong Chinese Population[J].Asia Pac J Ophthalmol(Phila),2016,5(3):185-191
[28]Stutchfield CJ,Jain A,Odd D,et al.Foetal haemoglobin,blood transfusion,and retinopathy of prematurity in very preterm infants:a pilot prospective cohort study[J].Eye(Lond),2017,31(10):1451-1455
[29]Zepeda-Romero LC,Lundgren P,Gutierrez-Padilla JA,et al.Oxygen Monitoring Reduces the Risk for Retinopathy of Prematurity in a Mexican Population[J].Neonatology,2016,110(2):135-140
[30]朱赟,潘家华.172例早产儿视网膜病变高危因素分析[J].安徽医学,2017,38(8):976-978