四川省早产儿视网膜病变初步筛查结果及危险因素分析
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摘要
目的:了解四川盆地地区早产儿视网膜病变(ROP)的发病特点及其相关的高危因素。方法:2017-07/2018-08对出生胎龄≤34周或出生体质量≤2 500g早产儿的238例476眼采用RetCamⅢ进行ROP筛查。根据筛查结果分为ROP组和无ROP组,筛查同时评估并记录受检儿全身情况和母孕期健康状况,分析ROP发生的高危因素。结果:ROP组35例70眼,ROP检出率为14.7%,其中1期14例28眼,2期11例22眼,3期8例16眼,4期2例4眼,5期0例。需接受激光光凝治疗者12例24眼。非ROP组出生胎龄、出生体质量均明显高于ROP组(P<0.01);不同胎龄组、不同出生体质量组ROP发病情况均有差异(P<0.01);两组持续吸氧>72h、缺血缺氧性脑病及机械通气者所占比例均有差异(P=0.034、0.001、0.004);两组患儿其他全身疾病、母孕期健康状况均无差异(P>0.05)。结论:2017-07/2018-08四川盆地地区ROP检出率为14.7%;出生胎龄、出生体质量、持续吸氧>72h、缺血缺氧脑病、机械通气是影响ROP发病率的重要危险因素。
?AIM:To investigate the incidence and risk factors of retinopathy of prematurity(ROP) in Sichuan Province.?METHODS: From July 2017 to Augest. 2018, 238 premature infants(476 eyes) with gestational age of 34 wk or less, or birth weight of 2500 g or less, were examined by RetCamⅢ for ROP screening. The infants were divided into ROP group and non-ROP group according to the results of screening. Meanwhile, the general condition of the premature infants and maternal health during pregnancy were assessed and recorded to determine the risk factors of ROP.?RESULTS: In 238 infants(476 eyes), ROP developed in 35 infants and the incidence of ROP was 14.7%, which including 14 cases(28 eyes) suffering from stage 1, 11 cases(22 eyes) from stage 2, 8 cases(16 eyes) from stage 3, 2 cases(4 eyes) from stage 4, 0 cases from stage 5. 12 cases(24 eyes) received laser therapy. The gestation age and birth weight in non-ROP group were higher than ROP group, significant difference was found between the two groups(P<0.01). The incidence of ROP was statistically significant between different gestational age groups and different birth weight groups(P<0.01). The ratios of oxygen inhalation>72 h, hypoxic-ischemic encephalopathy and mechanical ventilation in non-ROP group and ROP group were statistically significant(P=0.034; P=0.001; P=0.004). However, the significant difference had not been found with other systemic diseases of the premature infants sand maternal health during pregnancy between the two groups(P>0.05).?CONCLUSION: The incidence of ROP in Sichuan Province is 14.7% from July 2017 to Augest 2018. The gestation age, birth weight, oxygen inhalation>72 h, hypoxic-ischemic encephalopathy and mechanical ventilation are high risk factors for the occurrence of ROP.
?AIM:To investigate the incidence and risk factors of retinopathy of prematurity(ROP) in Sichuan Province.?METHODS: From July 2017 to Augest. 2018, 238 premature infants(476 eyes) with gestational age of 34 wk or less, or birth weight of 2500 g or less, were examined by RetCamⅢ for ROP screening. The infants were divided into ROP group and non-ROP group according to the results of screening. Meanwhile, the general condition of the premature infants and maternal health during pregnancy were assessed and recorded to determine the risk factors of ROP.?RESULTS: In 238 infants(476 eyes), ROP developed in 35 infants and the incidence of ROP was 14.7%, which including 14 cases(28 eyes) suffering from stage 1, 11 cases(22 eyes) from stage 2, 8 cases(16 eyes) from stage 3, 2 cases(4 eyes) from stage 4, 0 cases from stage 5. 12 cases(24 eyes) received laser therapy. The gestation age and birth weight in non-ROP group were higher than ROP group, significant difference was found between the two groups(P<0.01). The incidence of ROP was statistically significant between different gestational age groups and different birth weight groups(P<0.01). The ratios of oxygen inhalation>72 h, hypoxic-ischemic encephalopathy and mechanical ventilation in non-ROP group and ROP group were statistically significant(P=0.034; P=0.001; P=0.004). However, the significant difference had not been found with other systemic diseases of the premature infants sand maternal health during pregnancy between the two groups(P>0.05).?CONCLUSION: The incidence of ROP in Sichuan Province is 14.7% from July 2017 to Augest 2018. The gestation age, birth weight, oxygen inhalation>72 h, hypoxic-ischemic encephalopathy and mechanical ventilation are high risk factors for the occurrence of ROP.
引文
1早产儿视网膜病变多中心调查协作组.中国大陆早产儿视网膜病变临床特点和眼底病变的多中心调查.中国循证儿科杂志2015;10(3):161-165
2中华人民共和国卫生部.早产儿治疗用氧和视网膜病变防治指南.卫生部新闻办公室2004
3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).中华眼科杂志2014;50(12):933-935
4苏钰,陈长征,李璐,等.湖北地区早产儿视网膜病变筛查结果及相关因素分析.中华眼底病杂志2012;28(1):53-56
5王雨生,张自峰,李曼红,等.西安地区早产儿视网膜病变筛查的初步结果.中华眼科杂志2010;46(2):119-123
6毕明超,李松鹤,陆成伟,等.吉林省早产儿视网膜病变筛查结果分析.中国实用眼科杂志2014;32(7):909-913
7金顺祥,许江涛,肖亦爽,等.昆明市儿童医院 1010 例早产儿或低体重儿早产儿视网膜病变发病率及其影响因素分析.中华眼底病杂志2016;32(3):314-316
8 International Committee for the Classificationof Retinopathy of Prematurity.The International Classification of Retinopathy of Prematurity revisited.Arch Ophthalmol 2005;123(7):991-999
9马学仁,张琼,康宏,等.青海省310例早儿视网膜病变筛查结果及其危险因素分析.中华眼底病杂志2017;33(6):631-632
10 Azami M,Jaafari Z,RahmatiS,et al.Prevalence and risk factors of retinopathy of prematurity in Iran:a systematic review and meta-analysis.BMC Ophthalmol 2018;18(1):83
11 Hwang JH,Lee EH,Kim EA.Retinopathy of Prematurity among Very-Low-Birth-Weight Infants in Korea:Incidence,Treatment,and Risk Factors.J Korean Med Sci 2015;30(Suppl 1):S88-S94
12张自峰,李曼红,王雨生,等.西安地区出生体重2kg以上早产儿视网膜病变分析.中华眼科杂志2014;50(3):184-188
13 Vasavada D,Sengupta S,Prajapati VK,et al.Incidence and risk factors of retinopathy of prematurity in Western India-Report from A Regional Institute of Ophthalmology.Nepal J Ophthalmol 2017;9(18):1112-1120
14王倩,李聪慧,信伟,等.早产儿视网膜病变2203例筛查结果分析.国际眼科杂志2018;18(6):1093-1096
15 Sabzehei MK,Afjeh SA,Dastjani Farahani A,et al.Retinopathy of prematurity:incidence,risk factors,and outcome.Arch Iran Med 2013;16(9):507-512
16 Tunay Z?,?zdemir ?,Acar DE,et al.Maternal diabetes as an independent risk factor for retinopathy of prematurity in infants with birth weight of 1500g or more.Am J Ophthalmol 2016;168(8):201-206
17 Zayed MA,Uppal A,Hartnett ME.New-onset maternal gestational hypertension and risk of retinopathy of prematurity.Invest Ophthalmol Vis Sci 2010;51(10):4983-4988
2中华人民共和国卫生部.早产儿治疗用氧和视网膜病变防治指南.卫生部新闻办公室2004
3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).中华眼科杂志2014;50(12):933-935
4苏钰,陈长征,李璐,等.湖北地区早产儿视网膜病变筛查结果及相关因素分析.中华眼底病杂志2012;28(1):53-56
5王雨生,张自峰,李曼红,等.西安地区早产儿视网膜病变筛查的初步结果.中华眼科杂志2010;46(2):119-123
6毕明超,李松鹤,陆成伟,等.吉林省早产儿视网膜病变筛查结果分析.中国实用眼科杂志2014;32(7):909-913
7金顺祥,许江涛,肖亦爽,等.昆明市儿童医院 1010 例早产儿或低体重儿早产儿视网膜病变发病率及其影响因素分析.中华眼底病杂志2016;32(3):314-316
8 International Committee for the Classificationof Retinopathy of Prematurity.The International Classification of Retinopathy of Prematurity revisited.Arch Ophthalmol 2005;123(7):991-999
9马学仁,张琼,康宏,等.青海省310例早儿视网膜病变筛查结果及其危险因素分析.中华眼底病杂志2017;33(6):631-632
10 Azami M,Jaafari Z,RahmatiS,et al.Prevalence and risk factors of retinopathy of prematurity in Iran:a systematic review and meta-analysis.BMC Ophthalmol 2018;18(1):83
11 Hwang JH,Lee EH,Kim EA.Retinopathy of Prematurity among Very-Low-Birth-Weight Infants in Korea:Incidence,Treatment,and Risk Factors.J Korean Med Sci 2015;30(Suppl 1):S88-S94
12张自峰,李曼红,王雨生,等.西安地区出生体重2kg以上早产儿视网膜病变分析.中华眼科杂志2014;50(3):184-188
13 Vasavada D,Sengupta S,Prajapati VK,et al.Incidence and risk factors of retinopathy of prematurity in Western India-Report from A Regional Institute of Ophthalmology.Nepal J Ophthalmol 2017;9(18):1112-1120
14王倩,李聪慧,信伟,等.早产儿视网膜病变2203例筛查结果分析.国际眼科杂志2018;18(6):1093-1096
15 Sabzehei MK,Afjeh SA,Dastjani Farahani A,et al.Retinopathy of prematurity:incidence,risk factors,and outcome.Arch Iran Med 2013;16(9):507-512
16 Tunay Z?,?zdemir ?,Acar DE,et al.Maternal diabetes as an independent risk factor for retinopathy of prematurity in infants with birth weight of 1500g or more.Am J Ophthalmol 2016;168(8):201-206
17 Zayed MA,Uppal A,Hartnett ME.New-onset maternal gestational hypertension and risk of retinopathy of prematurity.Invest Ophthalmol Vis Sci 2010;51(10):4983-4988