血气分析值、胰岛素样生长因子-1检测在早产儿视网膜病诊断中的意义  

Detection of Blood Gases or IGF-1 in the Diagnosis of Retinopathy of Prematurity

作　　者：郭静[1] 孙慧清[1] 熊虹[1] 康文清[1] 

机构地区：[1]郑州市儿童医院新生儿重症监护室,河南450000

出　　处：《社区医学杂志》2013年第2期18-22,共5页Journal Of Community Medicine

摘　　要：目的探讨早产儿生后3天内血气分析值对胰岛素样生长因子-1(IGF-1)与早产儿视网病(ROP)的影响,及IGF-1与早产儿视网膜病的关系。方法按照我国卫生部在2004年制定的《早产儿治疗用氧和视网病变防治指南》规定的筛查对象,收集396例早产儿生后最初3天的血气分析,统计分析ROP患儿及无ROP患儿的PaO2、PCO2上下四分位值及PH值下四分位值。并分别在出生后第1、3、5、7周(出院前)监测血清IGF-1因子变化。结果 ROP患儿中占下四分位数PaO2PH值比率、上四分位数PaO2PCO2比率均高于无ROP患儿,差异有统计学意义(P<0.05)。PaO2上、下四分位数、PCO2上四分位数、PH值下四分位数、及ROP患儿第1周、第2周、第3周血清IGF-1浓度与对照组比较,差异有统计学意义(P<0.05);PH值下四分位数与对照组比较第1周、第5周的差异有统计学意义(P<0.05);ROP组与对照组两两比较有差异有统计学意义(P<0.001)。结论低PaO2、PH值及高PaO2、高PCO2使发生ROP的危险性增加;低PH值、ROP患儿血清IGF-1浓度明显降低,低血清IGF-1浓度,预示ROP危险性增加。Objective To discuss the influence of blood gases in preterm infants during the first 3 days of life on IGF - land retinopathy of prematurity （ ROP）, and to evaluate the relation between IGF - 1 and ROP. Methods According to the inclusion criteria（ from Guide to Oxygen Therapy and the Prevention and Control of Retinopathy in Premature Infants established by ministry of health）, 396 prcterm infants who needed ROP screening were selected. Their blood gases were analyzed during the first 3 days after birth, and the upper and lower quartile PaO2, PCO2, and the lower quartile PH value were analyzed statistically in infants with or without ROP. Serum IGF - 1 was monitored in the 1^st, 3^rd, 5^th and 7^th week after birth. Results Preterm infants with ROP had a higher percentage of the lower quartile PaO2, PH value and the up- per quartile PaO2, PCO2 than those without ROP, and significant difference was found between them（ P 〈 0. 05）. The up- per and lower quartile PaO2, the upper quartile PCO2, the lower quartile PH value, and the level of serum IGF - 1 in the 1^st, 3^rd and 5^th week after birth in infants with ROP were significantly different from those in the controls （ P 〈 0.05 ）. The lower quartile PH value in infants with ROP was significantly different from that in the controls in the 1＋l and 5m week after birth（ P 〈0.05）. Difference was statistically significant between the two groups（ P 〈 0. 001 ）. Conclusions Low PaO2, PH and high PaO2, PCO2 increase the risk of ROP. The level of serum IGF - 1 is low in infants with low PH and ROP, which indicates that the infants with the lower IGF - 1 may be at high risk for ROP.

关 键 词：视网膜病 血气分析 胰岛素样生长因子Ⅰ 氧分压 二氧化碳分压 

分 类 号：R774.1[医药卫生—眼科]