0-6岁早产儿和正常儿童屈光状态的比较研究  

A study of refractive state in premature infants without retinopathy of prematurity and full-term children at the age of 0 to 6

作　　者：田明星[1] 周炼红[1] 罗琪[1] 叶美红[1] 徐永红[1] 

机构地区：[1]武汉大学人民医院眼科,430060

出　　处：《中华眼科杂志》2015年第7期505-509,共5页Chinese Journal of Ophthalmology

基　　金：国家卫生和计划生育委员会公益性行业科研专项基金

摘　　要：目的：探讨0-6岁早产儿和正常儿童的屈光发育情况。方法病例对照研究。回访自2011年9月至2012年9月在武汉大学人民医院进行早产儿视网膜病变（ROP）筛查的无视网膜病变的早产儿1164例，其中纳入研究1088例（2176只眼），按矫正胎龄分组：〈0.5岁（150例），≥0.5岁且〈1.0岁（118例），≥1.0岁且〈1.5岁（155例），≥1.5岁且〈2.0岁（137例），≥2.0岁且〈2.5岁（153例），≥2.5岁且〈3.0岁（95例），≥3.0岁且〈4.0岁（103例），≥4.0岁且〈5.0岁（89例），≥5.0岁（88例）。同时收集来武汉大学人民医院门诊体检的正常足月儿1191例，纳入同龄随机对照组足月儿1102例（2204只眼）。所有儿童行睫状肌麻痹检影验光确定屈光状态。其中3-6岁早产儿采用相干光生物测量仪（IOL Master）测量眼轴和角膜曲率。定量资料组间差异使用t检验，定性资料组间差异采用卡方检验。相关性使用多元线性回归分析。结果0～6岁早产儿平均近视患病率为9.1%，足月儿为4.4%；0～6岁早产儿平均散光患病率为35.4%，足月儿为18.9%。2～6岁早产儿平均球镜度数为（1.15±0.87）D，平均柱镜度数为（0.84±0.71）D，平均等效球镜度数为（1.47±0.28）D，球镜、等效球镜度数以及柱镜均随年龄的增大而呈现下降趋势。3～6岁早产儿等效球镜度数与眼轴、角膜曲率、胎龄、出生体重及年龄相关（r=-0.232，0.112，0.117，0.254，-0.215；P=0.000，0.009，0.008，0.000，0.001）。结论早产儿近视及散光患病率高于足月儿；早产儿正视化过程要早于足月儿。（中华眼科杂志，2015，51：505-509）Objective To investigate the development of the refractive status in premature infants full-term children aged 0 to 6 years old. Method Case control study. One thousand one hundred and sixty-four premature infants and One thousand one hundred and ninety-one full-term children were collected from September 2011 to September 2012 in Renmin Hospital of Wuhan University,among them, one thousand and eighty-eight premature infants premature infants（2 176 eyes）without retinopathy of prematurity （ROP） and one thousand one hundred and two cases of full-term children （2 204 eyes） were included in the study. Refraction with cycloplegic retinoscopy was determined. The corneal curvatures and axial lengths of premature infants aged 3 to 6 years old were measured by Optical coherence interferometry. Results （1） The incidence of myopia and astigmatism were 9.1%and 35.4%in premature infants aged 0 to 6 years old, and 4.4%, 18.9% in full-term children. （2） The spherical diopter, cylindrical lens diopter and spherical equivalent degree were （1.15±0.87）, （0.84±0.71） and （1.47±0.28） D, three types of refractive value reduced progressively along with increasing age.（3） Changes in spherical equivalent degree in preterm children are associated with axial length, corneal curvature, gestational age, birth weight and age（r=-0.232, 0.112, 0.117, 0.254,-0.215,P=0.000, 0.009, 0.008, 0.000, 0.001）. Conclusions The incidence of myopia of premature infants without ROP was higher than that of full-term children;The emmetropization of premature infants begins earlier than full-term children.

关 键 词：屈光 眼 早产 婴儿 视网膜病 早产儿 

分 类 号：R778[医药卫生—眼科]