呼吸支持模式对早产儿视网膜病的影响  

Effects of respiratory support mode on retinopathy of premature infants

作　　者：孙慧清[1] 康文清[1] 李明超[1] 许邦礼[1] 郭静[1] 刘大鹏[1] 熊虹[1] 

机构地区：[1]郑州市儿童医院新生儿重症监护室,河南郑州450053

出　　处：《河南医学研究》2016年第1期32-34,共3页Henan Medical Research

摘　　要：目的探讨不同呼吸支持模式对早产儿视网膜病及血清VEGF和IGF-1水平变化的影响。方法共578例出生胎龄小于34周,从第1次眼底筛查到最后1次眼底筛查生存的早产儿,所有纳入研究早产儿被分为无ROP、1期、2期、3期以上ROP或3期ROP+plus病变。血清IGF-1、VEGF在生后1周、2周、3周和4周被检测。结果 323例早产儿无ROP,126例早产儿发生1期ROP,80例发生2期ROP,39例发生3期以上ROP,10例患儿发生3期ROP+plus病变。对于1期ROP,机械通气组的发生率是41%,显著高于其他组(P<0.05);对于2期ROP,鼻导管吸氧组、CPAP组、机械通气组与对照组的发生率类似,但是鼻导管吸氧组+CPAP组+机械通气组ROP的发生率显著高于对照组(P<0.05)。生后1周、2周、3周和4周血清IGF-1、VEGF水平各组间类似。结论呼吸支持不同模式对早产儿2期以上ROP无明显影响,对血清IGF-1和VEGF也无明显影响。Objective To explore the effects of different modes of respiratory support on the occurrence of retinopathy（ ROP）and the levels of VEGF and IGF- 1 in premature infants. Methods A total of 578 premature infants with gestational age（ GA）of 34 weeks or less who had survived from the time of the initial ophthalmologic examination to the final ROP examination were included in the study. Each infant was categorized as no ROP,stage 1,stage 2,more than stage 3 ROP or stage 3 ROP ＋ plus disease. The serum levels of VEGF and IGF- 1 were detected at postnatal 1,2,3,4 weeks. Results There were 323 infants without ROP,126 infants with stage 1 ROP,80 infants with stage 2 ROP,39 infants with ≥stage 3 ROP and 10 infants with stage 3 ROP ＋ plus disease. For stage 1 ROP,the incidence was 41% in mechanical ventilation group which was significantly higher than other groups（ P〈0. 05）. For the stage 2 ROP,the incidence of ROP was similar in control group,nasal cannula group,CPAP group,and mechanical ventilation group. But the incidence of ROP in nasal cannula,CPAP and mechanical ventilation groups together was significantly higher than the control group（ P〈0. 05）. The levels of VEGF and IGF- 1 at the end of1 week,2 weeks,3 weeks and 4 weeks were similar between nasal cannula group,CPAP group,and mechanical ventilation groups. Infants receiving respiratory support and controls also had similar VEGF and IGF- 1 levels. Conclusion Different modes of respiratory support do not affect the occurrence of more than stage 2 ROP,and also for the levels of VEGF and IGF-1 in premature infants.

关 键 词：呼吸支持 早产儿 视网膜病 

分 类 号：R774.1[医药卫生—眼科]