海南地区早产儿视网膜病变筛查及相关因素分析  

SCREENING FOR RETINOPATHY OF PREMATURITY IN HAINAN OF CHINA AND RELATED RISK FACTORS

作　　者：麦伟虎 向伟[2] 郭梦颖 陈彩华[2] 黎小年 朱道谋 郑君 MAI Weihu;XIANG Wei;GUO Mengying;CHEN Caihua;LI Xiaonian;ZHU Daomou;ZHENG Jun(Department of Ophthalmology,The Maternal and Child Health Hospital of Hainan Province,Haikou 570206,China)

机构地区：[1]海南省妇幼保健院眼科,海南海口570206 [2]海南省妇幼保健院儿科,海南海口570206

出　　处：《精准医学杂志》2018年第4期328-332,共5页Journal of Precision Medicine

基　　金：海南省自然科学基金资助项目(817361);海南省医药卫生科研项目(16A200007)

摘　　要：目的了解海南地区早产儿视网膜病变(ROP)发生率及相关影响因素,探讨制订海南地区的ROP筛查标准。方法对2017年海南省妇幼保健院和海南省内各市县医院转诊来我院的早产儿进行ROP筛查,如患有严重疾病认为较高危的可适当扩大筛查范围。资料完整并随访的有1 124例(2 248眼),其中男624例,女500例,出生胎龄(GA)<37周,出生体质量≤2 000g。采用新生儿眼底广域成像系统(Retcam3)或双目间接眼底镜进行眼底筛查,并详细记录眼底发育情况。发生ROP的早产儿须对其全身情况进行记录,并随访至病变退化或视网膜完全血管化。采用Logistic回归分析的方法探讨ROP的相关高危因素。结果发生ROP的早产儿209例,占18.59%。Logistic回归分析显示,出生胎龄小、出生体质量低、有吸氧史、呼吸窘迫综合征及胎盘早剥或新生儿缺氧缺血性脑病是发生ROP的重要高危因素(P<0.01);而性别、分娩方式、试管婴儿、多胎妊娠、感染、黄疸、蓝光照射治疗与ROP发生无关(P>0.05)。结论海南地区ROP发生率为18.59%,高于国内部分地区,其发生与多种因素有关。新生儿有胎龄小、低出生体质量、吸氧史、呼吸窘迫综合征及胎盘早剥或新生儿缺氧缺血性脑病等危险因素时应予以特别关注,采取相应措施以降低ROP的发生率。Objective To investigate the incidence rate of retinopathy of prematurity （ROP） in Hainan of China and related influencing factors, and to discuss the development of ROP screening criteria. Methods ROP screening was performed for the preterm infants who were referred to our hospital from The Maternal and Child Health Hospital of Hainan Province and hospitals in cities and counties in Hainan in 2017, and the scope of screening was expanded in cases of severe diseases and high risks. A total of 1 124 preterm infants （with 2 248 eyes） had complete data and follow-up data, among whom there were 624 boys and 500 girls, with a gestational age （GA） of 〈37 weeks and a birth weight of ≤2 000 g. Retcam3 retino-digital photography or binocular indirect ophthalmoscopy was performed for fundus screening, and the development of the fundus was recorded in detail. The general physical conditions of the preterm infants with ROP were recorded, and they were followed up to degeneration or complete retinal vascularization. A logistic regression analysis was performed to identify the risk factors for ROP. Results Of all 1 124 Preterm infants, 209（18.59%） had ROP. The Logistic regression analysis showed that low GA, low birth weight, a history of oxygen inhalation, respiratory distress syndrome, placental abruption, and neonatal hypoxic-ischemic encephalopathy were important risk factors for ROP （ P 〈0.01）, while sex, mode of delivery, in vitro fertilization, multiple pregnancy, infection, jaundice, and blue light irradiation were not associated with the development of ROP （ P 〉0.05）. Conclusion The incidence rate of ROP is 18.59% in Hainan, which is higher than that in some other parts of China. Its development is associated with many factors. Risk factors such as low GA, low birth weight, a history of oxygen inhalation, respiratory distress syndrome, placental abruption, and neonatal hypoxic-ischemic encephalopathy should be taken seriously, and appropriate measures should be taken to reduce the i

关 键 词：视网膜病 早产儿 流行病学研究 新生儿筛查 回归分析 危险因素 

分 类 号：R774.1[医药卫生—眼科]