早产儿与足月儿学龄期屈光状态的2年随访研究  

The refractive status in premature infants and fullterm infants when they are at school age during 2 years follow-up

作　　者：常翠荣[1] 于建国[1] 齐世欣[1] 刘会娟 CHANG Cui-Rong;YU Jian-Guo;QI Shi-Xin;LIU Hui-Juan(The refractive status in premature infants and full-term infants when they are at school age during 2 years follow-up)

机构地区：[1]天津市宝坻区人民医院眼科,301800

出　　处：《眼科新进展》2018年第7期673-676,共4页Recent Advances in Ophthalmology

摘　　要：目的了解早产儿和足月儿学龄期时屈光发育的差异,分析早产儿屈光状态的影响因素。方法纵向研究,随机选取2014年9月至2015年3月在本院进行健康体检的262名6～7岁一年级学生,跟踪随访2 a,收集相关资料并作对比。结果最终完成2 a随访者早产儿81例(162眼)、足月儿138例(276眼)。基线时早产儿与足月儿屈光状态均以正视为主,随访2 a后,早产儿近视比例为30.9%(50/162),高于足月儿25.7%(71/276)。早产儿的基线等效球镜度数为(-0.04±0.85)D,小于足月儿的(0.15±0.59)D(t=-2.860,P=0.004),早产儿近视进展速度为每年-0.19 D,快于足月儿的-0.15 D(F=9.621,P<0.05),两组间基线时、随访1 a和随访2 a时的散光检出率差异均无统计学意义(均为P>0.05)。胎龄越小,学龄期早产儿的近视进展越快,其中胎龄≤30周、>30～33周、>33～36周时2 a等效球镜度数改变量分别为(-0.61±1.03)D、(-0.32±0.72)D和(-0.22±0.55)D(F=3.073,P=0.049)。较大的出生胎龄(OR=0.70)、较长的户外活动时间(OR=0.40)是早产儿近视发病的保护因素。结论早产儿学龄期时的近视进展速度高于足月儿,且胎龄越小,近视发展速度越快。Objective To explore the differences in refractive development between premature infants and full-term infants when they are at school age and analyze the risk factors of refractive in premature infants.Methods It was a longitudinal study in 262 first grade children at 6-7 years old who had health check-ups in our hospital.We collected basic information about these children and followed them for two years.Results Totally 81 premature infants(162 eyes)without retinopathy of prematurity(ROP)and 138 full-term infants(276 eyes)returned for all the follow-up examinations.Emmetropia was the main type in both premature infants and full-term infants at baseline.Two years later,the prevalence of myopia was 30.9%(50/162)in premature infants,which was higher than that of full-term infants(25.7%,71/276).There was a significant difference in the mean spherical equivalent(SE)between the premature infants[(-0.04±0.85)D]and full-term infants[(0.15±0.59)D](t=-2.860,P=0.004)at baseline.The rate of myopia progression in premature infants(-0.19 D·a-1)was faster than that in full-term infants(-0.15 D·a-1)(F=9.621,P<0.05).There was no significant difference in the prevalence of astigmatism between full-term infants and premature infants when they were at baseline one year later and two years later(all P>0.05).Myopia development was faster with the decrease of gestational age in premature infants,and the changes in SE was(-0.61±1.03)D,(-0.32±0.72)D,and(-0.22±0.55)D in gestational age≤33 weeks,gestational age ranging from 30 to 33 weeks,and gestational age from 33 to 36 weeks(F=3.073,P=0.049),respectively.Older gestational age(OR=0.70)and longer time in outdoor activity(OR=0.40)were protective factors for new myopia in premature infants.Conclusion The premature infants shows more myopic and faster myopia development than full-term infants in their school age,and myopia development is faster with decreasing gestational age.

关 键 词：早产儿 足月儿 屈光不正 学龄期 

分 类 号：R779.7[医药卫生—眼科]