早产儿视网膜病变筛查及危险因素研究  

Screening results and risk factors of retinopathy of prematurity in 102 premature infants

作　　者：路亮 郭文香[1] 陈璐[2] LU Liang;GUO Wenxiang;CHEN Lu(Department of Pediatrics,The Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China;不详)

机构地区：[1]河北医科大学第二医院儿科,石家庄市050000 [2]河北省儿童医院眼科

出　　处：《河北医药》2021年第24期3705-3708,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20200631)。

摘　　要：目的分析影响早产儿视网膜病变(ROP)发病及严重程度的危险因素,指导临床合理、有效地进行ROP预防及筛查。方法回顾性分析2018年6月1日至2020年5月31日早产儿视网膜病变筛查结果。入组病例分为ROP组和无ROP组,分析危险因素与ROP发病及严重程度的相关性,并通过多因素logistic分析确定独立危险因素。以受试者工作特征曲线(ROC)确定临界值,曲线下面积(AUC)评估危险因素的预测价值。结果单因素分析显示,胎龄,出生体重,住院期间血红蛋白量最低值,用氧时间,机械通气时间,小于胎龄儿,在ROP组与无ROP组间差异有统计学意义(P<0.05)。多因素logistic分析显示,胎龄,机械通气时间为ROP的独立危险因素,胎龄越小或机械通气时间越长,ROP发病率越高。ROC曲线显示,胎龄诊断临界值为30.07周,<30.07周早产儿发生ROP风险增加,AUC为0.715,具有中等预测价值;机械通气时间诊断临界值为15.5 d,机械通气持续时间>15.5 d的早产儿发生ROP风险增加,AUC为0.674,预测价值较低。结论胎龄、机械通气时间是早产儿发生ROP的独立危险因素。胎龄越小,发生ROP风险越大,减少早产儿出生是预防ROP发生的关键;早产儿机械通气时间越长,发生ROP风险越大。胎龄<30.07周或机械通气时间>15.5 d的早产儿应在ROP筛查时给予更多关注。此外,减少医源性失血,严格掌握用氧指征,可在一定程度上降低ROP发病率。Objective To investigate the risk factors of retinopathy of prematurity ROP in premature infants,so as to guide the rational and effective prevention and screening of ROP.Methods A total of 102 preterm infants screened for ROP in hospitalfrom June 1,2018 to May 31,2020 were divided into ROP group and non-ROP group.The correlation between risk factors and the pathogenesis as well as the severity of ROP was analyzed.And the independent risk factors were determined by multivariate Logistic analysis.Moreover,receiver operating characteristic curve(ROC)was used to determine the critical value and area under curve(AUC)was used to evaluate the predictive value of risk factors.Results Univariate analysis showed that there was significant difference in gestational age,birth weight,minimum level of hemoglobin during hospitalization,duration of oxygen and mechanical ventilation and small for gestational age between the two groups(P<0.05).Multivariate logistic analysis showed that gestational age and duration of mechanical ventilation were independent risk factors for ROP.And the younger gestational age or longer duration of mechanical ventilation was,the higher the incidence of ROP would be.Moreover,ROC curve suggested that the critical value was 30.07 weeks,and the risk of ROP for premature infants with gestational age less than 30.07 weeks was increased.In addition,the AUC was 0.715 which had a medium predictive value.The critical value of mechanical ventilation duration was 15.5 days,suggesting that the he risk of ROP was increased with mechanical ventilation duration more than 15.5 days.The AUC was 0.674,which had lower predictive value.Conclusion The gestational age and duration of mechanical ventilation were independent risk factors for ROP in premature infants.The younger the gestational age is and the longer duration of mechanical ventilation is,the higher risk for ROP.So more attention should be paid to those with gestational age less than 30.07 weeks and those with mechanical ventilation duration longer than 15.5

关 键 词：早产儿 早产儿视网膜病变 危险因素 眼底筛查 

分 类 号：R774.1[医药卫生—眼科]