极低出生体重儿发生早产儿视网膜病的危险因素分析  

Risk factors for retinopathy of prematurity in very low birth weight infants

作　　者：陈冠初 杨婷[1] 唐建明[1] 谈笑[1] 易彬[1] 高红霞[1] Chen Guanchu;Yang Ting;Tang Jianming;Tan Xiao;Yi Bin;Gao Hongxia(Department of Neonatology,Gansu Provincial Women and Child-care Hospital,Gansu Provincial Pediatric Medical Center,Gansu Central Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省妇幼保健院,甘肃省中心医院,甘肃省儿童医学中心新生儿科,兰州730050

出　　处：《中华新生儿科杂志（中英文）》2023年第6期349-353,共5页Chinese Journal of Neonatology

基　　金：甘肃省儿科临床医学研究中心项目(18JR2FA004);甘肃省卫生行业科研计划项目(GSWSKY-2019-13);甘肃省卫生行业科研计划项目(GSWSKY-2019-17)。

摘　　要：目的探讨极低出生体重儿(very low birth weight infant,VLBWI)发生早产儿视网膜病(retinopathy of prematurity,ROP)的危险因素。方法回顾性选取甘肃省妇幼保健院新生儿科2020年10月至2021年12月收治的胎龄≤32周VLBWI为研究对象,根据是否发生ROP分为ROP组和非ROP组。比较两组患儿的临床资料,分析VLBWI发生ROP的危险因素。结果共251例VLBWI纳入研究,包括ROP组60例(23.9%)和非ROP组191例(76.1%)。ROP组胎龄、出生体重小于非ROP组[28(26,30)周比29(28,31)周、1035(840,1285)g比1260(1110,1380)g],氧疗时间、输血次数、高血糖发生率、第1周平均血糖值、第1周血糖峰值大于非ROP组[42.0(26.0,53.5)d比24.0(18.0,34.0)d、2.5(1.0,3.0)次比2.0(1.0,2.0)次、80.0%比16.8%、(5.6±0.5)mmol/L比(5.1±0.5)mmol/L、10.4(7.8,13.2)mmol/L比6.5(6.1,6.8)mmol/L],差异均有统计学意义(P<0.001)。多因素回归分析显示,氧疗时间长(OR=1.047,95%CI 1.008~1.087,P=0.018)和第1周血糖峰值高(OR=1.268,95%CI 1.092~1.474,P=0.002)是VLBWI发生ROP的独立危险因素。结论第1周血糖峰值高和氧疗时间长是VLBWI发生ROP的危险因素。Objective To study the risk factors for retinopathy of prematurity(ROP)in very low birth weight infants(VLBWIs).Methods From October 2020 to December 2021,VLBWIs with gestational age(GA)≤32 weeks admitted to the neonatal department of our hospital were retrospectively studied.According to the occurrence of ROP,they were assigned into ROP group and non-ROP group.The clinical data of the two groups were compared and the risk factors of ROP in VLBWI were analyzed.Results A total of 251 VLBWIs were enrolled,including 60 cases(23.9%)in ROP group and 191(76.1%)in non-ROP group.The GA and birth weight(BW)of ROP group were significantly lower than non-ROP group[28(26,30)w vs.29(28,31)w,1035(840,1285)g vs.1260(1110,1380)g,respectively,all P<0.001].The ROP group had longer duration of oxygen therapy[42.0(26.0,53.5)d vs.24.0(18.0,34.0)d],higher incidences of blood transfusion[2.5(1.0,3.0)times vs.2.0(1.0,2.0)times]and hyperglycemia(80.0%vs.16.8%),higher average[(5.6±0.5)mmol/L vs.(5.1±0.5)mmol/L]and peak[10.4(7.8,13.2)mmol/L vs.6.5(6.1,6.8)mmol/L]blood glucose levels in the first week than the non-ROP group(all P<0.001).Multivariate analysis showed that longer duration of oxygen therapy(OR=1.047,95%CI 1.008-1.087,P=0.018)and higher peak blood glucose level in the first week(OR=1.268,95%CI 1.092-1.474,P=0.002)were the independent risk factors for ROP.Conclusions Longer duration of oxygen therapy and higher peak of blood glucose level in the first week are risk factors for ROP in VLBWIs.

关 键 词：高血糖 早产儿视网膜病 极低出生体重儿 早产儿 

分 类 号：R722.6[医药卫生—儿科]