血常规指标与早产儿视网膜病变发病率及严重程度的相关性  

The Correlation between Routine Blood Indicators and Severity of Retinopathy of Prematurity

作　　者：吴斯琪[1] 陈刚 肖亦爽[1] WU Siqi;CHEN Gang;XIAO Yishuang(Dept.of Ophthalmology,Kunming Children’s Hospital,Kunming Yunnan 650034;Dept.of Ophthalmology,Dali Maternal and Child Health Hospital,Dali Yunnan 671000,China)

机构地区：[1]昆明市儿童医院眼科,云南昆明650034 [2]大理州妇幼保健院眼科,云南大理671000

出　　处：《昆明医科大学学报》2024年第5期130-135,共6页Journal of Kunming Medical University

基　　金：昆明市卫计委昆明市儿童眼病诊治技术中心计划基金资助项目[2016-SW(技)-18]。

摘　　要：目的分析血常规指标与早产儿视网膜病变发病率(retinopathy of prematurity,Rop)及严重程度的相关性,为临床防治及减轻ROP严重程度提供依据。方法回顾性系列病例研究(Retrospective case study),选取自2018年9月至2023年9月到昆明市儿童医院进行眼底检查的早产儿648例,男371例,女277例,分为无ROP组和ROP组包括阈值前ROP、阈值ROP及急进型后极部ROP(A-ROP),收集患儿胎龄、出生体重、血常规各参数,采用卡方检验检测性别组间差异,单因素方差分析胎龄、出生体重的组间差异,采用秩和检验检测血常规各项数据组间差异,及Logistic回归分析确立相关独立危险因素,并通过绘制受试者工作特征(ROC)曲线,评估LMR及NLR对ROP的早期预测价值。结果性别在组间比较差异无统计学意义(P>0.05),BW、GA在4组间比较中差异具有统计学意义(P<0.05)。3组ROP相较于无ROP组患儿WBC、N、M、HB、NLR比值均明显降低,LMR比值明显增高,差异均有统计学意义(P<0.05)。多因素Logistic回归分析提示BW、GA、HB、NLR、N、M、LMR是发生ROP的独立危险因素(P<0.05)。ROC曲线显示,LMR的曲线下面积为0.651,LMR对ROP具有一定早期预测价值。结论BW、GA、HB、NLR、N、M、LMR是ROP的独立危险因素,LMR对ROP具有一定早期预测价值。Objective To analyze the morbidity rate and severity of retinopathy of prematurity(ROP)so as to provide a basis for the clinical prevention and treatment and reduce the severity of ROP.Methods 648 premature infants,including 371 males and 277 females,who underwent the fundus examination at Kunming Children’s Hospital from September 2018 to September 2023 were selected and divided into a non ROP group and a ROP group including pre threshold ROP,threshold ROP,and rapidly advancing posterior pole ROP(A-ROP).The parameters of gestational age,birth weight,and blood routine were collected,and chi square test was used to detect gender group differences.Univariate analysis of variance was used to analyze the inter group differences in gestational age and birth weight.Rank sum test was used to detect the inter group differences in blood routine data,and the logistic regression analysis were conducted to establish the relevant independent risk factors,and evaluate the early predictive value of LMR and NLR for ROP by drawing receiver operating characteristic(ROC)curves.Results The rank-sum test showed that the differences in gestational age,daytime age,and birth weight were statistically significant(P<0.05)in the four groups compared with the no-ROP,pre-threshold,threshold,and A-ROP groups.The white blood cell count,neutrophil count,monocyte count,hemoglobin,and NLR ratio were significantly lower and the LMR ratio was significantly higher in the three ROP groups compared to the children in the no-ROP group,and the differences were statistically significant(P<0.05).Multi-factor logistic regression analysis suggested that birth weight,gestational age,hemoglobin,NLR,and LMR were independent risk factors for the development of ROP(P<0.05).The ROC curve showed that the area under the curve for LMR was 0.651(95%CI:0.605-0.698),with a best predictive value was 7.36,corresponding to a sensitivity of 55.8%and a specificity of 71.4%.Conclusion Birth weight,gestational age,hemoglobin,and NLR are independent risk factors for ROP,with

关 键 词：早产儿视网膜病变 危险因素 血常规指标 疾病严重程度 

分 类 号：R77[医药卫生—眼科]