早产儿视网膜病变危险因素分析及氧气疗法应用的再评估  

Retinopathy of Prematurity:A Re-exploration of Oxygen-Related Risk Factors Analysis

作　　者：吴世元 陈高艳 张景怡 潘睿[2] Wu Shiyuan;Chen Gaoyan;Zhang Jingyi;Pan Rui(School of Medicine,Wuhan University of Science and Technology,Wuhan 430000,China;Department of Pediatrics,Xiangyang Central Hospital,Hubei University of Arts and Science,Xiangyang 441000,China)

机构地区：[1]武汉科技大学医学部医学院,武汉430000 [2]湖北文理学院附属襄阳市中心医院儿科,襄阳441000

出　　处：《成都医学院学报》2025年第1期54-57,共4页Journal of Chengdu Medical College

基　　金：湖北省科技厅自然科学基金项目(No:2022CFB370)。

摘　　要：目的根据对早产儿视网膜病变(ROP)进行早期筛查和随访研究结果,探讨其相关危险因素,并分析氧浓度与ROP发病之间的关系。方法选取2020年1月至2022年12月襄阳市中心医院新生儿重症监护室(NICU)收治的符合ROP筛查条件的早产儿共74例,按照ROP的发生与否,58例未发生ROP的患儿纳入对照组,16例发生ROP的患儿纳入试验组。结果在74例早产儿中,ROP发生率为21.6%。试验组中,男性占68.8%,胎龄(212.3±13.5)d,体重(1.5±0.3)kg,吸氧时间13.5(4.3,28.0)d,吸氧浓度30.0%(26.3%,35.0%)。对照组中,男性占60.3%,胎龄(225.4±21.9)d,体重(1.7±0.4)kg,吸氧时间7.5(0.0,16.3)d,吸氧浓度为24.0%(21.0%,25.5%)。多因素Logistic回归分析显示,胎龄(OR=0.931,95%CI:0.871~0.976,P=0.020)、吸氧浓度(OR=1.142,95%CI:1.021~1.228,P=0.032)和吸氧时间(OR=1.046,95%CI:1.013~1.092,P=0.041)与ROP发生明显相关。平滑拟合曲线分析发现,吸氧浓度与ROP发生呈剂量效应关系,当氧浓度低于30%时,ROP风险随氧浓度增加而升高,超过30%后风险趋于稳定。结论胎龄、吸氧浓度和吸氧时间是ROP发生的独立危险因素,对有ROP风险的患儿应谨慎提高吸氧浓度,以避免增加ROP的发生风险。Objective To investigate the risk factors of retinopathy of prematurity(ROP)and analyze the correlation between the concentration of inhaled oxygen(COI)and the incidence of ROP based on the results of early fundus screening and follow-up data.Methods A retrospective examination was performed on the clinical documentation and follow-up results of preterm infants admitted to the Neonatal Intensive Care Unit(NICU)of Xiangyang Central Hospital from January 2020 to December 2022,specifically focusing on those who met the criteria for ROP screening.A total of 74 cases were included and divided into a control group(without ROP,n=58)and an experimental group(with ROP,n=16)based on the occurrence or absence of ROP.Results The incidence of ROP was 21.6%among the 74 preterm infants.In the ROP group,68.8%were male,with a mean gestational age of(212.3±13.5)d,a mean birth weight of(1.5±0.3)kg,a median duration of oxygen therapy of 13.5(4.2,28.0)d,and a median oxygen concentration of 30%(26.3%,35.0%).In the control group,60.3%were male,with a mean gestational age of(225.4±21.9)d,a mean birth weight of(1.7±0.4)kg,a median duration of oxygen therapy of 7.5(0.0,16.3)d,and a median oxygen concentration of 24.0%(21.0%,25.5%).Multivariate Logistic regression analysis revealed that gestational age(OR=0.931,95%CI 0.871-0.976,P=0.020),oxygen concentration(OR=1.142,95%CI:1.021-1.228,P=0.032),and duration of oxygen therapy(OR=1.046,95%CI:1.013-1.092,P=0.041)were independently associated with the occurrence of ROP.Smooth curve fitting analysis demonstrated a dose-dependent relationship between oxygen concentration and ROP incidence.Specifically,when oxygen concentration was below 30%,the risk of ROP increased with the increase of oxygen concentration,while above 30%,the risk plateaued and did not significantly increase further.Conclusion Gestational age,COI and duration of oxygen therapy are independent risk factors for ROP.For children at risk of ROP,COI should be carefully increased to avoid increasing the risk of ROP.

关 键 词：眼底筛查 吸氧 早产儿 视网膜病变 危险因素 

分 类 号：R722.1[医药卫生—儿科]