【摘要】 目的调查心脏病早产儿视网膜病变(retinopathy of prematurity,ROP)的发生率及危险因素。方法对2017年1月1日至2019年12月31日广东省人民医院新生儿重症监护室收治的合并心脏病的早产儿进行眼底筛查。收集相关临床资料,通过多因素Logistic回归分析方法分析不同出生胎龄、出生体质量、呼吸支持方式、心脏病类型及严重程度等因素对ROP发生率的影响。结果 165例心脏病早产儿完成眼底筛查,出生胎龄为(33.7±2.7)周,出生体质量为(1 910±590)g。ROP阳性27例(16.4%),单眼发病2例(均为右眼),双眼发病25例。其中,1期7(4.2%)例、2期10(6.1%)例、3期及3+期(伴有附加病变)10(6.1%)例,未检出4～5期病变。出生胎龄<32周ROP发生率为42.5%(17/40),3期及3+期ROP发生率为15%(6/40);出生胎龄≥32周ROP发生率为8.0%(10/125),3期及3+期ROP发生率为3.2%(4/125)。检出阈值病变或阈值前病变Ⅰ型为22.2%(6/27),均在72 h内接受激光手术,术后病变均退化满意。Logistic回归分析显示,ROP发生与低出生体质量(OR=0.510,95%CI:0.301～0.865)、机械通气≥7 d(OR=3.697,95%CI:1.082～12.638)、败血症(OR=4.230,95%CI:1.088～16.442)相关,与心脏病分类、严重程度无关。结论本研究心脏病早产儿ROP发生率为16.4%,出生胎龄<32周早产儿ROP发生率为42.5%,出生胎龄≥32周早产儿ROP发生率为8.0%。低出生体质量、机械通气≥7 d、败血症是心脏病早产儿ROP发生的独立危险因素。更多还原

【Abstract】 Objectives To investigate the incidence and risk factors of retinopathy of prematurity(ROP) in preterm infants with cardiac diseases.Methods The clinical data of preterm infants with cardiac diseases in the Department of Neonatology at Guangdong Provincial People’ s Hospital from January 2017 to December 2019 were collected retrospectively.These infants were divided into ROP group or non-ROP group.Gestational age,birth weight,respiratory support,classification and severity of cardiopathy were analyzed.Risk factors of ROP were determined by multi-factor Logistic regression analyses.Results One hundred and sixty-five preterm infants were enrolled,27(16.4%) cases were with ROP,including 2 cases of monocular disease(all right eyes) and 25 cases of binocular disease.Incidence of stage 1,stage 2,stage 3 and stage 4-5 was 4.2%,6.1%,6.1%,and 0% respectively.Among infants with gestational age <32 weeks,the incidence of ROP and severe(stage 3 or above) ROP were 42.5% and 15% respectively.Among infants with gestational age≥32 weeks,the incidence of ROP and severe ROP were 8.0% and 3.2% respectively.Among all infants with ROP,22.2%(6/27) patients with threshold lesion or pre threshold lesion type Ⅰ were treated with laser photocoagulation in 72 h with good outcomes.The multivariate Logistic regression analysis revealed that birth weight(OR=0.510,95%CI:0.301-0.865),mechanical ventilatio≥ 7 d(OR=3.697,95%CI:1.082-12.638),sepsis(OR=4.230,95%CI:1.088-16.442) were independent risk factors of ROP.Conclusions The incidences of ROP among infants <32 weeks’ and ≥ 32 weeks’ gestation were 42.5% and 8.0% respectively.Birth weight,mechanical ventilation and sepsis were independent risk factors of ROP.更多还原