CAJ | 학술논문

目的探讨西安地区出生体重＞2 000 g早产儿视网膜病变(ROP)的发生情况及临床特征.方法回顾性系列病例研究.对2008年1月至2012年12月在第四军医大学西京医院眼科ROP筛查与治疗中心行ROP筛查的受检儿童资料进行回顾性描述分析.共有1 866例儿童(3 732只眼)接受检查,其中男1 166例,女700例;孕(34±4)周(24 ～ 46周)出生;出生体重(2 106 ±743) g(730～4 900 g).筛查同时详细询问并记录受检儿童的相关资料,如出生孕周、出生体重、持续吸氧和呼吸机使用情况,是否有窒息、缺血缺氧性脑病、新生儿急性呼吸窘迫综合征、肺炎、黄疸、贫血、先天性心脏病等疾病;以及妊娠期间母亲健康状况,包括是否有妊娠性高血压、羊水早破、胎盘早剥和前置胎盘等.通过百分位数法计算所有ROP患儿出生体重的P90和P95.将出生体重＞2 000 g的ROP患儿视为高出生体重患儿,≤2 000 g者为低出生体重患儿.对高出生体重组和低出生体重组患儿ROP特征进行对比分析.对ROP筛查数据分别进行t检验、x2检验或Fisher精确检验.结果所有受检儿童中,筛查出各期ROP患儿243例(468只眼),检出率为13.0％,其中需要治疗的(严重程度在阈值前病变Ⅰ型以上者)96例,占39.5％.243例ROP患儿出生体重的P90和P95分别为2 060 g和2 240 g.若将出生体重≤2 000 g作为筛查标准,有9.9％的ROP患儿未被涵盖.高出生体重的24例ROP患儿,孕(33±3)周(28～ 40周)出生,出生体重(2 411±354)g(2 100～3 300 g),其中需要治疗者6例(6.3％).与低出生体重ROP患儿相比,其病情严重程度和全身发病危险因素无差异(P＞0.05).结论西安地区ROP患儿中,高出生体重者占有一定比例;与低出生体重ROP患儿相比,其病变程度和性质并无特殊性.
목적 탐토서안지구출생체중＞2 000 g조산인시망막병변(ROP)적발생정황급림상특정.방법 회고성계렬병례연구.대2008년1월지2012년12월재제사군의대학서경의원안과ROP사사여치료중심행ROP사사적수검인동자료진행회고성묘술분석.공유1 866례인동(3 732지안)접수검사,기중남1 166례,녀700례;잉(34±4)주(24 ～ 46주)출생;출생체중(2 106 ±743) g(730～4 900 g).사사동시상세순문병기록수검인동적상관자료,여출생잉주、출생체중、지속흡양화호흡궤사용정황,시부유질식、결혈결양성뇌병、신생인급성호흡군박종합정、폐염、황달、빈혈、선천성심장병등질병;이급임신기간모친건강상황,포괄시부유임신성고혈압、양수조파、태반조박화전치태반등.통과백분위수법계산소유ROP환인출생체중적P90화P95.장출생체중＞2 000 g적ROP환인시위고출생체중환인,≤2 000 g자위저출생체중환인.대고출생체중조화저출생체중조환인ROP특정진행대비분석.대ROP사사수거분별진행t검험、x2검험혹Fisher정학검험.결과 소유수검인동중,사사출각기ROP환인243례(468지안),검출솔위13.0％,기중수요치료적(엄중정도재역치전병변Ⅰ형이상자)96례,점39.5％.243례ROP환인출생체중적P90화P95분별위2 060 g화2 240 g.약장출생체중≤2 000 g작위사사표준,유9.9％적ROP환인미피함개.고출생체중적24례ROP환인,잉(33±3)주(28～ 40주)출생,출생체중(2 411±354)g(2 100～3 300 g),기중수요치료자6례(6.3％).여저출생체중ROP환인상비,기병정엄중정도화전신발병위험인소무차이(P＞0.05).결론 서안지구ROP환인중,고출생체중자점유일정비례;여저출생체중ROP환인상비,기병변정도화성질병무특수성.
Objective To survey popularity and clinical characteristics of retinopathy of prematurity (ROP) in Xi'an area in infants with birth weight over 2 000 g.Methods Retrospective case-series study.ROP screening data of 1 866 infants was collected and reviewed from Department of Ophthalmology,Xijing Hospital from January 2008 to December 2012.One thousand eight hundreds and sixty-six cases (3 732 eyes) with 1 166 males and 700 females were examined.Their gestation age was (34 ± 4)weeks (24-46 weeks),and birth weight was (2 106 ± 743)g (730-4 900 g).All the related information about infants accepted examinations was screened,inquired and recorded carefully,such as gestation age,birth weight,continuous inhalation of oxygen and respirator applied records.Whether they had asphyxia,hypoxic-ischemic encephalopathy,acute respiratory distress syndrome,pneumonia,jaundice,anemia,congenital heart disease was also recorded.Moreover the physical situations of maternity including gestational hypertension,premature rupture of amniotic fluid,placenta abruption and placenta previa were also assessed.Percentiles (P90 and P95) of birth weight in ROP infants were calculated.Birth weight over 2 000 g in ROP patients was identified as high birth weight,whereas birth weight less than 2 000 g was confirmed as low birth weight.Clinical characteristics were compared in the two groups.T-test,Chi-square test,and Fisher's exact test were used for this study.Results In all the infants examined,243 cases were screened out as ROP patients with different stages.The positive rate was 13.0％.Among them,96 cases needed to be treated which was 39.5％.They were severer than pre-threshold Type Ⅰ.P90 and P95 of birth weight percentiles of these ROP infants were 2 060 g and 2 240 g.If birth weight less than 2 000 g was coufirmed as screen guideline,9.9％ patients might be excluded.There were 24 ROP infants whose birth weight were over 2 000 g with gestation age of (33 ±3)weeks(28-40 weeks),and with birth weight of (2 411 ± 354)g (2 100-3 300 g).Six of them needed to be treated,which was 6.3％.Compared with ROP infants with low birth weight,they had almost same stages and risk factors.Conclusions High birth weight ROP infants occupies some proportions in Xi'an area.They has no special characteristics or severity compared with low birth weight ones.