目的 分析早产儿眼底疾病的患病率及患早产儿视网膜病变的高危因素,为临床诊治提供参考依据。方法 采用RetCam 3小儿视网膜成像系统对2015年3月-2016年3月出生的所有早产儿进行眼底疾病筛查,并结合患儿的一般临床资料对早产儿视网膜病变进行高危因素分析。结果 对1 313例早产儿进行筛查,一共筛查出301例眼底疾病患儿,其中早产儿视网膜病变208例,非特异性视网膜渗出性病变53例,视网膜出血33例,原始玻璃体动脉残留4例,视神经发育不全1例,永存原始玻璃体增生症1例,黄斑色素沉着1例。Logistic回归分析早产儿视网膜病变的高危因素有低胎龄、低出生体重、不规范吸氧史、多胎及输血史。结论 RetCam 3眼病筛查能在早产儿人群中筛查出眼底疾病;早产儿视网膜病变的高危因素有低胎龄、低出生体重、不规范吸氧史、多胎及输血史。
Abstract
Objective To investigate the incidence of the premature infants and analyse the high risk factors associated with the development of retinopathy of prematurity (ROP) in premature infants. Method Retinal imagine system (RetCam 3) was applied to a screening of the fundus diseases in premature infants born between March 2015 and March 2016,and logistic regress analysis of ROP risk factors was conducted. Results A total of 301 infants with fundus diseases were screened out,consisting of 208 cases of ROP,53 cases of nonspecific exudative retinal lesions,33 cases of retinal hemorrhage,4 cases of original residual vitreous artery,1 case of optic nerve hypoplasia,1 case of persistent hyperplastic primary vitreous and 1 case of macular pigmentation.Logistic regress analysis indicated that young gestational age,low birth body weight,non-standard history of using oxygen,simple polyembryony and transfusion history were high risks for the development of ROP in premature infants. Conclusions RetCam 3 is an important means of fundus examination in premature infants.Young gestational age,low birth body weight,non-standard history of using oxygen,simple polyembryony and transfusion history are high risks for the development of ROP in premature infants.
关键词
早产儿 /
RetCam 3筛查 /
视网膜病 /
非特异性视网膜渗出性疾病 /
早产儿视网膜病变 /
眼底筛查
Key words
premature infant /
RetCam 3 /
retinopathy /
nonspecific exudative retinal lesions /
retinopathy of prematurity /
fundus screening
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参考文献
[1] Gilbert C.Retinopathy of prematurity:a global perspective of the epidemics,population of babies at risks and implications for control[J].Early Hum Dev,2008,84(2):77-82.
[2] Gilbert C,Fielder A,Gordillo L,et al.Characteristics of babies with severe retinopathy of prematurity in countries with low,moderate and high levels of development:implications for screening programmes[J].Pediatr Electron Pages,2005,115:518-525.
[3] Ng EY,Connolly BP,McNamara JA,et al.A comparison of laser photocoagulation with cryotherapy for threshold retinopathy of prematurity at 10 years:part 1.Visual function and structural outcome[J].Ophthalmology,2002,109(5):928-934.
[4] Jalali S,Azad R,Trehan HS,et al.Technical aspects of laser treatment for acute retinopathy of prematurity under topical anesthesia[J].Indian J Ophthalmol,2010,58(6):509-515.
[5] Paysse EA,Lindsey JL,Coats DK,et al.Therapeutic outcomes of cryotherapy versus transpupillary diode laser photocoagulation for threshold retinopathy of prematurity[J].J AAPOS,1999,3(4):234-240.
[6] Hornby SJ,Xiao Y,Gilbert CE,et al.The causes of childhood blindness in the People's Republic of China:results from 1131 blind school students in 18 provinces[J].Br J Ophthalmol,1999,83:929-932.
[7] 张国明,李娜,张福燕.早产儿视网膜病变和足月新生儿眼病筛查指南[J].眼科新进展,2014,34(2):101-107.
[8] 叶鸿瑁,黎晓新.早产儿治疗用氧和视网膜病变防治指南[J].中华围产医学杂志,2006,9(6):363-364.
[9] An international classification of retinopathy of prematurity.The committee for the classification of retinopathy of prematurity[J].Arch Ophthalmol,1984,102(8):1130-1134.
[10] An international classification of retinopathy of prematurity II.The classification of retinal detachment.The international committee for the classification of the late stages of retinopathy of prematurity[J].Arch Ophthalmol,1987,105(7):906-912.
[11] International committee for the classification of retinopathy of prematurity.The International classification of retinopathy of prematurity revisited[J].Arch Ophthalmol,2005,123(7):991-999.
[12] Lorenz B,Bock M,Mǜller HM,et al.Telemedicine based screening of infants at risk for retinopathy of p rematurity[J].Stud Health Tech nol In form,1999,64:155-163.
[13] Schwartz SD,Harrison SA,Ferrone PJ,et al.Telemedical evaluation and management of retinopathy of prematu rity using a fiberoptic digital fundus camera[J].Ophthalmology,2000,107(1):25-28.
[14] Ells AL,Holmes JM,Astle W F,et al.Telemedicine approach to screening for severe retinopathy of prematurity:a pilot s tudy[J].Ophthalmology,2004,110(11):2113-2117.
[15] 周也群,陈超,陈露 等.中国大陆早产儿视网膜病变临床特点和眼底病变的多中心调查[J].中国循证儿科杂志,2015,10(3):161-165.
[16] 罗俊,郭燕,熊师,等.婴幼儿眼底渗出样改变489例临床分析[J].医学临床研究,2014,31(7):1316-1318.
[17] 周丹虹,张志强.早产儿视网膜病变的高危因素分析[J].中国实用眼科杂志,2005,23(8):830-831.
[18] Larsson E,Carle-Petrelius B,Cernerud G et al:Incidence of ROP in two consecutive Swedish population based studies[J].Br J Ophthalmol,2002,86:1122-1126.
[19] Shah VA,Yeo CL,Ling YL,et al.Incidence,risk factors of retinopathy of prematurity among very low birth weight infants in Singapore[J].Ann Acad Med Singapore,2005,34(2):169-178.
[20] Gallo J,Jacobson L,Broberger U.Perinatal factors associated with retinopathy of prematurity[J].Acta Paediatrica,1993,82(11):829-834.
[21] 郑戈,林振浪,朱敏丽,等.早产儿视网膜病年度筛查报告[J].临床儿科杂志,2008,26(9):752-756.
[22] Brown BA,Thach AB,Song JC,et al.Retinopathy of prematurity:evaluation of risk factors[J].Int Ophthalmol,1998,22(5):279-283.
[23] 王平,罗俊,何容,等.多生子早产儿视网膜病变的临床特点[J].中华临床医师杂志,2012,6(4):932-934.
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