Lin Hui-Ju, Lin Cheng-Chieh, Tsai Shih-Wei, Lin Horg-Chin, Su Bai-Horng
Department of Ophthalmology, China Medical University, Taichung, Taiwan, ROC.
J Chin Med Assoc. 2003 Nov;66(11):662-8.
To calculate incidence and evaluate the risk factors of the threshold retinopathy of prematurity (ROP) in very low birth-weight (VLBW, birth weight less than 1,251 gram) infants. We also compared the incidence of threshold ROP in Taiwan with those of Caucasians and Negros. Additionally, the post-conception age when threshold ROP happened was considered.
From February 1995 to February 2000, we enrolled 458 VLBW infants at the China Medical College Hospital. Patients with congenital anomalies and those who survived less than 6 months were excluded. The perinatal and neonatal data of enrolled infants were reviewed. Student's t test and chi-square test were used to evaluate the statistical significance of risk factors. We also used logistic regression test and correct classification rate to evaluate different risk factors.
The incidence of threshold ROP in our study was 6.8%. The gestational age (GA), birth weight (BW), number of days in using ventilator, continuous positive airway pressure (CPAP) and oxygen supplements, the occurrence of broncopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC) and the length of hospitalization were statistically different between patients groups with and without threshold ROP (p < 0.05). However, small size for gestational age (SGA), sepsis status, intraventricular hemorrhage (IVH) status (Gr.III and Gr.IV) and type of delivery were not significantly different between patients with and without threshold ROP (p > 0.05). Threshold ROP was noted at an average post-conception age of 34.25 weeks.
The incidence of threshold ROP (6.8%) in VLBW Taiwan babies is comparable with the incidence of Caucasian patients in Western countries. Risk factors including PVL, NEC, BPD and RDS should be avoided to prevent the occurrence of threshold ROP. Threshold ROP occurred at an average of 34.3 weeks of post-conception age; the premature baby around this age must be checked carefully.
计算极低出生体重（VLBW，出生体重小于1251克）婴儿阈值性早产儿视网膜病变（ROP）的发病率并评估其危险因素。我们还比较了台湾地区阈值性ROP的发病率与白种人和黑人的发病率。此外，还考虑了阈值性ROP发生时的孕龄。
1995年2月至2000年2月，我们在中国医药学院附设医院纳入了458例极低出生体重婴儿。排除患有先天性异常及存活时间少于6个月的婴儿。回顾纳入婴儿的围产期和新生儿数据。采用学生t检验和卡方检验评估危险因素的统计学意义。我们还使用逻辑回归检验和正确分类率来评估不同的危险因素。
我们研究中阈值性ROP的发病率为6.8%。有和没有阈值性ROP的患者组之间，胎龄（GA）、出生体重（BW）、使用呼吸机的天数、持续气道正压通气（CPAP）和吸氧情况、支气管肺发育不良（BPD）、呼吸窘迫综合征（RDS）、脑室周围白质软化（PVL）、坏死性小肠结肠炎（NEC）的发生情况以及住院时间在统计学上存在差异（p < 0.05）。然而，小于胎龄儿（SGA）、败血症状态、脑室内出血（IVH）状态（III级和IV级）及分娩方式在有和没有阈值性ROP的患者之间无显著差异（p > 0.05）。阈值性ROP在平均孕龄34.25周时被发现。
台湾地区极低出生体重婴儿中阈值性ROP的发病率（6.8%）与西方国家白种人患者的发病率相当。应避免包括PVL、NEC、BPD和RDS在内的危险因素以预防阈值性ROP的发生。阈值性ROP平均发生在孕龄34.3周；这个年龄段左右的早产儿必须仔细检查。
