Flynn J T, Bancalari E, Snyder E S, Goldberg R N, Feuer W, Cassady J, Schiffman J, Feldman H I, Bachynski B, Buckley E
Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, FL 33101.
N Engl J Med. 1992 Apr 16;326(16):1050-4. doi: 10.1056/NEJM199204163261603.
Retinopathy of prematurity is a disease affecting the blood vessels of the retina in premature infants that may result in scarring, retinal detachment, and loss of vision. An association between this condition and the exposure of premature infants to supplemental oxygen has been postulated, but the relation between retinopathy of prematurity and blood oxygen levels has not been defined. The purpose of this study of a cohort of preterm infants was to correlate the incidence and severity of retinopathy of prematurity with the duration of exposure to different ranges of oxygen tension as measured by transcutaneous monitoring (tcPO2).
One hundred one premature infants (birth weight, 500 to 1300 g) requiring supplemental oxygen had continuous monitoring of tcPO2. The number of hours during which the tcPO2 was 80 mm Hg or higher was tabulated for each infant during the first four weeks of life.
There was a significant association between the amount of time that the tcPO2 was greater than or equal to 80 mm Hg and the incidence and severity of retinopathy of prematurity. The odds ratio for each 12-hour period in which the tcPO2 was greater than or equal to 80 mm Hg was 1.9 (95 percent confidence interval, 1.2 to 3.0) after adjustment for the following factors: birth weight less than or equal to 1300 g (odds ratio, 2.3 [95 percent confidence interval, 1.6 to 3.4]), five-minute Apgar score of 7 or less (odds ratio, 7.2 [95 percent confidence interval, 2.5 to 21]), and exposure to inspired oxygen at a concentration greater than or equal to 0.4 (odds ratio, 1.0 [95 percent confidence interval, 0.97 to 1.05]). The association was stronger for tcPO2 values of greater than or equal to 80 mm Hg occurring from the second through the fourth week of life; during this period, the adjusted odds ratio for a 12-hour period of such exposure was 3.1 (95 percent confidence interval, 1.6 to 6.1).
This study supports an association between the incidence and severity of retinopathy of prematurity and the duration of exposure to arterial oxygen levels of 80 mm Hg or higher, measured transcutaneously.
早产儿视网膜病变是一种影响早产儿视网膜血管的疾病，可能导致瘢痕形成、视网膜脱离和视力丧失。虽然推测这种情况与早产儿暴露于补充氧气之间存在关联，但早产儿视网膜病变与血氧水平之间的关系尚未明确。本项针对一组早产儿的研究目的是，将早产儿视网膜病变的发病率和严重程度与经皮监测（tcPO2）测量的不同氧分压范围的暴露持续时间相关联。
101名需要补充氧气的早产儿（出生体重500至1300克）接受了tcPO2的持续监测。在出生后的头四周内，为每名婴儿列出tcPO2为80毫米汞柱或更高的小时数。
tcPO2大于或等于80毫米汞柱的时间量与早产儿视网膜病变的发病率和严重程度之间存在显著关联。在对以下因素进行调整后，tcPO2大于或等于80毫米汞柱的每12小时时间段的比值比为1.9（95%置信区间，1.2至3.0）：出生体重小于或等于1300克（比值比，2.3[95%置信区间，1.6至3.4]）、5分钟阿氏评分7分或更低（比值比，7.2[95%置信区间，2.5至21]）以及暴露于浓度大于或等于0.4的吸入氧气（比值比，1.0[95%置信区间，0.97至1.05]）。对于出生后第二周至第四周出现的tcPO2大于或等于80毫米汞柱的值，这种关联更强；在此期间，这种暴露的12小时时间段的调整后比值比为3.1（95%置信区间，1.6至6.1）。
本研究支持早产儿视网膜病变的发病率和严重程度与经皮测量的动脉血氧水平80毫米汞柱或更高的暴露持续时间之间存在关联。
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