Ertl Tibor, Gyarmati Judit, Gaál Valéria, Szabó Ilona
Department of Obstetrics and Gynecology, Medical School, University of Pécs, Pécs, Hungary.
Biol Neonate. 2006;89(1):56-9. doi: 10.1159/000088199. Epub 2005 Sep 8.
Retinopathy of prematurity (ROP) is a multifactorial vasoproliferative retinal disorder that increases in incidence with decreasing gestational age. Recently, an association between hyperglycemia and severe ROP was found in extremely low birth weight infants (ELBWI). The purpose of this study was to evaluate the possible relation between hyperglycemia and ROP at any stage in very low birth weight infants (VLBWI). We analyzed the data of 201 VLBWI. The incidence of ROP and hyperglycemia was detected and the chi2 test was applied to investigate the association between the two variables. The Clinical Risk Index for Babies (CRIB) score was attributed as a marker of illness severity. The incidence of ROP and hyperglycemia in VLBWI was 35.3 and 19.4%, respectively. ROP developed more frequently in hyperglycemic infants (p < 0.001). The gestational age, birth weight, and Apgar scores were significantly lower, the CRIB score was higher in ROP patients. In hyperglycemic ROP patients the CRIB score was significantly higher compared to euglycemic ROP patients (mean (SD) 8.1 (4.2) vs. 5.5 (3.3); p < 0.01). A logistic regression model revealed that gestational age (OR 0.59; 95% CI 0.46-0.76; p < 0.001) and hyperglycemia (OR 3.15; 95% CI 1.12-8.84; p < 0.05) are independent risk factors in ROP development. When ELBWI were analyzed separately, gestational age (OR 0.38; 95% CI 0.20-0.72; p < 0.01) and CRIB score (OR 1.58; 95% CI 1.02-2.45; p < 0.05) were found as significant contributors. Further studies are needed to elucidate the pathophysiological role of hyperglycemia in the development of vasoproliferative retinal disorder.
早产儿视网膜病变（ROP）是一种多因素导致的视网膜血管增生性疾病，其发病率随孕周减小而增加。最近，在极低出生体重儿（ELBWI）中发现高血糖与重度ROP之间存在关联。本研究的目的是评估极低出生体重儿（VLBWI）在任何阶段高血糖与ROP之间的可能关系。我们分析了201例VLBWI的数据。检测ROP和高血糖的发病率，并应用卡方检验来研究这两个变量之间的关联。婴儿临床风险指数（CRIB）评分被用作疾病严重程度的指标。VLBWI中ROP和高血糖的发病率分别为35.3%和19.4%。高血糖婴儿中ROP的发生更为频繁（p<0.001）。ROP患者的孕周、出生体重和阿氏评分显著更低，CRIB评分更高。与血糖正常的ROP患者相比，高血糖ROP患者的CRIB评分显著更高（均值（标准差）8.1（4.2）对5.5（3.3）；p<0.01）。逻辑回归模型显示，孕周（比值比0.59；95%置信区间0.46 - 0.76；p<0.001）和高血糖（比值比3.15；95%置信区间1.12 - 8.84；p<0.05）是ROP发生的独立危险因素。当单独分析ELBWI时，发现孕周（比值比0.38；95%置信区间0.20 - 0.72；p<0.01）和CRIB评分（比值比1.58；95%置信区间1.02 - 2.45；p<0.05）是重要因素。需要进一步研究以阐明高血糖在视网膜血管增生性疾病发生中的病理生理作用。
