Flückiger S, Bucher H U, Hellström A, Lövqist C, Sturm V, Arri S J
Klinik für Neonatologie, UniversitätsSpital Zürich, Schweiz.
Klin Monbl Augenheilkd. 2011 Apr;228(4):306-10. doi: 10.1055/s-0031-1273217. Epub 2011 Apr 11.
Premature infants are often stressed by the current retinopathy of prematurity (ROP) screening procedure. Additionally, only < 10 % of the screened infants will develop a ROP stadium requiring laser therapy. Therefore the present screening strategy is unsatisfactory. Furthermore, the current guidelines do not take into account postnatal factors. A new method considering postnatal factors is the weight, insulin-like growth factor, neonatal ROP (WINROP) algorithm. This approach is based on the early postnatal weight gain. The aim of this study was to assign the WINROP-algorithm to a preterm population in Switzerland and to analyze its ability for prediction.
In this retrospective study, all preterm infants with a gestational age (GA) < 32 weeks and/or a birth weight (BW) ≤ 1500 g taken care of in the Department of Neonatology at the University Hospital Zurich from January 2003 to December 2008 were included. The weekly postnatal weight gain was analyzed by means of the modified WINROP-algorithm.
Altogether 376 preterm infants were analyzed. In 58 infants a "high-risk" alarm was released, thereof eight preterms developed a severe ROP and four of them needed laser therapy.
The high predictive value of the WINROP-algorithm was confirmed in our population of Swiss preterms. This instrument has the potential to simplify the current ROP screening procedure. Accordingly, the amount of ophthalmoscopies could be reduced significantly.
目前的早产儿视网膜病变(ROP)筛查程序常使早产儿承受压力。此外,接受筛查的婴儿中只有不到10%会发展到需要激光治疗的ROP阶段。因此,目前的筛查策略并不理想。此外,现行指南未考虑出生后的因素。一种考虑出生后因素的新方法是体重、胰岛素样生长因子、新生儿ROP(WINROP)算法。该方法基于出生后早期的体重增加情况。本研究的目的是将WINROP算法应用于瑞士的早产儿群体,并分析其预测能力。
在这项回顾性研究中,纳入了2003年1月至2008年12月在苏黎世大学医院新生儿科接受治疗的所有孕周(GA)<32周和/或出生体重(BW)≤1500g的早产儿。采用改良的WINROP算法分析出生后每周的体重增加情况。
共分析了376例早产儿。58例婴儿发出了“高危”警报,其中8例早产儿发展为重度ROP,4例需要激光治疗。
WINROP算法在我们的瑞士早产儿群体中具有较高的预测价值得到了证实。该工具有可能简化目前的ROP筛查程序。因此,可以显著减少眼底检查的次数。