Jensen Anne K, Ying Gui-Shuang, Huang Jiayan, Karp Karen, Quinn Graham E, Binenbaum Gil
Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
J AAPOS. 2011 Feb 1;15(1):e3-e4. doi: 10.1016/j.jaapos.2011.07.006.
Platelets may act as vascular endothelial growth factor (VEGF) scavengers, possibly limiting neovascularization in retinopathy of prematurity (ROP). The purpose of this study was to investigate the association between thrombocytopenia (platelets <150,000/μL) and the development of type 1 ROP. METHODS: This was a retrospective 1:1 matched case-control study. Cases required laser; controls developed no or stage 1 ROP and were matched for birth weight within 100 g and gestational age within 1 week. Most recent platelet count prior to laser (case) and matched postmenstrual age (control) were abstracted. Conditional logistic regression was used. RESULTS: A total of 91 cases and 91 controls were reviewed. Of the cases, 25% had thrombocytopenia; of controls, 13% (P = 0.034; OR = 2.38; 95% CI, 1.04-5.43). Birth weight, gestational age, postmenstrual age, and culture-proven sepsis were not confounders in multivariate analysis. The association was significant for zone 1 (n = 16; OR = 9.00; 95% CI, 1.14-71.0) but not for zone 2 (OR = 1.43; 95% CI, 0.54-3.75) cases and controls. CONCLUSIONS: Thrombocytopenia was associated with type 1 ROP, primarily among infants with zone 1 ROP. This effect may result from disease location or disease timing, as posterior disease occurs at an earlier postmenstrual age. Longitudinal studies are required to further examine the roles of cumulative platelet deficits, thresholds, or critical time windows in the observed association.
血小板可能作为血管内皮生长因子（VEGF）清除剂，可能限制早产儿视网膜病变（ROP）中的新生血管形成。本研究的目的是调查血小板减少症（血小板<150,000/μL）与1型ROP发生之间的关联。方法：这是一项回顾性1:1匹配病例对照研究。病例需要进行激光治疗；对照未发生或为1期ROP，且出生体重相差100 g以内、胎龄相差1周以内进行匹配。提取激光治疗前（病例）和匹配的月经后年龄（对照）时的最新血小板计数。采用条件逻辑回归分析。结果：共纳入91例病例和91例对照。病例组中，25%有血小板减少症；对照组中，13%（P = 0.034；OR = 2.38；95%CI，1.04 - 5.43）。出生体重、胎龄、月经后年龄和经培养证实的败血症在多因素分析中不是混杂因素。该关联在1区病例（n = 16；OR = 9.00；95%CI，1.14 - 71.0）中显著，但在2区病例和对照中不显著（OR = 1.43；95%CI，0.54 - 3.75）。结论：血小板减少症与1型ROP相关，主要发生在1区ROP婴儿中。这种效应可能是由于疾病部位或疾病发生时间，因为后部疾病在较早的月经后年龄发生。需要进行纵向研究以进一步研究累积血小板缺乏、阈值或关键时间窗在观察到的关联中的作用。
