Tsui Irena, Ebani Edward, Rosenberg Jamie B, Lin Juan, Angert Robert M, Mian Umar
Department of Ophthalmology, Montefiore Medical Center; Albert Einstein College of Medicine, Bronx, NY, USA.
J Pediatr Ophthalmol Strabismus. 2013 Mar-Apr;50(2):88-92. doi: 10.3928/01913913-20130108-03. Epub 2013 Jan 15.
To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment.
Retrospective, cross-sectional study. Charts were reviewed for gestational age, birth weight, birth head circumference, birth length, maternal characteristics, gender, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, blood transfusions, and sepsis. Main outcome measures were increased rates of plus disease or ROP requiring treatment.
A total of 450 premature infants screened for ROP in a mid-sized, urban neonatal intensive care unit were included. On univariate analysis, gestational age, birth weight, birth head circumference, birth length, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, and sepsis were significantly correlated to plus disease and ROP requiring treatment. PDA was significantly associated with bronchopulmonary dysplasia, neurologic comorbidities, sepsis, and blood transfusions (P < .0001). With type 3 multivariate analysis, only gestational age and bronchopulmonary dysplasia were independent risk factors for ROP.
PDA and indomethacin were associated with plus disease and ROP requiring treatment on univariate analysis but this was not significant after adjusting for other risk factors. PDA was also strongly related to bronchopulmonary dysplasia and blood transfusions, which may explain its effect on ROP.
研究临床上显著的动脉导管未闭（PDA）或吲哚美辛治疗是否与需要治疗的增值性疾病或早产儿视网膜病变（ROP）相关。
回顾性横断面研究。查阅病历以获取胎龄、出生体重、出生头围、出生身长、母亲特征、性别、支气管肺发育不良、神经合并症、PDA及其治疗、胃肠道合并症、输血和败血症等信息。主要观察指标是需要治疗的增值性疾病或ROP发生率增加。
纳入了在一家中型城市新生儿重症监护病房接受ROP筛查的450例早产儿。单因素分析显示，胎龄、出生体重、出生头围、出生身长、支气管肺发育不良、神经合并症、PDA及其治疗、胃肠道合并症和败血症与需要治疗的增值性疾病和ROP显著相关。PDA与支气管肺发育不良、神经合并症、败血症和输血显著相关（P <.0001）。在多因素3型分析中，只有胎龄和支气管肺发育不良是ROP的独立危险因素因素。
单因素分析显示PDA和吲哚美辛与需要治疗的增值性疾病和ROP相关，但在调整其他危险因素后，这种相关性并不显著。PDA还与支气管肺发育不良和输血密切相关，这可能解释了其对ROP的影响。
