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过去十年早产儿视网膜病变的发病率增加,且存在显著的地区差异。

Increased frequency of retinopathy of prematurity over the last decade and significant regional differences.

机构信息

Department of Neuroscience/ophthalmology, Uppsala University, Uppsala, Sweden.

Department of Clinical Sciences, Ophthalmology, Skane University Hospital, Lund University, Lund, Sweden.

出版信息

Acta Ophthalmol. 2018 Mar;96(2):142-148. doi: 10.1111/aos.13549. Epub 2017 Oct 25.

Abstract

PURPOSE

Retinopathy of prematurity (ROP) causes childhood blindness globally in prematurely born infants. Although increased levels of oxygen supply lead to increased survival and reduced frequency of cerebral palsy, increased incidence of ROP is reported.

METHODS

With the help of a Swedish register for ROP, SWEDROP, national and regional incidences of ROP and frequencies of treatment were evaluated from 2008 to 2015 (n = 5734), as well as before and after targets of provided oxygen changed from 85-89% to 91-95% in 2014.

RESULTS

Retinopathy of prematurity (ROP) was found in 31.9% (1829/5734) of all infants with a gestational age (GA) of <31 weeks at birth and 5.7% of the infants (329/5734) had been treated for ROP. Analyses of the national data revealed an increased incidence of ROP during the 8-year study period (p = 0.003), but there was no significant increase in the frequency of treatment. There were significant differences between the seven health regions of Sweden, regarding both incidence of ROP and frequency of treatment (p < 0.001). Comparison of regional data before and after the new oxygen targets revealed a significant increase in treated ROP in one region [OR: 2.24 (CI: 1.11-4.49), p = 0.024] and a borderline increase in one other [OR: 3.08 (CI: 0.99-9.60), p = 0.052].

CONCLUSION

The Swedish national ROP register revealed an increased incidence of ROP during an 8-year period and significant regional differences regarding the incidence of ROP and frequency of treatment.

摘要

目的

早产儿视网膜病变(ROP)在全球范围内导致早产儿失明。虽然增加氧气供应水平会提高存活率并降低脑瘫的发生频率,但报告的 ROP 发病率却有所增加。

方法

借助瑞典 ROP 登记处 SWEDROP,评估了 2008 年至 2015 年(n=5734)ROP 的全国和地区发病率以及治疗频率,以及 2014 年氧气供应目标从 85-89%变为 91-95%前后的情况。

结果

ROP 发现所有出生时胎龄(GA)<31 周的婴儿中有 31.9%(1829/5734),5.7%(329/5734)的婴儿接受了 ROP 治疗。8 年研究期间 ROP 的发病率呈上升趋势(p=0.003),但治疗频率没有显著增加。瑞典七个卫生区之间 ROP 的发病率和治疗频率均存在显著差异(p<0.001)。新氧气目标前后的区域数据比较显示,一个地区的治疗 ROP 显著增加[OR:2.24(CI:1.11-4.49),p=0.024],另一个地区的治疗 ROP 增加边缘显著[OR:3.08(CI:0.99-9.60),p=0.052]。

结论

瑞典国家 ROP 登记处显示,8 年内 ROP 的发病率增加,并且 ROP 的发病率和治疗频率存在显著的地区差异。

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