Wu M A, Wu M Y, Wu S J, Zhu J J, Lyu Z, Li C L, Shen L J
Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Zhonghua Yan Ke Za Zhi. 2018 Feb 11;54(2):115-119. doi: 10.3760/cma.j.issn.0412-4081.2018.02.009.
To analyse the corneal and conjunctival sensitivities of premature babies and to study the relevant influencing factors. Cross-sectional study. One hundred premature infants born at Women's Hospital School of Medicine Zhejiang University between May 2015 and September 2015 were enrolled, among which 51 were male (51%) and 49 were female (49%), the mean gestational age was (30.93±1.75)w, the mean corrected gestational age was (33.65±1.53)w, the mean birth weight was (1 592±336)g. The thresholds of cornea and conjunctiva of infants' left or right eyes were measured with Cochet-Bonnet aesthesiometer at 8-10 o'clock every morning when they naturally woke up, the minimum length of nylon wire that induced three successive times of eye-blink responses was recorded. Paired sample test was used to compare the corneal and conjunctival sensitivities, the ocular surface sensitivities of preterm infants of different gender were compared using independent samples -test, Pearson correlation and multiple linear regression analysis was conducted to analyze the correlation of corneal and conjuncitval sensitivities with gestational age, birth weight, age and corrected gestational age. The mean corneal sensitivity was (44.85±5.53) mm and the mean conjunctival sensitivity was (23.50±5.48)mm in premature babies, corneal sensitivity was significantly higher than conjunctival sensitivity (25.620, 0.001). No statistical significance was found between male and female preterm infants in corneal sensitivity [(44.80±5.83) mm . (44.90±5.25) mm, -0.085, 0.933] and conjunctival sensitivity[(23.14±5.83) mm . (23.88±5.13) mm, -0.673, 0.502]. Pearson correlation analysis showed that corneal sensitivity was significantly associated with conjunctival sensitivity in prematurity(0.676, 0.001). There was significant correlation between corneal sensitivity and age, corrected gestational age (0.238, 0.017; 0.679, 0.001), however no significant correlation was found between corneal sensitivity and gestational age, birth weight in preterm infants (0.067, 0.510; -0.179, 0.075). There was significant correlation between conjunctival sensitivity and corrected gestational age (0.490, 0.001), however no significant correlation was found between conjunctival sensitivity and gestational age, birth weight and age in preterm infants (0.078, 0.439; -0.096, 0.344; 0.151, 0.133). Multiple linear regression revealed that corneal sensitivity(Y1) was positively correlated with corrected gestational age(X), the regression equation was Y1=2.45X-37.52, the conjunctical sensitivity(Y2) was also positively correlated with corrected gestational age(X), the regression equation was Y2=1.75X-35.41. The corneal sensitivity is higher than conjunctival sensitivity in premature babies.No statistical significance is found between male and female preterm infants in corneal sensitivity and conjunctival sensitivity. The corneal sensitivity and conjunctival sensitivity are correlated with corrected gestational age in preterm infants. The corneal and conjunctival sensitivities of premature babies tend to increase along with the increase of corrected gestational age. .
分析早产儿角膜和结膜的敏感性，并研究相关影响因素。横断面研究。选取2015年5月至2015年9月在浙江大学医学院附属妇产科医院出生的100例早产儿，其中男51例（51%），女49例（49%），平均胎龄为（30.93±1.75）周，平均矫正胎龄为（33.65±1.53）周，平均出生体重为（1592±336）g。每天上午8 - 10点待婴儿自然醒来后，使用Cochet - Bonnet麻醉计测量婴儿左眼或右眼的角膜和结膜阈值，记录诱发三次连续眨眼反应的最短尼龙丝长度。采用配对样本t检验比较角膜和结膜的敏感性，使用独立样本t检验比较不同性别的早产儿眼表敏感性，进行Pearson相关分析和多元线性回归分析以分析角膜和结膜敏感性与胎龄、出生体重、年龄及矫正胎龄的相关性。早产儿平均角膜敏感性为（44.85±5.53）mm，平均结膜敏感性为（23.50±5.48）mm，角膜敏感性显著高于结膜敏感性（t = 25.620，P = 0.001）。男女早产儿角膜敏感性[（44.80±5.83）mm 、（44.90±5.25）mm，t = - 0.085，P = 0.933]及结膜敏感性[（23.14±5.83）mm 、（23.88±5.13）mm，t = - 0.673，P = 0.502]差异均无统计学意义。Pearson相关分析显示早产儿角膜敏感性与结膜敏感性显著相关（r = 0.676，P = 0.001）。角膜敏感性与年龄、矫正胎龄显著相关（r = 0.238，P = 0.017；r = 0.679，P = 0.001），然而早产儿角膜敏感性与胎龄、出生体重无显著相关性（r = 0.067，P = 0.510；r = - 0.179，P = 0.075）。结膜敏感性与矫正胎龄显著相关（r = 0.490，P = 0.001），然而早产儿结膜敏感性与胎龄、出生体重及年龄无显著相关性（r = 0.078，P = 0.439；r = - 0.096，P = 0.344；r = 0.151，P = 0.133）。多元线性回归显示角膜敏感性（Y1）与矫正胎龄（X）呈正相关，回归方程为Y1 = 2.45X - 37.52，结膜敏感性（Y2）也与矫正胎龄（X）呈正相关，回归方程为Y2 = 1.75X - 35.41。早产儿角膜敏感性高于结膜敏感性。男女早产儿角膜敏感性和结膜敏感性差异均无统计学意义。早产儿角膜敏感性和结膜敏感性与矫正胎龄相关。早产儿角膜和结膜敏感性随矫正胎龄增加而呈上升趋势。
