Leng Yunxia, Huang Wenzhi, Ren Guoliang, Cai Cheng, Tan Qingbiao, Liang Yuqin, Yang Weizhong, Gao Zongyin
Guangzhou First People's Hospital, Guangzhou city, China.
Second Affiliated Hospital of South China University of Technology, Guangzhou city, China.
BMC Ophthalmol. 2018 Nov 20;18(1):301. doi: 10.1186/s12886-018-0973-1.
Retinopathy of prematurity (ROP) is a vascular proliferative disorder of the developing retina and a significant cause of childhood blindness around the world. The incidence of ROP is affected by many factors, and the incidence rate varies from country to country. The purpose of this study is to report the incidence and risk factors of ROP in neonatal intensive care unit (NICU) of Guangzhou First People's Hospital in China.
A retrospective review was performed on 436 premature infants who were consecutive ROP screened in the NICU of Guangzhou First People's Hospital from March 2013 to October 2017. The single-factor analysis and the logistic multivariate regression analysis were used to detect risk factors of ROP.
Total 436 premature infants were consecutive ROP screened, 138 (31.65%) were found ROP, and 61(13.99%) were treated. The single-factor analysis revealed that the incidence of ROP was associated with multiple births, gestational age, birth weight, mechanical ventilation, intravascular hemolysis, the number of operations and blood culture results. The logistic multivariate regression analysis revealed that gestational age; birth weight, mechanical ventilation, minimum SaO2 and daily weight gain were independent risk factors for ROP onset. Forty-nine patients underwent retinal laser photocoagulation with recurrence 20 patients. Twelve patients underwent anti-VEGF drug (Ranibizumab) via intraocular injection with 5 patients of recurrence.
The incidence of ROP in NICU of Guangzhou China will match those in middle-income countries, but higher than high-income countries. Anti-VEGF drugs could be preferred as a good treatment method for zone 1 ROP and aggressive posterior ROP.
早产儿视网膜病变(ROP)是发育中的视网膜的一种血管增生性疾病,是全球儿童失明的一个重要原因。ROP的发病率受多种因素影响,各国发病率有所不同。本研究的目的是报告中国广州市第一人民医院新生儿重症监护病房(NICU)中ROP的发病率及危险因素。
对2013年3月至2017年10月在广州市第一人民医院NICU连续接受ROP筛查的436例早产儿进行回顾性研究。采用单因素分析和逻辑多元回归分析来检测ROP的危险因素。
共436例早产儿连续接受ROP筛查,138例(31.65%)被发现患有ROP,61例(13.99%)接受了治疗。单因素分析显示,ROP的发病率与多胎、胎龄、出生体重、机械通气、血管内溶血、手术次数和血培养结果有关。逻辑多元回归分析显示,胎龄、出生体重、机械通气、最低动脉血氧饱和度(SaO2)和每日体重增加是ROP发病的独立危险因素。49例患者接受了视网膜激光光凝治疗,其中20例复发。12例患者通过眼内注射抗血管内皮生长因子(VEGF)药物(雷珠单抗)治疗,5例复发。
中国广州NICU中ROP的发病率与中等收入国家相当,但高于高收入国家。抗VEGF药物可作为1区ROP和侵袭性后部ROP的良好治疗方法优先选用。