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极低出生体重儿1型早产儿视网膜病变危险因素及眼科结局的病例对照研究

Case control study of risk factors and ophthalmological outcomes of very low birth weight infants with Type 1 retinopathy of prematurity.

作者信息

Ng Tryphena Rachel, Wong Inez B, Ngo Cheryl S, Niduvaje Krishnamoorthy, Ngiam Xin Ying, Sensaki Sonoko, Lee Le Ye

机构信息

Khoo Teck Puat-National University Children's Medical Institute, Singapore.

Department of Ophthalmology, National University Hospital, National University Health System, Singapore.

出版信息

Singapore Med J. 2020 Aug;61(8):426-434. doi: 10.11622/smedj.2019095. Epub 2019 Aug 7.

Abstract

INTRODUCTION

We evaluated the risk factors associated with Type 1 retinopathy of prematurity (ROP) in very low birth weight (VLBW) infants and compared ophthalmologic outcomes between cases with Type 1 ROP who received treatment and gestational age-matched controls with mild or no ROP not requiring treatment.

METHODS

This was a retrospective case-control study of VLBW infants born in National University Hospital, Singapore, from January 2001 to December 2013. 17 cases with Type 1 ROP were each matched for gestational age with controls who had either mild (below Stage 2) or no ROP. Antenatal, perinatal and postnatal variables, as well as childhood ophthalmologic outcomes, were collected from their clinical records and analysed.

RESULTS

The number of packed cell transfusions and highest fraction of inspired oxygen given at weeks 7-10 were found to be statistically significant on multivariate analysis (p = 0.045 and p = 0.049, respectively). None of the infants had blindness or retinal detachment, and there were no significant differences in refractive errors between the groups at 1-4 years of age. Strabismus at four years of age was more common in the group with Type 1 ROP (p = 0.023).

CONCLUSION

Increased episodes of blood transfusions and chronic lung disease requiring high oxygen supplementation at 7-10 weeks of life are significant risk factors associated with Type 1 ROP in VLBW infants in our study. Strabismus at four years is more common in this group of patients. This study highlights the importance of long-term ophthalmologic surveillance for these high-risk children.

摘要

引言

我们评估了极低出生体重(VLBW)婴儿中与1型早产儿视网膜病变(ROP)相关的风险因素,并比较了接受治疗的1型ROP患儿与胎龄匹配的轻度ROP或无ROP且无需治疗的对照组患儿的眼科结局。

方法

这是一项对2001年1月至2013年12月在新加坡国立大学医院出生的VLBW婴儿进行的回顾性病例对照研究。17例1型ROP患儿分别与轻度(2期以下)或无ROP的对照组患儿进行胎龄匹配。从他们的临床记录中收集产前、围产期和产后变量以及儿童眼科结局并进行分析。

结果

多因素分析发现,红细胞压积输血次数以及出生后7 - 10周给予的最高吸氧分数具有统计学意义(分别为p = 0.045和p = 0.049)。所有婴儿均未出现失明或视网膜脱离,1 - 4岁时两组之间的屈光不正无显著差异。1型ROP组4岁时斜视更为常见(p = 0.023)。

结论

在我们的研究中,输血次数增加以及出生后7 - 10周因慢性肺病需要高浓度吸氧是与VLBW婴儿1型ROP相关的重要风险因素。该组患者4岁时斜视更为常见。这项研究强调了对这些高危儿童进行长期眼科监测的重要性。

相似文献

本文引用的文献

7
Retinopathy of prematurity.早产儿视网膜病变。
Lancet. 2013 Oct 26;382(9902):1445-57. doi: 10.1016/S0140-6736(13)60178-6. Epub 2013 Jun 17.

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