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极早产儿炎症标志物与早产儿视网膜病变的关系。

The relationship between inflammatory markers and retinopathy of prematurity in extremely premature infants.

作者信息

Bektaş Fatma Merve, Güçlü Emin Serbülent, Şimşek Hüseyin, Akçali Mustafa

机构信息

Ophthalmology Clinic, Mersin City Training and Research Hospital, Mersin, Turkey.

Neonatology Clinic, Mersin City Training and Research Hospital, Mersin, Turkey.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2025 Jan;263(1):69-76. doi: 10.1007/s00417-024-06604-9. Epub 2024 Aug 22.

Abstract

PURPOSE

This study aimed to evaluate the relationships among blood parameters, clinical factors, and retinopathy of prematurity (ROP) in extremely premature (EP) infants.

METHODS

This retrospective study included 153 EP infants who were categorized into two groups based on the presence of inflammatory diseases such as necrotizing enterocolitis, neonatal sepsis, bronchopulmonary dysplasia, severe intraventricular hemorrhage, preeclampsia, and premature rupture of membranes. Complete blood count parameters, neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio, platelet-lymphocyte ratio (PLR), systemic inflammatory index, and platelet mass index were recorded during the first week and first month after birth. The study analyzed the impact of parameters obtained through blood tests during the first week and first month on the development of ROP and the requirement for treatment.

RESULTS

In this study, 96 infants were diagnosed with inflammatory diseases. After multivariate regression analyses, the duration of mechanical ventilation (p = 0.010) was found to be the only factor that led to ROP development. Moreover, lower gestational age (GA) (p = 0.006), higher NLR (p = 0.026), and lower PLR (p = 0.019) were observed in infants requiring treatment compared to infants with spontaneous resolution of ROP in this group. 57 infants did not have inflammatory diseases. Although the duration of mechanical ventilation (p = 0.041) and low levels of platelets (PLT) (p = 0.046) measured in the first month postnatally were significantly found to be associated with ROP developement, no parameter affecting the required treatment could be determined.

CONCLUSION

EP infants with longer mechanical ventilation durations and lower PLT counts are vulnerable to ROP development. GA, PLR, and NLR are predictive factors for treatment.

摘要

目的

本研究旨在评估极早产儿(EP)的血液参数、临床因素与早产儿视网膜病变(ROP)之间的关系。

方法

这项回顾性研究纳入了153例EP婴儿,根据是否存在坏死性小肠结肠炎、新生儿败血症、支气管肺发育不良、重度脑室内出血、先兆子痫和胎膜早破等炎症性疾病将其分为两组。记录出生后第一周和第一个月的全血细胞计数参数、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值、血小板与淋巴细胞比值(PLR)、全身炎症指数和血小板质量指数。该研究分析了出生后第一周和第一个月通过血液检测获得的参数对ROP发生发展及治疗需求的影响。

结果

在本研究中,96例婴儿被诊断患有炎症性疾病。多因素回归分析后发现,机械通气时间(p = 0.010)是导致ROP发生的唯一因素。此外,与该组ROP自发消退的婴儿相比,需要治疗的婴儿胎龄(GA)更低(p = 0.006)、NLR更高(p = 0.026)、PLR更低(p = 0.019)。57例婴儿没有炎症性疾病。虽然出生后第一个月测得的机械通气时间(p = 0.041)和血小板(PLT)水平低(p = 0.046)与ROP发生显著相关,但无法确定影响所需治疗的参数。

结论

机械通气时间较长且PLT计数较低的EP婴儿易发生ROP。GA、PLR和NLR是治疗的预测因素。

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