苏州市立医院本部3471例新生儿中ROP患病情况分析

摘要

目的:回顾性分析苏州市立医院本部3471例新生儿的早产儿视网膜病变(retinopathy of prematurity, ROP)患病情况.方法:选择2010-01/2016-09在苏州市立医院本部(苏州市母子中心)新生儿重症监护病房住院及苏州市立医院本部ROP专科门诊就诊且符合筛查标准的3471例早产、低体质量、有吸氧史的患儿采用RetCam Ⅱ辅以双目间接眼底镜进行ROP筛查.首次检查在出生后4~6wk开始.诊断标准按照国际ROP分类法,双眼病变程度不对称则记录病变严重眼,双眼或单眼发病的患儿均按1例人数纳入统计;接受治疗的病例均定义为重症ROP.回顾分析近6a余ROP及重症ROP患病情况.结果:筛查的3471例6942眼患儿中,发生不同程度ROP患者591例1132眼,ROP患儿检出率17.03%;重症ROP患儿40例80眼,占筛查人数的1.15%.男性检出率16.38%,重症ROP为1.08%;女性检出率17.85%,重症ROP为1.25%;男性和女性ROP检出率比较差异无统计学意义(x2=1.296,P=0.255).单胎儿 ROP 检出率为17.61%,重症ROP为1.13%;多胎儿检出率为15.13%,重症ROP为1.23%.单胎及多胎ROP检出率比较差异无统计学意义(x2= 2.706,P = 0.100).出生体质量<1000g、1000 ~ 1499g、1500 ~ 1999g、2000 ~ 2499g、≥2500g者,ROP 检出率分别为75. 00%、36.17%、10.75%、6.86%、3.77%(体质量<2000g的三组间比较差异具有统计学意义,P<0.005),重症检出率分别占筛查人数的36.54%、1.68%、0.31%、0.19%、0(体质量<2000g的三组间比较差异具有统计学意义,P<0.005).出生胎龄<28周、28~31周、32~36周、≥37周者,ROP检出率分别为69.12%、29.91%、8.28%、3.33%(胎龄<37周的三组间比较差异具有统计学意义,P<0.005);重症ROP检出率分别占筛查人数的25%、1.52%、0.24%、0(胎龄<37周的三组间比较差异具有统计学意义,P<0.005).结论:筛查的3471例早产儿中ROP检出率17.03%,重症ROP检出率1.15%,性别及单多胎ROP患病情况无差异,出生体质量越低、胎龄越小ROP检出率越高.%·AIM: To retrospectively analyze the prevalence of retinopathy of prematurity(ROP) in 3471 neonates in Suzhou Municipal Hospital. ·METHODS: A total of 3471 children (1947 males, 1524 females) were screened for ROP in Suzhou Municipal Hospital from January 2010 to September 2016 using binocular ophthalmoscope or ( and) RetCamⅡ. First examination was performed from 4-6wk after birth. The ocular findings were recorded according to the International Classification of ROP and The Early Treatment for ROP. Only the more aggressive eye of bilateral asymmetrical cases was counted for statistical purpose. Children with ROP in both binocular or single eye were counted in 1 case, and the cases required surgeries were defined as severe cases. The prevalence of ROP and severe ROP in recent 6a were analyzed retrospectively. ·RESULTS: The overall relevance ratio of ROP and severe ROP was 17.03% and 1.15%. The relevance ratio of ROP and severe ROP of the males were 16.38% and 1.08%,and of the females were 17.85% and 1.25%, the results were not statistically different (x2= 1. 296, P =0.255). The relevance ratio of ROP and severe ROP of the single birth infants were 17.61% and 1.13%, and of the multiple birth infants were 15.13% and 1.23%,the results were not statistically different (x2=2.706, P=0.100). The children were divided into 5 groups according to the birth weight. The relevance ratio of ROP with birth weight<1000g,1000-1499g,1500-1999g,2000-2499g and ≥2500g were 75. 00%, 36. 17%, 10. 75%, 6. 86% and 3. 77%respectively with significant differences (There were significant differences between the three groups which the birth weight <2000g, P<0.005). The relevance ratio of severe ROP were 36.54%, 1.68%, 0.31%, 0.19% and 0 respectively in these birth weight groups (There were significant differences between the three groups which the birth weight <2000g,P<0.005). The children were divided into 4 groups according to gestational weeks, the relevance ratio of severe ROP of gestational age<28wk,28-31wk, 32-36wk and ≥37wk were 69. 12%, 29. 91%, 8.28% and 3.33% respectively with significant differences (There were significant differences between the three groups which the gestational age <37wk, P<0.005). The relevance ratio of severe ROP were 25%, 1.52%, 0.24% and 0 in these gestational age groups respectively (There were significant differences between the three groups which the gestational age <37wk,P<0.005). · CONCLUSION: The detection rate of ROP in 3471 premature infants was 17. 03%, the severe ROP was 1.15%. There was no evidence that sex and birth were related to ROP, but lower birth weight and smaller gestational age increased the detection rate of ROP.