早产儿视网膜病变高危因素Logistic分析

Logistic analysis of risk factors for retinopathy of prematurity

摘要:

目的 探讨早产儿视网膜病变（ROP）高危因素，为本病预防工作提供有利参考。方法 以安阳市妇幼保健院2021年1月至2023年1月808例住院早产儿为筛查对象，应用广角数码视网膜成像系统（RetCam3）进行眼底筛查，根据是否发生ROP分组。比较两组一般临床资料，Logistic多因素回归分析ROP发生的危险因素。结果 本研究808例早产儿中ROP有82例，非ROP有726例，ROP检出率为4.22%。ROP组胎龄、出生体重及血清血管内皮生长因子（VEGF）、胰岛素样生长因子-1（IGF-1）、锌（Zn）、铜（Cu）水平与非ROP组比较差异有统计学意义（P<0.05）。血清VEGF（>295.33 ng/L）、Zn（>0.55 mg/L）是早产儿发生ROP的危险因素；胎龄（>33.10周）、出生体重（≥1 500 g）、IGF-1（>35.39 ng/mL）、Cu（>0.69 mg/L）是早产儿发生ROP的保护因素。结论 早产儿发生ROP的影响因素包括胎龄、出生体重及血清VEGF、IGF-1、Zn、Cu水平，临床应针对其高危因素采取有效措施或提早干预，进而预防/减少早产儿ROP发生。

Abstract:

Objective To explore the high risk factors of retinopathy of prematurity (ROP) and to provide reference for the prevention of ROP.Methods A total of 808 premature infants hospitalized in Anyang Maternal and Child Health Care Hospital from January 2021 to January 2023 were selected as screening objects. Wide-angle digital retinal imaging system (RetCam3) was used for fundus screening, and the patients were grouped according to whether ROP occurred. The general clinical data of the two groups were compared, and the risk factors of ROP were analyzed by logistic multivariate regression.Results In this study, there were 82 cases of ROP and 726 cases of non-ROP among 808 premature infants. The detection rate of ROP was 4.22%. There were significant differences in gestational age, birth weight and serum levels of vascular endothelial growth factor (VEGF), insulin-like growth faction-1 (IGF-1), zinc (Zn) and copper (Cu) in ROP group compared with non-ROP group (P<0.05). Serum VEGF (>295.33 ng/L) and Zn (>0.55 mg/L) were risk factors for ROP in premature infants. Gestational age (>33.10 weeks), birth weight (≥1500 g), IGF-1 (>35.39 ng/mL) and Cu (>0.69 mg/L) were protective factors for ROP in premature infants.Conclusion Gestational age, birth weight and serum levels of VEGF, IGF-1, Zn and Cu are the factors affecting the occurrence of ROP in premature infants. Effective measures or early intervention should be taken to prevent/reduce the occurrence of ROP in premature infants.