检索历史 清除

目的:观察并探讨支气管肺发育不良（BPD）早产儿发生早产儿视网膜病变（ROP）及其严重程度的临床危险因素。方法:回顾性临床研究。2016年1月至2018年12月于青岛大学附属医院新生儿科住院的BPD早产儿126例纳入研究。其中，男性69例，女性57例；出生胎龄<32周；出生体重<1500 g。BPD分级Ⅰ、Ⅱ、Ⅲ级分别为63、40、23例。根据有无ROP将患儿分为ROP组、非ROP组，分别为48 （38.1%）、78 （61.9%）例。对比分析两组患儿临床资料的差异性。组间定量资料比较行 t检验，计数资料比较行 χ2检验；采用多因素logistics回归分析BPD早产儿发生ROP的危险因素。BPD严重程度与ROP严重程度相关性采用Spearman秩相关检验。 结果:与无ROP组比较，ROP组患儿出生胎龄小（ t=5.988 ）、出生体重低（ t=7.371）、氧浓度>30%（持续使用时间>24 h）比例高（ χ2=17.244 ）、无创通气时间长（ t=-7.139），差异均有统计学意义（ P<0.05）。Logistic回归分析结果显示，无创通气时间是BPD早产儿发生ROP的独立危险因素（ OR≈1.054， P<0.05），胎龄和出生体重是BPD早产儿发生ROP的保护因素（ OR≈0.938、0.996， P<0.05）。相关性分析结果显示，BPD严重程度与ROP严重程度呈显著正相关（ rs=0.306， P<0.035）。 结论:小出生胎龄、低出生体重、高氧和长期无创机械通气是BPD早产儿发生ROP的主要危险因素。BPD严重程度与ROP发生率和严重程度呈正相关。

Objective:To investigate the clinical risk factors of preterm infants and its severity in premature infants with bronchopulmonary dysplasia (BPD) with retinopathy of prematurity (ROP).Methods:Retrospective clinical study was performed. A total of 126 preterm infants with BPD in the Neonatal Department of the Affiliated Hospital of Qingdao University from January 2016 to December 2018 were enrolled in the study. Among them, 69 were males and 57 were females, whose gestational age<32 weeks and birth weight<1500 g. BPD grades Ⅰ , Ⅱ , and Ⅲ were 63, 40, and 23 cases respectively. According to the presence or absence of ROP, children were divided into ROP group and non-ROP group, with 48 (38.1%) and 78 (61.9%) cases respectively. The differences of clinical data between the two groups were compared and analyzed. Quantitative data comparison between groups was performed by t test, and count data comparison was performed by χ2 test. The risk factors of ROP in BPD premature infants were analyzed by multi-factor logistics regression. The correlation between BPD severity and ROP severity was tested by Spearman rank correlation test. Results:Compared with the non-ROP group, the ROP group had a smaller gestational age ( t=5.988), lower birth weight ( t=7.371), higher the application rate of oxygen concentration> 30% (duration of service> 24 h), high rate ( χ2=17.244) and longer noninvasive ventilation time ( t=-7.139), the differences were statistically significant ( P<0.05). In the logistic regression model, the noninvasive ventilation time was the risk factor for ROP in preterm infants with BPD ( OR≈1.054, P<0.05), while gestational age and birth weight were importantly protective factors for ROP in preterm infants with BPD ( OR≈0.938, 0.996; P<0.05). The results of the correlation analysis found that the severity of BPD was significantly positively correlated with the severity ofROP. As the severity of BPD increased, the severity of ROP increased, and the difference was statistically significant ( rs=0.306, P<0.035). Conclusions:Fetal gestational age, low birth weight, hyperoxia, and long-term non-invasive mechanical ventilation are the main risk factors for ROP in preterm infants with BPD. The severity of BPD is positively correlated with the incidence and severity of ROP.