摘要目的 观察红细胞增多症对早产儿视网膜病变(ROP)的影响.方法 回顾分析262例早产儿的临床资料.患儿中红细胞增多症46例,占17.56%;其中,男性27例,女性19例.无红细胞增多症216例,占82.46%;其中,男性155例,女性61例.有无红细胞增多症两组患儿在出生体重(t=0.730,P=0.466)、胎龄(t=1.603,P=0.110)、吸氧人数(χ1=0.04,P>0.90)、吸氧时间(t=1.225,P=0.223)、吸氧浓度(t=1.823,P=0.071)之间比较,差异均无统计学意义.所有受检早产儿均由有经验的服科医生采用双目间接检眼镜检查眼底,确定有无ROP并进行分期.回顾分析时,着重分析有无红细胞增多症与ROP发生和分期之间的相互关系.结果 262例早产儿中发生ROP 120例,占45.80%.其中,红细胞增多症组发生ROP 25例,占红细胞增多症患儿的54.34%;无红细胞增多症组发生ROP 95例,占无红细胞增多症患儿的43.98%.有无红细胞增多症两组ROP发生率比较,差异无统计学意义(χ2=1.64,P>0.1).120例ROP患儿中,ROP<3期者104例,占86.67%;≥3期者16例,占13.33%.25例发生ROP的红细胞增多症患儿中,ROP<3期者18例,占发生ROP的红细胞增多症患儿的72.00%;≥3期者7例,占发生ROP的红细胞增多症患儿的28.00%.95例发生ROP无红细胞增多症患儿中,ROP<3期者的86例,占发生ROP的无红细胞增多症患儿的90.53%;≥3期者9例,占发生ROP的无红细胞增多症患儿的9.47%.有无红细胞增多症两组间在<3期和≥3期ROP发生率之间比较,差异有统计学意义(x2=4.38P<0.05).120例ROP患儿中,阈值前病变106例,占88.33%;阈值及以上病变14例,占11.67%.25例发生ROP的红细胞增多症患儿中,阈值前病变19例,占发生ROP的红细胞增多症患儿的76.00%;阈值及以上病变6例,占发生ROP的红细胞增多症患儿的24.00%.95例发生ROP无红细胞增多症患儿中,阈值前病变87例,占发生ROP的无红细胞增多症息儿的91.58%;阈值及以上病变8例,占发生ROP的无红细胞增多症患儿的8.42%.有无红细胞增多症两组间阈值前病变和阈值及以上病变ROP发生率比较,差异无统计学意义(χ2=3.27,P>0.05).结论 红细胞增多症不影响ROP发生率,但可能影响ROP的严重程度.

abstractsObjective To explore the effect of polycythemia on retinopathy of prematurity (ROP).Methods The clinical data of 262 premature cases was analyzed retrospectively in Xi'an Children Hospital from January 2005 to January 2009. Polycythemia was found in 46 cases (17. 56 %), including 27 males and 19 females. In 216 infants without polycythemia (82.46%), 155 were male and 61 were female. The difference of the birth weight (t = 0. 730, P = 0. 466), gestational age (t= 1. 603, P= 0. 110), oxygen inhalation numbers (χ2 =0. 04 ,P>0. 90) and times (t= 1. 225, P= 0. 223), and concentration (t= 1. 823,P=0. 071) between polycythemia group and no polycythemia group were not significant. In order to diagnose ROP, the ocular fundus of all premature infants was examined with binocular indirect ophthalmoscope, and the stage of ROP was assessed. Results In all the premature infants, ROP was found in 120 cases (45.80%). In 46 cases of polycythemia, ROP was found in 25 cases (54.34%); in 216 infants without polycythemia, ROP was found in 95 cases (43.98%); the difference of ROP incidence betweenthe two groups was not significant (χ2=1.64, P>0. 1). In 120 ROP patients, 104 cases (86.67%) with ROP< 3 stage and 16 cases (13.33%) with ROP ≥3 stage were found. In 25 ROP patients with polycythemia, 18 cases (72.00%) with ROP <3 stage and 7 cases (28. 00%) with ROP ≥3 stage were found. In 95 ROP patients without polycythemia, 86 cases (90. 53%) with ROP <3 stage and 9 cases (9. 47%) with ROP ≥3 stage were found. The difference of the incidence of ROP <and ≥3 stage between the two group was significant (χ2=4. 38, P<0. 05). In 120 cases of ROP, pre-threshold retinopathy was found in 106 cases (88.33 % ), while threshold and post-threshold retinopathy was in 14 cases (11.670%).In 25 ROP patients with polycythemia, pre-threshold retinopathy was found in 19 cases (76.00%), and threshold and post-threshold retinopathy was in 6 eases (24.00%). In 95 ROP infants without polycythemia, pre-threshold retinopathy was found in 87 cases (91.58%), while threshold and postthreshold retinopathy was in 8 cases (8. 42 %). The difference of the incidence of ROP with pre-threshold,and threshold and post-threshold retinopathy between the two groups was not significant (χ2=3.27, P>0. 05). Conclusion Polycythemia may not affect the incidence of ROP, but impact on the severity of ROP.