摘要目的 通过多中心调查,前瞻性研究早产儿视网膜病(ROP)发病相关危险因素.方法 将2005年1月1日至2006年2月28日在ROP协作网内11家医院出生或收治的出生体重＜2000 g 的早产儿或低出生体重儿纳入研究,按时进行ROP筛查,并记录完整的临床资料,调查ROP发病率,分析相关危险因素.结果 882例早产儿纳入研究,完成ROP随访752例,123例发生ROP (16 4%).ROP组出生时平均胎龄为(30.82±0.20)周,平均出生体重(1430±25)g,平均吸氧时间为(11.6±1.4)d;无ROP组出生时平均胎龄(32.56±0.09)周,平均出生体重(1636±10)g,平均吸氧时间为(4 4±0.3)d.单因素分析提示窒息[相对危险度(RR)=1.462]、吸氧时间＞5 d(RR=2.644)、肺表面活性物质的应用(RR=1.880)、肺炎(RR=2.138)、贫血(RR=3.039)、呼吸窘迫综合征(NRDS,RR=2.325)和酸中毒(RR=1.507)与ROP相关(均P＜0 05),多因素分析提示出生体重[比值比(OR)=0.998]、呼吸暂停(OR=1.653)和输血(OR=1.763)是ROP独立作用的因素(均P＜0.05).结论 在诸多因素中,窒息、吸氧、贫血、NRDS、酸中毒与ROP相关,出生体重、呼吸暂停、输血是ROP独立危险因素.

abstractsObjective To evaluate the incidence and risk factors of ROP (retinopathy of prematurity) through a prospective multicenter study. Methods Eleven children's or maternal & child hospitals participated in a collective network. All infants of birth weight＜2000 g, born in or transferred to one of the participating centers from January 1st 2005 to February 28th 2006 were recruited. Timely ophthalmologic examinations were performed. The relevant data at baseline and endpoints were collected at each unit. Results A total of 882 preterm infants fulfilled the screening criteria and 752 finished a follow-up. And 123 infants (16.4%) had some degree of ROP. Infants with ROP had a lower gestational age,birth weight and a longer duration of oxygen versus those without ROP[(30.82±0.20) weeks vs (32.56±0.09) weeks, (1430±25) g vs (1636±10) g, (11.6±1.4) d vs (4.4±0.3)d]. Through a univariate analysis, birth weight, gestational age, asphyxia, oxygen duration＞5 days, apnea, surfactant usage,pneumonia, anemia, blood transfusion, acidosis and neonatal respiratory distress syndrome (NRDS) were associated with ROP (P＜0.05) . Logistic regression analysis showed that birth weight (OR=0.998) ,apnea (OR=1.653) and blood transfusion (OR=1.763) were independent risk factors for ROP.Conclusion Asphyxia, oxygen duration＞5 days, surfactant usage, anemia, acidosis and NRDS, lower birth weight, apnea and blood transfusion may improve the risks of ROP.