首页|生命早期红细胞计数及血红蛋白水平与早产儿视网膜病变的相关性研究

生命早期红细胞计数及血红蛋白水平与早产儿视网膜病变的相关性研究

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目的 观察并分析生命早期红细胞计数及血红蛋白水平与早产儿视网膜病变(ROP)的相关性。方法 回顾性临床研究。2020年1月至2022年12月于河南省儿童医院住院行眼底筛查的早产儿303名纳入研究。其中,男性219名,女性84名;出生胎龄(30。36±1。52)周;出生体重(1 368。43±171。37)g。生命早期定义为出生后14d。依据筛查结果,将受检儿分为ROP组,无ROP组(对照组)。对比观察两组受检儿出生后3、7、14d的红细胞计数、红细胞压积和血红蛋白水平检测结果。组间定量资料比较行t检验;计数资料比较行x2检验。采用logistic回归模型分析ROP发生的危险因素;受试者工作特征(ROC)曲线分析生命早期红细胞计数、血红蛋白水平与ROP发生的相关性。结果 接受筛查的303名早产儿中,ROP组101例,出生胎龄(30。39±1。48)周;对照组202名,出生胎龄(30。35±1。55)周。两组受检儿性别构成比(x2=0。296)和出生胎龄(t=0。251)比较,差异均无统计学意义(P>0。05);出生体重(t=-2。024)、输血次数(U=-4。957)、有创机械通气时间(U=-2。215)、持续气道正压通气时间(U=-5。224)比较,差异均有统计学意义(P<0。05);脑室周围白质软化(x2=5。069)、支气管肺发育不良(x2=9。794)、败血症(x2=8。041)发生率比较,差异均有统计学意义(P<0。05)。ROP组患儿出生后3、7、14d血红蛋白水平均低于对照组,差异有统计学意义(t=-3。813、-2。753、-2。847,P<0。05)。多因素logistic回归分析结果显示,输血次数少[比值比(OR)=1。241,95%可信区间(CI)1。016~1。517]、持续气道正压通气时间短(OR=1。128,95%CI 1。031~1。234)为ROP发生的保护因素。ROC曲线分析结果显示,出生后14d血红蛋白水平、红细胞压积的灵敏度最高,分别为88。1%和83。2%;异常临界值分别为115。5g/L和36。25%。结论 早产儿生命早期红细胞计数及血红蛋白水平可能与ROP发生有一定相关性。
Correlation between erythrocyte count and hemoglobin level in early life and retinopathy of prematurity
Objective To observe and analyze the correlation between erythrocyte count and hemoglobin level in early life and retinopathy of prematurity(ROP).Methods A clinical retrospective study.From January 2020 to December 2022,a total of 303 premature infants,who underwent fundus screening in Children's Hospital of Henan Province were included.There were 219 males and 84 females,with the average gestational age of(30.36±1.52)weeks and the average birth weight of(1 368.43±171.37)g.Early life was defined as 14 days after birth.According to the screening results,patients were divided into ROP group and no ROP group(control group).The results of red blood cell count,hematocrit and hemoglobin concentration of the two groups were compared and observed on the 3rd,7th and 14th day after birth.The measurement data were compared by t-test,and the count data were compared by x2 test.The risk factors of ROP were analyzed by logistic regression.The correlation between red blood cell count as well as hemoglobin concentration in early life and ROP was analyzed by receiver operating characteristics(ROC)curve.Results Among the 303 premature infants screened,a total of 101 preterm infants were included in the ROP group,with the average gestational age of(30.39±1.48)weeks.And a total of 202 preterm infants were included in the control group,with the average gestational age of(30.35±1.55)weeks.There was no significant difference between the two groups in sex composition ratio(x2=0.296)and gestational age(t=0.251)(P>0.05).There were significant differences in birth weight(t=-2.024),blood transfusion times(U=-4.957),invasive mechanical ventilation duration(U=-2.215)and continuous positive airway pressure ventilation time(U=-5.224)between the two groups(P<0.05).The incidence of periventricular leukomalacia(x2=5.069),bronchopulmonary dysplasia(x2=9.794)and sepsis(x2=8.041)were significantly different(P<0.05).The average hemoglobin level of patients in the ROP group on the 3rd,7th and 14th day after birth were lower than those in the control group(t=-3.813,-2.753,-2.847;P<0.05).Logistic regression analysis showed that low frequency of blood transfusion[odds ratio(OR)=1.241,95%confidence interval(CI)1.016-1.517]and short duration of continuous positive airway pressure(OR=1.128,95%CI 1.031-1.234)were protective factors for ROP.The ROC curve analysis indicated that the abnormal threshold values of hematocrit and hemoglobin were the highest on the 14th day after birth,which were 115.5 g/L and 36.25%respectively.The sensitivities were 88.1%and 83.2%,respectively.Conclusion Red blood cell count and hemoglobin level in early life of preterm infants may have a certain correlation with the occurrence and development of ROP.

Retinopathy of PrematurityHemoglobinErythrocyteEarly life

余牧纯、孙慧清

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郑州大学附属儿童医院河南省儿童医院郑州儿童医院早产儿重症监护室,郑州 450018

早产儿视网膜病变 血红蛋白 红细胞 生命早期

河南省科技攻关项目

162102310001

2024

中华眼底病杂志
中华医学会

中华眼底病杂志

CSTPCD北大核心
影响因子:0.928
ISSN:1005-1015
年,卷(期):2024.40(1)
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