中华眼底病杂志

中华眼底病杂志

健康足月新生儿虹膜血管暴露观察及相关因素分析

查看全文

目的 观察分析健康足月新生儿虹膜血管暴露情况及相关因素。 方法 回顾性病例研究。1855名健康足月新生儿纳入研究。其中,男性947名,女性908名。平均出生胎龄(38.84±1.10)周;平均体重(3 396.52±402.08)g。顺产1235名,剖腹产402名,器械助产218名。新生儿出生后1~3 d由经过培训的两名眼科医生一人一次用手持裂隙灯显微镜检查。以裂隙灯显微镜下观察到沿虹膜小梁纤维放射状分布的红色血管为虹膜血管暴露。若两名检查者意见产生分歧,记录为无虹膜血管暴露。计算虹膜血管暴露的发生率。对比有无虹膜血管暴露者性别、分娩方式、出生胎龄、出生体重、出生身长的差异;分析虹膜血管暴露的相关因素。 结果 1855名新生儿中,虹膜血管暴露者298名(虹膜血管暴露组),占16.1%;未见虹膜血管者1557名(虹膜血管非暴露组),占83.9%。虹膜血管暴露组、非暴露组新生儿性别(χ2=0.551)和分娩方式(χ2=3.036)比较,差异无统计学意义(P>0.05);出生胎龄(χ2=47.216)、出生体重(t=4.603)及出生身长(t=3.936)比较,差异有统计学意义(P=0.000)。多因素Logistics回归分析结果显示,出生胎龄与虹膜血管暴露呈负相关(β=−0.291,比值比=0.747,95%可信区间:0.656~0.851,P=0.000)。 结论 健康足月新生儿中虹膜血管暴露发生率为16.1%。出生胎龄与健康足月新生儿虹膜血管暴露呈负相关。

Objective To observe the rate of iris vessels exposure and analyze its relevant factors in normal full-term neonates. Methods A retrospective study. 1855 normal full term neonates, including 947 boys and 908 girls, were enrolled. The mean gestational age (GA) was (38.84±1.10) weeks and mean birth weight (BW) was (3 396.52±402.08) g. There were 1235 neonates from normal term vaginal delivery, 402 cases of cesarean delivery and 218 cases of forceps delivery. All neonates were examined with hand-held portable slit lamp biomicroscopy within 1 to 3 days after birth by two trained ophthalmologist respectively. Iris vessels exposure was defined as radial red blood vessels along iris fibers. Infants were divided into iris vessels exposure group and iris vessels unexposed group according to the findings of slit lamp biomicroscopy. 78 infants with iris vessels exposure were followed up for 42 days after birth till the iris vessels can’t be seen under microscope. The differences between the two groups were compared for gender, mode of delivery (MOD), GA, BW and body length (BL). Multiple logistic regressions were used to determine the factors related to iris vessels exposure. Results There were 298 neonates with iris vessels exposure among 1855 neonates and the rate was 16.1%. 1557 neonates (83.9%) had unexposed iris vessels. There were no different in gender (χ2=0.551) and MOD (χ2=3.036) between iris vessels exposure group and unexposed group (P>0.05), while the differences in GA (χ2=47.216), BW (t=4.603) and BL (t=3.936) between the two groups were statistically significant (P=0.000). Multiple logistic regression analysis revealed that only GA (β=−0.291, odds ratio=0.747, 95% confidence interval: 0.656 - 0.851, P=0.000) was correlated to iris vessels exposure significantly. The iris vessels couldn’t be seen in 77 of 78 infants with iris vessels exposure when followed up to 42 days. Conclusions The iris vessels exposure in normal full-term neonates is frequently observed. There is a significant inverse correlation between GA and iris vessels exposure.

关键词: 新生儿筛查; 虹膜/生长和发育; 影响因素分析

Key words: Neonatal screening; Iris/growth & development; Root cause analysis

引用本文: 陈巍, 王立华, 冯晶晶, 仝欢, 董立萍, 浦佳宁, 邢杉杉. 健康足月新生儿虹膜血管暴露观察及相关因素分析. 中华眼底病杂志, 2017, 33(6): 609-611. doi: 10.3760/cma.j.issn.1005-1015.2017.06.013 复制

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. 赵少贞, 袁佳琴. 裂隙灯活体显微镜检查, 虹膜检查 [M]//李凤鸣, 谢立信. 中华眼科学. 北京: 人民卫生出版社, 2014: 604-605.Zhao SZ, Yuan JQ. Examination of slit lamp biomicroscopy, examination of the iris [M]//Li FM, Xie LX. Chinese ophthalmology. Beijing: People's Medical Publishing House, 2014: 604-605.
2. 朱秀安. 眼球壁, 葡萄膜 [M]//李凤鸣, 谢立信. 中华眼科学. 北京: 人民卫生出版社, 2014: 87-94.Zhu XA. Wall of the eyeball, uvea [M]//Li FM, Xie LX. Chinese ophthalmology. Beijing: People's Medical Publishing House, 2014: 87-94.
3. 李汉林, 周琼. 虹膜新生血管[J]. 江西医药, 2004, 39(6): 448-450. DOI: 10.3760/cma.j.issn.1673-5803.2006.04.018.Li HL, Zhou Q. Iris neovascularization [J]. Jiangxi Medical Journal, 2004, 39(6): 448-450. DOI: 10.3760/cma.j.issn.1673-5803.2006.04.018.
4. 中华医学会眼科学分会眼底病学组. 中国早产儿视网膜病变筛查指南(2014年)[J]. 中华眼科杂志, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. Screening guidelines of Chinese retinopathy of prematurity (2014) [J]. Chin J Ophthalmol, 2014, 50(12): 933-935. DOI: 10.3760/cma.j.issn.0412-4081.2014.12.017.
5. 李凤鸣, 黄时洲, 石珍荣. 眼的胚胎发育, 眼的血管系统 [M]//李凤鸣, 谢立信. 中华眼科学. 北京: 人民卫生出版社, 2014: 36-38.Li FM, Huang SZ, Shi ZR. Fetal development of eye, blood vessels of eye [M]//Li FM, Xie LX. Chinese ophthalmology. Beijing: People's Medical Publishing House, 2014: 36-38.
6. Ludwig CA, Callaway NF, Fredrick DR. What colour are newborns' eyes? Prevalence of iris colour in the Newborn Eye Screening Test (NEST) Study [J]. Acta Ophthalmol, 2016, 94(5): 485-488. DOI: 10.1111/aos.13006.
7. Li LH, Li N, Zhao JY, et al. Findings of perinatal ocular examination performed on 3573 healthy full-term newborns [J]. Br J Ophthalmol, 2013, 97(5): 588-591. DOI: 10.1136/bjophthalmol-2012-302539.
8. 王雅从, 耿韶辉, 李艳涛, 等. 新生儿10000例RetCam检查结果分析[J]. 中国眼耳鼻喉科杂志, 2015, 15(5): 348-351. DOI: 10.14166/j.issn.1671-2420.2015.05.012.Wang YC, Geng SH, Li YT, et al. Application of RetCam Ⅲ examination in 10 000 neonates[J]. Chin J Ophthalmol and Otorhinolaryngol, 2015, 15(5): 348-351. DOI: 10.14166/j.issn.1671-2420.2015.05.012.