早产儿视网膜病变与血小板及炎性指标的相关性研究

Study on correlation between retinopathy of prematurity and platelet, inflammatory indexes

摘要

目的 探究早产儿出生后早期血小板参数和炎性指标与早产儿视网膜病变(ROP)严重程度的相关性。方法 回顾性收集2022年4月1日至2023年1月30日于我院新生儿科收治的122例早产儿作为研究对象,分为需治疗ROP组(10例)、不需治疗ROP组(27例)和无ROP组(85例),采用方差分析、卡方检验、非参数检验对不同组别的一般临床指标、血常规、炎症指标以及合并症的发生情况进行比较,采用Logistic回归分析影响ROP发生的相关因素。结果 超早产儿、极早产儿、中期早产儿和晚期早产儿的ROP发病率依次降低(χ²值为11.348,P＜0.05);超低、极低和低体重早产儿间的ROP发病率依次降低(χ²值为10.773,P＜0.05);需治疗ROP组的胎龄(Z值为33.728)、出生体重(F值为18.150)、1分钟及5分钟Apgar评分(Z值分别为8.344、12.577)均显著低于不需治疗ROP组和对照组(均P＜0.05),需治疗ROP组及不需治疗ROP组阴道分娩占比显著高于对照组(χ²值为10.364,P＜0.05);需治疗ROP组血小板计数(PLT)、血小板平均体积(MPV)、血小板压积(PCT)三项指标均显著低于不需治疗ROP组及对照组(F值分别为7.767、9.865、7.694,P＜0.05);需治疗ROP组的中性粒细胞淋巴细胞比值(NLR)显著高于其余两组(F=3.281,P＜0.05);整体上三组研究对象发生呼吸窘迫综合征、脓毒血症、贫血的占比均有显著性差异(χ²/Fisher值为11.46、11.205、16.758,P＜0.05);逻辑回归分析结果显示胎龄、分娩方式、红细胞平均体积(MCV)、PLT、NLR与ROP发生相关(OR值及其95%CI分别为0.688(0.548~0.865)、0.222(0.064~0.775)、1.107(1.019~1.203)、0.985(0.976~0.995)、1.29(1.019~1.634),P＜0.05)。结论 早产儿生后红细胞平均体积和中性粒细胞淋巴细胞比值是ROP发生的独立危险因素,出生胎龄、阴道分娩和血小板计数是ROP的保护因素。

Abstract

Objective To explore the correlation between early platelet parameters and inflammatory indicators in premature infants and the severity of retinopathy of prematurity (ROP). Methods A total of 122 premature infants admitted to the neonatal department of our hospital from April 1,2022 to January 30,2023 were retrospectively collected as the research subjects.They were divided into the ROP treatment group (10 cases),the ROP non-treatment group (27 cases),and the ROP non-affected group (85 cases).Variance analysis,chi-square test,and non-parametric tests were used to compare the general clinical indicators,blood routine,inflammatory indicators,and the occurrence of complications among different groups.Logistic regression analysis was used to analyze the factors influencing the occurrence of ROP. Results The incidence of ROP in very preterm infants,very preterm infants,middle preterm infants and late preterm infants decreased in turn (χ²=11.348,P＜0.05);The incidence of ROP decreased successively among extremely low birth weight,very low birth weight,and low birth weight premature infants (χ²=10.773,P＜0.05);The gestational age (Z=33.728),birth weight (F=18.150),1-minute and 5-minute Apgar scores (Z=8.344 and 12.577) of the treatment ROP group were significantly lower than those of the non-treatment ROP group and the control group (all P＜0.05),and the proportion of vaginal delivery in the treatment ROP group and the non-treatment ROP group was significantly higher than that of the control group (χ²=10.364,P＜0.05);The platelet count (PLT),mean platelet volume (MPV),and plateletcrit (PCT) of the treatment ROP group were significantly lower than those of the non-treatment ROP group and the control group (F=7.767,9.865,and 7.694,respectively,P＜0.05);The neutrophil-to-lymphocyte ratio (NLR) of the treatment ROP group was significantly higher than that of the other two groups (F=3.281,P＜0.05);Overall,there were significant differences in the proportions of respiratory distress syndrome,pyemia,and anemia among the three groups of children (χ²/Fisher value was 11.46,11.205,and 16.758,respectively,P＜0.05);The logistic regression analysis results showed that gestational age,delivery mode,mean corpuscular volume (MCV),PLT,and NLR were associated with the occurrence of ROP (OR and 95%CI were 0.688 (0.548-0.865),0.222 (0.064-0.775),1.107 (1.019-1.203),0.985 (0.976-0.995),1.29 (1.019-1.634),P＜0.05). Conclusion MCV and NLR in premature infants after birth are independent risk factors for the occurrence of retinopathy of prematurity,while gestational age,vaginal delivery,and PLT are protective factors for retinopathy of prematurity.

关键词

早产儿 / 视网膜病变 / 血小板 / 炎性指标 / 相关性分析

Key words

premature infant / retinopathy / platelet / inflammatory maker / correlation analysis

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