基于Logistic回归分析喀什地区早产儿视网膜病变的影响因素

Analysis of influencing factors on retinopathy of prematurity in preterm infants in Kashgar area based on logistic regression analysis

摘要:

目的 分析新疆维吾尔自治区喀什地区早产儿视网膜病变的发生率及其影响因素。方法 选取2021年1月—2022年12月新疆维吾尔自治区喀什地区第二人民医院眼科进行视网膜病变筛查的新生儿作为研究对象。共筛查患儿838例，筛查出早产儿视网膜病变患儿652例。根据筛查结果分为病变组（652例）与非病变组（186例）。统计并记录所有新生儿的性别、出生体重、出生胎龄、胎数、出生方式、吸氧治疗、吸氧方式（无创或有创机械通气）、出生后其他疾病［颅内出血、贫血、败血症、急性呼吸窘迫综合征（包括窒息）、支气管肺发育不良（包括肺透明膜病、支气管肺炎）］。采用多因素一般Logistic回归模型分析喀什地区早产儿视网膜病变的影响因素。结果 病变组与非病变组新生儿的出生胎龄、出生体重、吸氧治疗、吸氧方式、急性呼吸窘迫综合征和支气管肺发育不良构成的比较，差异均有统计学意义（P <0.05）；病变组出生胎龄< 30周、出生体重1 000～2 000 g、有吸氧治疗、无创通气、有急性呼吸窘迫综合征、有肺透明膜病或支气管肺炎例数均高于非病变组（P <0.05）。多因素一般Logistic回归分析结果显示：出生胎龄< 30周［O^R =0.427（95% CI：0.291，0.629）］、出生体重1 000～2 000 g［O^R =0.221（95% CI：0.110，0.443）］、无吸氧治疗［O^R =3.657（95% CI：2.439，5.484）］、有急性呼吸窘迫综合征［O^R =8.518（95% CI：5.378，13.492）］及支气管肺部发育不良［O^R =2.571（95% CI：1.743，3.791）］均是早产儿发生视网膜病变的危险因素（P <0.05）。结论 喀什地区早产儿视网膜病变发生率较高，出生胎龄< 30周、出生体重1 000～2 000 g、无吸氧治疗、有急性呼吸窘迫综合征及支气管肺部发育不良均是喀什地区早产儿发生视网膜病变的危险因素。对高风险早产儿应加强视网膜病变的早期筛查和监测，及时采取预防和治疗措施。

Abstract:

Objective To analyze the incidence and influencing factors of retinopathy of prematurity (ROP) in preterm infants in the Kashgar area.Methods All newborns born from January 2021 to December 2022 in local hospitals and subsequently referred to our department for ROP screening were selected as research subjects. A total of 1261 newborns were screened, among which 652 cases of ROP were identified from 838 screened infants. Based on the screening results, these newborns were divided into an ROP group (652 cases) and a non-ROP group (186 cases). Data on gender, birth weight, gestational age at birth, number of fetuses, mode of delivery, oxygen therapy, mode of oxygen administration (non-invasive or invasive mechanical ventilation), and the occurrence of systemic complications, such as intracranial hemorrhage, anemia, sepsis, acute respiratory distress syndrome (including asphyxia), and bronchopulmonary dysplasia (including hyaline membrane disease, bronchopneumonia) were collected and recorded. Baseline and perinatal data of the two groups were compared, and factors influencing the occurrence of ROP in preterm infants in the Kashgar area were analyzed using Logistic regression.Results A comparison between the ROP group and the non-ROP group regarding gestational age at birth, birth weight, oxygen therapy, method of oxygen delivery, incidence of acute respiratory distress syndrome (ARDS), and rates of bronchopulmonary dysplasia showed statistically significant differences (P <0.05). In the ROP group, preterm infants with a gestational age of less than 30 weeks were more common than in the non-ROP group (P <0.05). Infants in the ROP group with a birth weight of 1,000 to 2,000 g were also more prevalent compared to those in the non-ROP group (P <0.05). The proportion of preterm infants receiving oxygen therapy, specifically non-invasive ventilation, as well as those suffering from ARDS and either hyaline membrane disease or bronchopneumonia, was higher in the ROP group compared to the non-ROP group (P < 0.05). Results indicated that a gestational age of less than 30 weeks [O^R = 0.427 (95% CI: 0.291, 0.629) ], a birth weight of 1,000 to 2,000 g [O^R = 0.221 (95% CI: 0.110, 0.443) ], not receiving oxygen therapy [O^R = 3.657 (95% CI: 2.439, 5.484) ], the presence of ARDS [O^R = 8.518 (95% CI: 5.378, 13.492) ], and bronchopulmonary dysplasia [O^R = 2.571 (95% CI: 1.743, 3.791) ] were all risk factors for the development of ROP in preterm infants (P <0.05).Conclusion The incidence of ROP in preterm infants in the Kashgar area is high. For high-risk preterm infants, early screening and monitoring of ROP should be strengthened, and preventive and therapeutic measures should be timely taken to reduce the occurrence and severity of ROP.