【摘要】：目的:研究5歲段早產(chǎn)兒伴或不伴早產(chǎn)兒視網(wǎng)膜病變(Retinopathy of Permaturity,ROP)的屈光狀態(tài)及光學(xué)部件的變化,觀察孕周、體重及ROP對(duì)幼兒眼部發(fā)育的影響。方法:從2009年1月起至2011年2月止,我院行眼底檢查的早產(chǎn)兒,將其分為ROP組和早產(chǎn)無(wú)ROP組(簡(jiǎn)稱(chēng)早產(chǎn)組),并納入同歲段的正常無(wú)早產(chǎn)兒童為對(duì)照組。第5年進(jìn)行角膜屈光力(Corneal Refraction,CR),角膜曲率(Corneal Curvature,CC),前房深度(Anterior Chamber Depth,ACD),晶狀體厚度(Lens Thickness,LT),玻璃體厚度(Vitreous Thickness,VITR),眼軸長(zhǎng)度(Axial Length,AL),并進(jìn)行大瞳下的檢影驗(yàn)光(1%環(huán)戊通擴(kuò)瞳)。三組間各結(jié)果進(jìn)行比較,并進(jìn)行孕周,出生體重與各因素的相關(guān)性比較。結(jié)果:1.共120人237眼,按上訴方法分為三組:ROP組(31例59眼,1期至3期閾值前期),早產(chǎn)組(47例94眼),足月兒組(42例84眼)。2.近視發(fā)生率ROP組最高(8/59,占13.56%),早產(chǎn)組次之(5/94,占5.32%),足月兒組最低(1/84,占1.19%)。散光發(fā)生率ROP組(24/59,占40.68%)、早產(chǎn)組(17/94,占18.09%)均高于足月兒組(7/84,占8.33%)。3.ROP組和早產(chǎn)組角膜散光(-1.47DC,-1.10DC,-1.05DC)和散光均值(1.08DC,1.08DC,0.56DC)比足月兒組高;早產(chǎn)組及足月兒組角膜屈光力(42.86D,42.91D,43.86D)、角膜曲率(7.69 mm,7.68 mm,7.89 mm)比ROP組低;ROP組及早產(chǎn)組眼軸長(zhǎng)度比足月兒組短(22.15mm,22.16mm,22.47mm),且均有統(tǒng)計(jì)學(xué)意義(P0.05)。晶狀體厚度三組間無(wú)統(tǒng)計(jì)學(xué)差異(4.41mm,4.41mm and 4.41 mm,P0.05)。4.孕周與角膜散光(r=-0.184,p=0.016),散光(r=-0.231,p=0.003)為負(fù)相關(guān),與眼軸長(zhǎng)度(r=0.228,p=0.003)為正相關(guān);出生體重與角膜散光(r=-0.254,p=0.001),散光(r=-0.279,p0.001),角膜屈光力(r=-0.258,p=0.001),角膜曲率(r=0.243,p=0.001)呈負(fù)相關(guān),與眼軸長(zhǎng)度(r=0.248,p=0.001),等效球鏡(r=0.155,p=0.044)呈正相關(guān)。結(jié)論:(1)5歲階段隨訪資料顯示早產(chǎn)兒及ROP患兒較足月兒發(fā)生近視及散光幾率更大。(2)低出生體重、低孕周及ROP的發(fā)生均可影響眼部各光學(xué)部件的生長(zhǎng),最終導(dǎo)致近視及散光的發(fā)生。
[Abstract]:Aim: to study the changes of refractive state and optical components in 5-year-old premature infants with or without retinopathy of prematurity (Retinopathy of Permaturity,ROP), and to observe the effects of gestational weeks, weight and ROP on the development of children's eyes. Methods: from January 2009 to February 2011, premature infants underwent fundus examination in our hospital were divided into ROP group and preterm non-ROP group (referred to as preterm delivery group), and normal non-preterm infants in the same age group were included as control group. In the fifth year, corneal refractive power (Corneal Refraction,CR), corneal curvature (Corneal Curvature,CC), anterior chamber depth (Anterior Chamber Depth,ACD), lens thickness (Lens Thickness,LT), vitreous thickness (Vitreous Thickness,VITR) and axis length (Axial Length,AL) were performed. The examination and optometry under large pupil (1% cyclopentone dilated pupil) were carried out. The results were compared among the three groups, and the correlation between gestational weeks, birth weight and various factors was compared. Results: 1. According to the appeal method, 237 eyes were divided into three groups: ROP group (31 cases 59 eyes, stage 1-3 pre-threshold), premature labor group (47 cases 94 eyes), term group (42 cases 84 eyes). The incidence of myopia was the highest in ROP group (8 / 59, 13.56%), the second in preterm delivery group (5 / 94, 5.32%), and the lowest in full-term group (1 / 8 / 84, 1.19%). The incidence of astigmatism in ROP group (24 / 59, 40.68%), premature delivery group (17 / 94, 18.09%) was higher than that in term group (7 / 84, 8.33%). The incidence of astigmatism in 3.ROP group and premature delivery group (- 1.47DC, / 1.10DC, P < 0.05) was higher than that in term group (- 1.47DC, 1.10DC, P < 0.05). -1.05DC) and mean astigmatism (1.08DC, 1.08DC, 0.56DC) were higher than that of full-term infants. The corneal refractive power (42.86 D, 42.91 D, 43.86 D) and corneal curvature (7.69 mm,7.68 mm,7.89 mm) in premature and full term infants were lower than those in ROP group. The length of ocular axis in ROP group was shorter than that in term group (22.15mm, 22.16mm, 22.47mm), and all of them were statistically significant (P0.05). There was no significant difference in lens thickness among the three groups (4.41 mm, 4.41 mm and 4.41 mm, P0.05). Gestational weeks were negatively correlated with corneal astigmatism (r = 0.184, p = 0.016), astigmatism (r = 0.231, p = 0.003), and positively correlated with axial length (r = 0.228, p = 0.003). Birth weight was negatively correlated with corneal astigmatism (r = 0.254, p = 0.001), astigmatism (r = 0.279, p < 0.001), corneal refractive power (r = 0.258, p = 0.001), corneal curvature (r = 0.243, p = 0.001), corneal refractive power (r = 0.248, p = 0.001), corneal refractive power (r = 0.248, p = 0.001), corneal curvature (r = 0.243, p = 0.001). It was positively correlated with the axial length (r = 0.248, p = 0.001) and the equivalent spherical mirror (r = 0.155, p = 0.044). Conclusion: (1) the incidence of myopia and astigmatism in preterm and ROP infants is higher than that in term infants at 5 years old. (2) low birth weight, low gestational week and ROP can affect the growth of optical components in the eye. Eventually leading to myopia and astigmatism.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R774.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 陳春;張謙慎;;超低出生體重兒救治的國(guó)內(nèi)外近況[J];中國(guó)當(dāng)代兒科雜志;2013年08期

2 鄒蕓蘇;程銳;封云;趙莉;陳志鈞;梅芳;周曉玉;;早產(chǎn)兒視網(wǎng)膜病相關(guān)危險(xiǎn)因素分析[J];中國(guó)實(shí)用兒科雜志;2012年05期

3 朱麗;陳超;石文靜;王玉環(huán);單海冬;趙培泉;;早產(chǎn)兒視網(wǎng)膜病多中心篩查及發(fā)病率調(diào)查[J];中華圍產(chǎn)醫(yī)學(xué)雜志;2006年06期

4 葉鴻瑁;早產(chǎn)兒治療用氧和視網(wǎng)膜病變防治指南[J];新生兒科雜志;2005年03期

5 王穎;周叢樂(lè);姜艷榮;黎曉新;;早產(chǎn)兒視網(wǎng)膜病發(fā)病情況及發(fā)病因素探討[J];中國(guó)實(shí)用兒科雜志;1995年02期

，

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