A COHORT STUDY OF TRANSCUTANEOUS OXYGEN-TENSION AND THE INCIDENCE AND SEVERITY OF RETINOPATHY OF PREMATURITY
A COHORT STUDY OF TRANSCUTANEOUS OXYGEN-TENSION AND THE INCIDENCE AND SEVERITY OF RETINOPATHY OF PREMATURITY
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DOI：
10.1056/nejm199204163261603
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发表时间：
1992-04-16
影响因子：
158.5
通讯作者：
GILLINGS, D
中科院分区：
文献类型：
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作者：
FLYNN, JT;BANCALARI, E;GILLINGS, D
背景。 早产儿视网膜病变是一种影响早产儿视网膜血管的疾病，可能导致疤痕、视网膜脱离和视力丧失。已经假设这种情况与早产儿接触补充氧气之间存在关联，但早产儿视网膜病变与血氧水平之间的关系尚未确定。这项针对一组早产儿的研究的目的是将早产儿视网膜病变的发生率和严重程度与经皮监测 (tcPO2) 测量的暴露于不同氧分压范围的持续时间相关联。方法。 对 101 名需要补充氧气的早产儿（出生体重 500 至 1300 克）进行了持续监测 tcPO2。将每个婴儿在生命的前 4 周内 tCPO2 达到 80 mm Hg 或更高的小时数制成表格。结果。 tCPO2 大于或等于 80 mm Hg 的时间与早产儿视网膜病变的发生率和严重程度之间存在显着相关性。调整以下因素后，每个 12 小时期间 tcPO2 大于或等于 80 mm Hg 的优势比为 1.9（95% 置信区间，1.2 至 3.0）：出生体重小于或等于 1300 g（优势比，2.3 [95% 置信区间，1.6 至 3.4]），五分钟Apgar 评分为 7 或更低（比值比，7.2 [95% 置信区间，2.5 至 21]），以及暴露于分数浓度大于或等于 0.4 的吸入氧（比值比，1.0 [95% 置信区间，0.97 至 1.05]）。对于出生后第二周到第四周的 tcPO2 值大于或等于 80 mm Hg，这种关联性更强；在此期间，此类暴露 12 小时的调整后优势比为 3.1（95% 置信区间，1.6 至 6.1）。结论。 这项研究支持早产儿视网膜病变的发生率和严重程度与经皮测量的暴露于 80 mm Hg 或更高动脉氧水平的持续时间之间存在关联。
Background. Retinopathy of prematurity is a disease affecting the blood vessels of the retina in premature infants that may result in scarring, retinal detachment, and loss of vision. An association between this condition and the exposure of premature infants to supplemental oxygen has been postulated, but the relation between retinopathy of prematurity and blood oxygen levels has not been defined. The purpose of this study of a cohort of preterm infants was to correlate the incidence and severity of retinopathy of prematurity with the duration of exposure to different ranges of oxygen tension as measured by transcutaneous monitoring (tcPO2).Methods. One hundred one premature infants (birth weight, 500 to 1300 g) requiring supplemental oxygen had continuous monitoring of tcPO2. The number of hours during which the tCPO2 was 80 mm Hg or higher was tabulated for each infant during the first four weeks of life.Results. There was a significant association between the amount of time that the tCPO2 was greater-than-or-equal-to 80 mm Hg and the incidence and severity of retinopathy of prematurity. The odds ratio for each 12-hour period in which the tcPO2 was greater-than-or-equal-to 80 mm Hg was 1.9 (95 percent confidence interval, 1.2 to 3.0) after adjustment for the following factors: birth weight less-than-or-equal-to 1300 g (odds ratio, 2.3 [95 percent confidence interval, 1.6 to 3.4]), five-minute Apgar score of 7 or less (odds ratio, 7.2 [95 percent confidence interval, 2.5 to 21]), and exposure to inspired oxygen at a fractional concentration greater-than-or-equal-to 0.4 (odds ratio, 1.0 [95 percent confidence interval, 0.97 to 1.05]). The association was stronger for tcPO2 values of greater-than-or-equal-to 80 mm Hg occurring from the second through the fourth week of life; during this period, the adjusted odds ratio for a 12-hour period of such exposure was 3.1 (95 percent confidence interval, 1.6 to 6.1).Conclusions. This study supports an association between the incidence and severity of retinopathy of prematurity and the duration of exposure to arterial oxygen levels of 80 mm Hg or higher, measured transcutaneously.