早产与足月产学龄前儿童视功能差异的研究
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摘要
目的研究早产与足月产学龄前儿童视功能的差异。方法收集早产学龄前儿童60例120眼,同年龄足月产学龄前儿童60例120眼,比较视力、斜视、屈光不正发生情况以及F-VEP的差异。结果早产学龄前儿童的最佳矫正视力低于同年龄足月产学龄前儿童(t=2.153,P=0.022);两者的斜视发生率的差异无统计学意义(χ~2=1.061,P=0.307);早产学龄前儿童屈光不正的发生率高于同年龄足月产儿(χ~2=5.581,P=0.020);和足月产学龄前儿童相比,早产学龄前儿童的P100潜伏期延长(t=2.382,P=0.019),且极低出生体质量儿较低出生体质量儿和足月产儿的差异更大,但P100波振幅两者差异均无统计学意义(均为P>0.05)。结论早产学龄前儿童的视功能发育落后于同年龄足月产儿,因此,应重视早产新生儿是否存在视功能异常,并应加强成长过程中的视功能监测与治疗,以促进视功能最大程度恢复。
Objective To compare the preschool children's visual function between premature and partus matures in the same age. Methods Sixty preschool children( 120 eyes) who were prematurity and 60 cases( 120 eyes) who were partus matures in the same age were collected. The difference in visual acuity,strabismus and refractive error and F-VEP were compared between premature and partus matures. Results Best corrected visual acuity in prematurity was lower than that in partus matures( t = 2. 153,P = 0.022); There was no statistically significant difference in the strabismus incidence( χ~2= 1.061,P = 0. 307); The incidence of refractive errors in prematurity was higher than that in partus matures( χ~2= 5.581,P = 0. 020); Latency period of P100 wave in prematurity was longer than that in partus matures( t = 2.382,P = 0.019),and the difference between the very low birth weight and the low birth weight,full-term infants was more significant,but there was no statistically significant difference in the amplitude of P100 wave( all P > 0.05). Conclusion Preschool children's visual function development in prematurity lags behind that in partus matures in the same age. Therefore,attention should be paid to visual function of prematurity,and the growth of visual function in the process of monitoring and treatment should be strengthened in order to promote visual function recovery to the greatest extent.
Objective To compare the preschool children's visual function between premature and partus matures in the same age. Methods Sixty preschool children( 120 eyes) who were prematurity and 60 cases( 120 eyes) who were partus matures in the same age were collected. The difference in visual acuity,strabismus and refractive error and F-VEP were compared between premature and partus matures. Results Best corrected visual acuity in prematurity was lower than that in partus matures( t = 2. 153,P = 0.022); There was no statistically significant difference in the strabismus incidence( χ~2= 1.061,P = 0. 307); The incidence of refractive errors in prematurity was higher than that in partus matures( χ~2= 5.581,P = 0. 020); Latency period of P100 wave in prematurity was longer than that in partus matures( t = 2.382,P = 0.019),and the difference between the very low birth weight and the low birth weight,full-term infants was more significant,but there was no statistically significant difference in the amplitude of P100 wave( all P > 0.05). Conclusion Preschool children's visual function development in prematurity lags behind that in partus matures in the same age. Therefore,attention should be paid to visual function of prematurity,and the growth of visual function in the process of monitoring and treatment should be strengthened in order to promote visual function recovery to the greatest extent.
引文
[1]罗黎力,陈大鹏,屈艺,母得志.早产儿218例视网膜病变筛查分析[J].中华实用儿科临床杂志,2013,28(14):1058-1060.
[2]郑璟,柯晓云,徐进,张燕,陈伟宾.无ROP早产儿视盘周围视网膜神经纤维层及黄斑区视网膜和脉络膜厚度分析[J].眼科新进展,2015,35(9):844-846.
[3]赵培泉,费萍.早产儿视网膜病变诊断治疗研究现状、问题及展望[J].中华眼底病杂志,2012,28(1):3-6.
[4]章晟,李秋平,孔祥永,张小英,张玉佩,王自珍,等.卷曲蛋白4基因多态性与早产儿视网膜病变易感性的关系[J].中华实用儿科临床杂志,2014,29(14):1055-1059.
[5]陈宜,冯婧,孟宪芬,邓洵,尹虹,梁建宏,等.玻璃体腔注射雷珠单抗治疗早产儿视网膜病变疗效观察[J].中华眼底病杂志,2015,31(1):1105-1015.
[6]黎晓新.我国早产儿视网膜病变特点和筛查指南[J].中华眼底病杂志,2004,20(6):384-386.
[7]HSIEH CJ,LIU JW,HUANG JS,LIN KC.Refractive outcome of premature infants with or without retinopathy of prematurity at 2years of age:a prospective controlled cohort study[J].Kaohsiung J Med Sci,2012,28(4):204-211.
[8]SAUNDERS KJ,MCCULLOCH DL,SHEPHERD AJ,WIKINSON AG.Emmetropisation following preterm birth[J].Br J Ophthalmol,2002,86(9):1035-1040.
[9]HOLMSTR O MG,EL AZAZI M,KUGELBERG U.Ophthalmological long term follow up of preterm infants:a population based,prospective study of the refraction and its development[J].Br J Ophthalmol,1998,82(11):1265-1271.
[10]FLEDEHUS H.Prematurity and eye.ophthalmic 10years follow up of children of low and normal birth weight[J].Acta Ophthalmol,1976,128:3-245.
[11]HOLMSTRO MG,EL AZAZI M,KUGELBERG U.Ophthalmological follow up of preterm infants:a population based,prospective study of visual acuity and strabismus[J].Br J Ophthalmol,1999,83(2):143-150.
[12]周建强,陈云,张强.早产对无早产儿视网膜病变的早产儿眼发育和发病的影响[J].中国斜视与小儿眼科杂志,2010,18(3):110-113.
[13]TUPPURAINEN K,HERRGRD E,MARTIKAINEN A,MYJR-VI M.Ocular findings in prematurely born children at 5 years of age[J].Graefes Arch Clin Exp Ophthalmol,1993,23l(5):261-266.
[14]MCCULLOCH DL,MARMOR MF,BRIGELL MG,HAMILTON R,HOLDER GE,TZEKOV R,et al.ISCEV Standard for full-field clinical electroretinography(2015 update)[J].Doc Ophthalmol,2015,130(1):1-12.
[15]周炼红,朱祥祥,邢怡桥,易连芳,王炯,吴丽.儿童视觉发育敏感期微视觉诱发电位研究[J].中华眼底病杂志,2009,25(6):440-442.
[16]阴正勤,余涛,陈莉.斜视性弱视猫发育过程中视皮层神经元NMDA-R1表达的免疫组织化学电镜观察[J].中华眼科杂志,2002,38(8):472-475.
[17]吴广强,童梅玲,魏宁,吴兴香,李忠.学龄前儿童视力发育状况及影响因素分析[J].国际眼科杂志,2013,13(12):2495-2498.
[2]郑璟,柯晓云,徐进,张燕,陈伟宾.无ROP早产儿视盘周围视网膜神经纤维层及黄斑区视网膜和脉络膜厚度分析[J].眼科新进展,2015,35(9):844-846.
[3]赵培泉,费萍.早产儿视网膜病变诊断治疗研究现状、问题及展望[J].中华眼底病杂志,2012,28(1):3-6.
[4]章晟,李秋平,孔祥永,张小英,张玉佩,王自珍,等.卷曲蛋白4基因多态性与早产儿视网膜病变易感性的关系[J].中华实用儿科临床杂志,2014,29(14):1055-1059.
[5]陈宜,冯婧,孟宪芬,邓洵,尹虹,梁建宏,等.玻璃体腔注射雷珠单抗治疗早产儿视网膜病变疗效观察[J].中华眼底病杂志,2015,31(1):1105-1015.
[6]黎晓新.我国早产儿视网膜病变特点和筛查指南[J].中华眼底病杂志,2004,20(6):384-386.
[7]HSIEH CJ,LIU JW,HUANG JS,LIN KC.Refractive outcome of premature infants with or without retinopathy of prematurity at 2years of age:a prospective controlled cohort study[J].Kaohsiung J Med Sci,2012,28(4):204-211.
[8]SAUNDERS KJ,MCCULLOCH DL,SHEPHERD AJ,WIKINSON AG.Emmetropisation following preterm birth[J].Br J Ophthalmol,2002,86(9):1035-1040.
[9]HOLMSTR O MG,EL AZAZI M,KUGELBERG U.Ophthalmological long term follow up of preterm infants:a population based,prospective study of the refraction and its development[J].Br J Ophthalmol,1998,82(11):1265-1271.
[10]FLEDEHUS H.Prematurity and eye.ophthalmic 10years follow up of children of low and normal birth weight[J].Acta Ophthalmol,1976,128:3-245.
[11]HOLMSTRO MG,EL AZAZI M,KUGELBERG U.Ophthalmological follow up of preterm infants:a population based,prospective study of visual acuity and strabismus[J].Br J Ophthalmol,1999,83(2):143-150.
[12]周建强,陈云,张强.早产对无早产儿视网膜病变的早产儿眼发育和发病的影响[J].中国斜视与小儿眼科杂志,2010,18(3):110-113.
[13]TUPPURAINEN K,HERRGRD E,MARTIKAINEN A,MYJR-VI M.Ocular findings in prematurely born children at 5 years of age[J].Graefes Arch Clin Exp Ophthalmol,1993,23l(5):261-266.
[14]MCCULLOCH DL,MARMOR MF,BRIGELL MG,HAMILTON R,HOLDER GE,TZEKOV R,et al.ISCEV Standard for full-field clinical electroretinography(2015 update)[J].Doc Ophthalmol,2015,130(1):1-12.
[15]周炼红,朱祥祥,邢怡桥,易连芳,王炯,吴丽.儿童视觉发育敏感期微视觉诱发电位研究[J].中华眼底病杂志,2009,25(6):440-442.
[16]阴正勤,余涛,陈莉.斜视性弱视猫发育过程中视皮层神经元NMDA-R1表达的免疫组织化学电镜观察[J].中华眼科杂志,2002,38(8):472-475.
[17]吴广强,童梅玲,魏宁,吴兴香,李忠.学龄前儿童视力发育状况及影响因素分析[J].国际眼科杂志,2013,13(12):2495-2498.
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