ObjectiveTo observe the morphologic characteristics of color Doppler flow imaging (CDFI) and blood stream in patients with retinopathy of prematurity, and provide the new clinical diagnostic gist.MethodsCDFI was performed on 78 patients (156 eyes) with ROP at Ⅳ and Ⅴ stage, who had the diseases history such as prematurity and low birthweight which had been diagnosed by indirect ophthalmoscope, underwent the examination of CDFI. Morphologic characteristics of the results of CDFI and features of blood flow of the pathological changes were observed. ResultsIn the patients with ROP at the Ⅳ stage, a weak zonal echo originated from one side of peripheral wall of eye ball in the vitreous body, and extended to the echo of post pole and wall of eye ball and joined the echo of optic disc. In the patients with ROP at the V stage, lumplike echo connected closely with echo of lens and the circumambience was surrounded; the focus looked like lotus when combined with retinal detachment: the swelled “corona” wrapped and tightly connected with the lens, and the thin “caulis” showed weak zonal echo which attached to the optic disc. The features of blood flow showed the signal of blood stream connected with central retinal artery at the “caulis”, which was analyzed by Doppler spectrum as the bloodflow spectrum of artery and vein in the same direction which was the same as the central retinal artery and vein.ConclusionsIn patients with ROP at the IV and V stage, the results of CDFI mainly shows zonal or lumplike echo, in which the bloodflow signal extended with central retinal artery could be seen. The morphological changes of CDFI and the features of blood flow are useful in diagnosis of ROP. (Chin J Ocul Fundus Dis, 2005,21:282-284)
目的:研究西北地区早产儿疾病构成情况,为更好的防治早产儿相关疾病提供帮助。方法: 调查研究西安市儿童医院2005年1月至2008年12月早产儿患病情况。结果:在住院572例早产儿中,肺部病变429例(75.0%),其中肺炎376例(65.8%);眼部病变283例(49.6%),其中3期以下218例(38.1%),3期以上早产儿视网膜病变65例(11.5%);黄疸262例(45.7%),其中病理性黄疸198例(34.6%),生理性黄疸64例(112%),二者之比为3:1;血液系统病变共165例(28.8%),其中红细胞增多症例99例(17.3%);神经系统病变161例(28.1%),其中缺氧缺血性脑病轻度70例(12.3%),颅内出血42例(7.3%),颅内出血合并缺氧缺血性脑病24例(4.2%),脑白质软化25例(2.7%);严重血液感染90例(15.8%),其中败血症86例(15%);先天性心脏病共22例(3.8%);糖代谢异常29例(5.0%),新生儿硬肿症17例(3.1%),坏死性小肠结肠炎4(0.7%)。结论: 早产儿肺部病变(主要是肺炎)、眼部病变(主要是早产儿视网膜病变)、黄疸(主要是病理性黄疸)、血液系统病变(主要是红细胞增多症)、神经系统病变(主要是缺血缺氧性脑病)和血液感染(主要是败血症),是威胁西部地区早产儿健康的常见病、多发病。
Objective To evaluate the effect of the treatment of diode laser for retinopathy of prematuriy (ROP).Methods Six-eight premature infants, with the gestation lt;32 weeks and birth weight lt;1500 g,were examined 6-7 weeks after birth. The infants suffering from threshold ROP were treated by diode laser through a binocular indirect ophthalmoscope within 48 hours after the confirmation of diagnosis, and with the follow-up of 4～6 moths. Retinal detachment was found in 1 eye 1 month after laser treatment, and scleral encircling operation was performed on the eye which was followed up for 3 months after the operation. Cycloplegic refractive examination was performed on the eyes with threshold ROP 4 months postnatally to determine the presence of refractive errors.Results Six infants (1) eyes were diagnosed as with threshold ROP. The average age of the occurrence of threshold ROP were (10±2.89) (ranging from 6 to 14 weeks) weeks postnatally. The successful rate of diode laser treatment was 91.67%. Retina was flat in one eye treated by scleral encircling operation. Refractive errors of the eye treated by scleral encircling operation was -14.5 D, and the median spherical equivalent errors in other 11 eyes was ( -2.89±-1.86) D. Conclusion The treatment of diode laser is effective for threshhold ROP. (Chin J Ocul Fundus Dis，2003，19：96-98)
Objective To observe the expression of erythropoietin (EPO) and its receptor (EPOR) mRNA and protein levels in retinae of mice with oxygen-induced retinopathy, and to evaluate the effect of EPO and EPOR in retinal vascular develo pment and in the occurrence and development of oxygen-induced retinopathy. Methods One hundred and thirty-two 7-day-old C57BL/6J mice were divided into two g rou ps: normal control group (control group) and oxygen-induced retinopathy group (experimental group). The proliferative neovascular response was estimated by obse rving the vascular pattern in adenosine diphosphatease (ADPase) stained retina flat-mounts by executing 6 mice in each group at the 12th, 15th, and 17th day, respectively. The expression of EPO, EPOR mRNA was determined by reverse transcription-polym erase chain reaction (RT-PCR), and the protein levels of EPO and E PO R were determined by immunohistochemistry. RT-PCR and immunohistochemistry were done every other day from the 7th to the 21st day. Results In the control group, retinal vascularization was found. In the experimental group, the large vesse ls were constricted straight, the branches decreased, and alarge nonperfusion area was observed at the 12th day; the large vessels were dilated and tortuous and neovascularization occurred at the 15th day; a mass of neovascularization was found and the vascular net structure of the deep and shallow layer was destroye d at the 17th day. The expression of EPO mRNA decreased from the 7th day and kee p decreasing in the whole oxygen-breathing duration in the experimental group. A fter the mice were returned to room air, the expression increased obviously from the 15th day and kept the high level until the 21st day. The expression of EPO mRNA increased at the 7th day and reached the peak at the 11th day, and kept the high level until the 21st day. The changes of protein levels of these three fac tors were later than that of their mRNA, but had the same trend. The difference of the expression between the two groups at the different time point was signifi cant except for the 7thday point (Plt;0.05). Conclusion It 's suggested that EPO and EPOR played important roles on the development of normal retina vascularizati on and the pathogenesis of ROP, which may provide new conception and method for the prevention and treatment of the oxygen-induced retinopathy.
ObjectiveTo screen compounds or drugs can affect the hypoxia induced-gene expression of retinal vascular endothelial cell based on gene expression microarrays and connectivity map (CMAP) technology. MethodsTotally 326 up-regulated and down-regulated genes of hypoxic human embryonic retinal microvascular endothelial cells minduced by cobalt chloride in the previous study were converted into query signature format documents. Gene profile of the disease characteristics was then compared with that of control in CMAP website database, positive and negative compounds related to retinopathy of prematurity (ROP) were finally screened out. Results44 and 18 compounds or drugs have positive and negative relationship with ROP respectively by searching CMAP database with differentially expressed genes. Ciclopirox, cobalt chloride, gossypol and withaferin A have positive relationship with ROP. Cyclic adenosine monophosphate, harmalol, naringin and probenecid have a negative effect on ROP. ConclusionsCiclopirox, cobalt chloride, gossypol and withaferin A have a positive effect on ROP. However, cyclic adenosine monophosphate, harmalol, naringin and probenecid have a negative effect.
目的:探讨早产儿呼吸暂停相关高危因素,指导临床防治工作。方法:对90例早产儿呼吸暂停进行回顾性分析。结果:胎龄越小,体重越低的早产儿,原发性呼吸暂停发生率越高,随着胎龄增加继发性呼吸暂停发生率亦增加,继发性呼吸暂停与缺氧、低体温、酸中毒、脑损伤、感染等因素有关,生后2～5d为发病高峰期。结论:呼吸暂停与胎龄、体重、缺氧、低体温、低血糖、酸中毒、感染、颅脑损伤等多因素有关。对有相关高危因素早产儿应足够重视,减少呼吸暂停发生。
目的 探讨早产儿配方奶及水解蛋白奶在住院早产低出生体重儿喂养过程中，在胃肠保护作用方面有无差异，以期进一步有效指导入院低体重儿乳制品的合理选择。 方法 收集新生儿科NICU 2008年2月－2010年8月收治的早产低出生体重儿156例，采用回顾性调查分析方法，通过翻阅病历收集新生儿的性别、孕周、出生体重、开奶日龄、持续喂养天数以及所患疾病。按照喂养开奶类型不同分为水解蛋白奶喂养组（A组，111例）和早产儿配方奶喂养组（B组，45例）。 结果 两组患儿性别、开奶日龄、持续喂养天数、胎龄、疾病分布上均无统计学差异（P＞0.05），A组和B组的胃肠功能障碍各临床特点发生概率无统计学差异。 结论 在住院生命体征相对稳定的早产低出生体重儿，无论是早产儿配方奶喂养还是水解蛋白奶喂养，其患儿的喂养不耐受发生情况无统计学差异。
ObjectiveTo observe the effect of retinal hemorrhage on the treatment of retinopathy of prematurity (ROP) by laser photocoagulation.MethodsRetrospective case analysis. Screening and diagnosis of 134 eyes in 67 patients with ROP in Zone Ⅱ Stage 3+ were included in the study. Among them, 32 patients were male and 35 patients were female. The average birth gestational age was 27.80±2.55 weeks. The average birth weight was 1060±320 g. All children underwent binocular indirect ophthalmoscopy and RetCam Ⅲ. Of the 134 eyes, 38 eyes (28%) with anterior, ridge or vitreous hemorrhage (group A); 96 eyes (72%) without hemorrhage. Retinal avascular photocoagulation was performed within 72 hours after diagnosis by intravenous sedative combined with ocular surface anesthesia with 810 nm laser. Follow-up was performed at 1, 4, 8 and 12 weeks after treatment, and then every 6 months thereafter. The same equipment and methods before treatment were used to examine and document the regression and progression of ROP. The number of eyes with lesions after photocoagulation in the two groups was compared by χ2 test. The t-test was used to compare the gestational age and birth weight.ResultsAmong 134 eyes, lesions completely resolved in 125 eyes (93.3%), progressed in 9 eyes (6.7%). In group A, 7 eyes were progressive (18.4%). In group B, 2 eyes were progressive (2.1%). There was a statistically significant difference in the number of eyes with lesions after laser treatment in group A and B (χ2=9.14, P=0.003). There was no significant difference in birth gestational age and birth weight (t=0.85, 0.25; P=0.40, 0.80).ConclusionThe laser photocoagulation is safe and effective in the treatment of ROP. The preretinal, ridge or vitreous hemorrhage is related to the progression of the lesion after laser photocoagulation.