目的：探讨早产儿视网膜病变(retinopathy of prematurity，ROP)的发病率和致病因素。

方法：采用Retcam Ⅲ数字广角小儿眼底成像系统对2015-01-15/2017-10-15在西北妇女儿童医院新生儿重症监护室(neonatal intensive care unit，NICU)收治及眼科门诊就诊的出生胎龄<37wk或出生体质量≤2 000g的2 203例早产儿进行眼底筛查，根据筛查结果计算ROP发病率，并分析致病因素。

结果：早产儿2 203例中，共检出ROP者367例(621眼)，发病率为16.66%。符合《中国早产儿视网膜病变筛查指南(2014)》筛查标准的887例早产儿中检出ROP者236例(399眼)，发病率26.61%，筛查标准之外的1 316例检出ROP者131例(222眼)，发病率9.95%。ROP组与无ROP组两组分析，胎龄、出生体质量、吸氧、机械通气与ROP发病密切相关，人工受孕、剖宫产、性别、多胎、新生儿呼吸窘迫综合征、母亲孕期高血压、母亲孕期糖尿病、宫内感染、宫内窘迫、胎膜早破与ROP发病无关。ROP发病在不同胎龄组、不同出生体质量组、不同吸氧组之间差异有统计学意义(P<0.05)。Logistic回归分析显示，胎龄、出生体质量、吸氧、机械通气是ROP发生的独立危险因素。

结论：本研究中ROP发病率为16.66%，《中国早产儿视网膜病变筛查指南(2014)》筛查标准之外ROP仍占有一定比例。胎龄、出生体质量、吸氧、机械通气是ROP发病的高危因素。

METHODS: The wide-field digital pediatric Retinal imaging system was used to screen 2 203 preterm infants with gestational age <37wk or birth weight ≤2 000g in NICU and the Ophthalmology Department of Northwest Women and Children Hospital from January 15, 2015 to October 15, 2017. The screening results were used to calculate the incidence of ROP and to analyze the risk factors.

RESULTS: Totally 367 infants(621 eyes)were diagnosed as retinopathy among 2 203 premature infants and the incidence of ROP was 16.66%; 236 cases(399 eyes)of ROP(26.61%)were detected in 887 cases of premature infants in accord with screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014), and 131 cases(222 eyes)of ROP(9.95%)was detected in 1 316 cases of premature infants outside the screening standard. In our research, the incidence of ROP was related with gestational age, birth weight, oxygen duration and mechanical ventilation. However, the relationship had not been found with artificial insemination, caesarean birth, gender, polyembryony, acute respiratory distress syndrome(ARDS), hypertensive disorders in pregnancy, gestational diabetes mellitus, intrauterine infection, intrauterine distress, premature rupture of membrane. The incidence of ROP was statistically significant between different gestational age groups, different birth weight groups and different oxygen groups(P<0.05). Logistic analysis showed that gestational age, birth weight, oxygen duration and mechanical ventilation were independent risk factors of ROP.

CONCLUSION: The incidence of ROP is 16.66% in this study, and there is still a certain proportion outside the screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014). Gestational age, birth weight, oxygen duration and mechanical ventilation are high risk factors for ROP.