目的：探究厦门地区早产儿视网膜病变(ROP)发生现状并分析其影响因素，以期为临床治疗和预防策略的制定提供科学依据。

方法：回顾性研究2020年2月11日至2023年2月25日于厦门大学翔安医院进行眼底检查的363例胎龄<32 wk的早产儿病例资料，根据筛查结果统计ROP的发生率，并将所有早产儿分为ROP组(37例64眼)和非ROP组(326例652眼)，比较两组早产儿一般临床资料及围产期相关资料，采用多因素Logistic回归分析早产儿发生ROP的影响因素。

结果：本次研究共纳入363例早产儿，眼底筛查结果显示，共检出ROP患儿37例64眼，其中单眼发病10例10眼，双眼发病27例54眼，ROP总发病率为10.2%(37/363)； 根据ROP国际分类标准判定严重程度(ROP分为5期，Ⅰ期最轻，Ⅴ期最严重)，在64眼ROP患眼中Ⅰ期30眼(46.9%)，Ⅱ期20眼(31.3%)，Ⅲ期10眼(15.6%)，Ⅳ期4眼(6.3%)，未发现Ⅴ期病例。通过对比两组早产儿临床相关资料得出，两组早产儿的性别、孕母分娩方式、单胎或多胎、是否胎膜早破、是否有窒息史、是否合并动脉导管未闭(PDA)、是否合并新生儿呼吸窘迫综合征(NRDS)比较无差异(均P>0.05)，ROP组的胎龄、出生时体质量比较低于非ROP组(均P<0.05)，且住院时间、合并患有新生儿支气管肺发育不良(BPD)、新生儿败血症、贫血、用氧时间超过1 wk、氧疗浓度高于40%、输血治疗的占比均较非ROP组更高(均P<0.05)； 多因素Logistic回归分析得出，合并新生儿败血症(OR=166.985，95%CI：35.239-791.277，P<0.001)、贫血(OR=8.111，95%CI：2.064-31.871，P=0.003)、用氧时间>1 wk(OR=10.216，95%CI：2.543-41.039，P=0.001)、氧疗浓度>40%(OR=7.647，95%CI：1.913-30.566，P=0.004)、接受输血治疗(OR=5.879，95%CI：1.412-24.470，P=0.015)是影响早产儿发生ROP的危险因素，早产儿出生体质量较高是ROP的保护因素(OR=0.093，95%CI：0.022-0.394，P=0.001)。

结论：早产儿ROP的发病率相对较高且影响因素较多，其中出生时低体质量、合并新生儿败血症、贫血、吸氧以及输血治疗是导致早产儿发生ROP的高危因素，针对此类早产儿临床应给予重视并规范进行眼底筛查，及早进行治疗，从而进一步降低早产儿ROP的发生风险。

METHODS: A retrospective study was conducted on the case data of 363 preterm infants with a gestational age of <32 wk who underwent fundus examination at Xiang'an Hospital of Xiamen University from February 11, 2020 to February 25, 2023. The incidence of ROP was statistically analyzed based on the screening results. All premature infants were divided into ROP group(37 cases, 64 eyes)and non-ROP group(326 cases, 652 eyes). General clinical data and perinatal-related information of the two groups were compared, and multivariate Logistic regression analysis was used to identify factors influencing the occurrence of ROP in premature infants.

RESULTS: A total of 363 premature infants were included in this study. The fundus screening results showed that a total of 37 cases(64 eyes)of premature infants were detected with ROP, including 10 cases(10 eyes)monocular and 27 cases(54 eyes)binocular, with an overall incidence of 10.2%(37/363). The severity was determined according to the ROP international classification standard(ROP is divided into 5 stages, with stage I being the least severe and stage V the most severe). Among the 64 eyes, 30 eyes(46.9%)were in stage I, 20 eyes(31.3%)were in stage II, 10 eyes(15.6%)were in stage III, 4 eyes(6.3%)were in stage IV, and there were no cases in stage V. By comparing the clinical data of the two groups, no significant differences were found in gender, mode of delivery, singleton or multiple births, premature rupture of membranes, history of asphyxia, patent ductus arteriosus(PDA), or neonatal respiratory distress syndrome(NRDS)between the two groups(all P>0.05). However, premature infants in the ROP group had significantly younger gestational age and lower birth weight compared to those in the non-ROP group(all P<0.05). Additionally, the ROP group had higher proportions of longer hospital stays, bronchopulmonary dysplasia(BPD), neonatal sepsis, anemia, oxygen therapy for more than 1 wk, oxygen concentration above 40%, and blood transfusion treatment(all P<0.05). Multivariate Logistic regression analysis revealed that combined neonatal sepsis(OR=166.985, 95% CI: 35.239-791.277, P<0.001), anemia(OR=8.111, 95% CI: 2.064-31.871, P=0.003), oxygen use time >1 wk(OR=10.216, 95% CI: 2.543-41.039, P=0.001), oxygen therapy concentration >40%(OR=7.647, 95% CI: 1.913-30.566, P=0.004), and receiving blood transfusion therapy(OR=5.879, 95% CI: 1.412-24.470, P=0.015)were the main risk factors affecting the occurrence of ROP in preterm infants, and the higher birth weight of preterm infants was a protective factor for ROP(OR=0.093, 95% CI: 0.022-0.394, P=0.001).

CONCLUSION: The incidence of ROP in premature infants is relatively high, and there are multiple influencing factors. Low birth weight, neonatal sepsis, anemia, oxygen therapy, and blood transfusion treatment are high-risk factors for ROP in premature infants. Clinical attention should be given to such infants, and fundus screening should be conducted in a standardized manner to provide early treatment, thereby further reducing the risk of ROP in premature infants.