目的：分析极低出生体质量早产儿视网膜病变(ROP)的临床特点。

方法：回顾分析2009-12/2018-06在我院眼科门诊及新生儿科住院并接受眼底检查的早产儿3 121例，男1 862例，女1 259例，其中出生体质量低于1 500g的极低出生体质量早产儿400例，男191例，女209例； 出生体质量≥1 500g的早产儿2 721例，男1 671例，女1 050例。比较不同出生体质量早产儿中ROP的检出率、出生胎龄、性别比例、ROP的诊断时间、ROP的严重程度及其他眼病的患病率。

结果：本研究筛查3 121例早产儿，ROP检出率8.2%(255/3 121)，出生体质量小于1 500g的极低出生体质量早产儿400例，ROP检出率23.8%(95/400)，其中无需治疗的1～2期病变93.7%(89/95)，阈值前及阈值病变3.2%(3/95)，4～5期病变3.2%(3/95)。出生体质量<1 000，1 000～1 499，≥1 500g，ROP检出率分别为25.0%、23.7%、5.9%。不同体质量组男女性别比例、ROP检出率、出生胎龄、ROP诊断时间、ROP严重程度均有差异(P<0.001)。出生体质量<1 000g组与出生体质量1 000～1 499g组，以及出生体质量<1 000g组与出生体质量≥1 500g组的ROP严重程度比较有差异(χ²=28.90，P<0.01； χ²=34.64，P<0.01)，但是出生体质量1 000～1 499g组与出生体质量≥1 500g组的ROP严重程度无差异(P>0.05)。不同出生体质量组其他眼病的发生率无差异(P>0.05)。

结论：出生体质量越低，ROP的发生率越高。出生体质量<1 000g的ROP严重程度明显高于出生体质量≥1 000g的早产儿。眼科应联合产科、新生儿科，降低极低出生体质量早产儿ROP的发生率，提高极低体质量ROP筛查、随访的依从性，是降低ROP致盲的重要手段。

METHODS: A retrospective analysis was made of 3 121 premature infants who were admitted to the ophthalmic clinic and neonatal department of our hospital from December 2009 to June 2018 and underwent fundus examination. There were 1 862 males and 1 259 females. Among them, there were 400 premature infants with very low birth mass whose body mass was less than 1 500g. 191 males and 209 females. To compare the detection rate of ROP, gestational age, gender ratio, diagnosis time of ROP, severity of ROP and prevalence of other eye diseases, among different birth quality groups in preterm infants with extremely low birth mass.

RESULTS: In this study, 3 121 premature infants were screened, and the ROP detection rate was 8.2%(255/3 121). There were 400 premature infants with very low birth mass with a body mass less than 1 500g, ROP detection rate was 23.8%(95/400), stage 1-2 lesions that do not require treatment were 93.7%(89/95), pre-threshold and threshold lesions were 3.2%(3/95), stage 4-5 lesions were 3.2%(3/95). ROP detection rates of birth weight(g)<1 000, 1 000-1 499, ≥1 500, were: 25.0%, 23.7%, 5.9%, respectively. There were statistically significant differences in gestational age, ROP diagnostic time, between different birth weight groups(P<0.001). There were significant differences in the severity of ROP among the groups with birth weight <1 000g, 1 000-1 499g and ≥ 1 500g. But, there was no significant difference in the severity of ROP between the group with birth weight 1 000-1 499g and the group with birth weight ≥1 500g(P>0.05). There was no statistical difference in the incidence of other eye diseases in different birth weight groups(P>0.05).

CONCLUSION: The lower of birth weight, with the higher of incidence of ROP. The severity of ROP in preterm infants with birth weight <1 000g was significantly higher than that of preterm infants with birth weight≥1 000g. Ophthalmology should combine obstetrics and neonatology to reduce the incidence of very low birth weight premature infants, and improve the compliance of screening and follow-up of retinopathy of very low birth weight premature infants, which is an important way to reduce the blindness caused by ROP.