Risk Factors Of Retinopathy Of Prematurity And Interleukin-17A Pairs The Value Of Early Prediction Of Disease

Objective To analyze the risk factors for retinopathy of prematurity(ROP).Meanwhile,we evaluated whether serum interleukin-17A(IL-17A)and Vascular endothelial growth factor A(VEGF-A)levels at different time periods have early predictive value for ROP.It has certain clinical guiding significance for early recognition early prevention and intervention of ROP children.Methods A total of 88 preterm infants with gestational age less than 32 weeks and body weight less than 2000 g who were admitted to the neonatal department and completed fundus screening during June 2019 to November 2020 were collected.According to the diagnostic criteria of ROP,the patients were divided into ROP group(n=30)and non-ROP group(n=58)according to the outcome of ROP.Firstly,the high-risk factors of ROP were analyzed.Then the serum levels of IL-17A and VEGF-A were determined by ELISA on the first and 15th day after the two groups were born.SPSS23.0 was used for statistical analysis of the data to analyze whether there was statistical significance in the content difference of each indicator of ROP between the two groups in different time periods and at different degrees.The ROC curve is drawn,and the area under the curve corresponding to the two indexes is calculated respectively to evaluate its early prediction.Results(1)Risk factors for ROP in premature infants: Ventilation time,gestational age and birth weight;The use of Pulmonary surfactant(PS),the duration of mechanical ventilation,blood transfusion,caffeine use,serious complications such as Neonatal respiratory distress syndrome(NRDS),Bronchopulmonary dysplasia(BPD),maternal complications of gestational hypertension,gestational diabetes,and prenatal use of glucocorticoids(P < 0.05).Oxygen intake,gestational age and birth weight were independent influencing factors for ROP in premature infants(P < 0.05).(2)The level of serum IL-17A in the ROP group was significantly lower than that in the non-ROP group on the first day after birth,and significantly higher than that in the non-ROP group on the 15th day after birth,with statistical significance(P < 0.05);In the ROP group,the more severe the lesion was,the lower the level of IL-17A on postnatal day 1 was,and the higher the level of serum IL-17A on postnatal day 15 was.(3)The level of serum VEGF-A in ROP group was significantly lower than that in non-ROP group on the 1st postnatal day,and significantly higher than that in non-ROP group on the 15th postnatal day,with statistical significance(P < 0.05);In the ROP group,the more severe the lesion,the higher the serum IL-17A level was 15 days after birth.(4)The ROC curve showed that the area under the curve(AUC)corresponding to the level of VEGF-A on day 1 postnatal,day 15 postnatal,day 1 postnatal and day 15 postnatal were 0.655,0.887,0.624 and 0.674,respectively,the level of IL-17A on postnatal day 1 and 15 and VEGF-A on postnatal day 15 had early predictive value for ROP(P < 0.05),and the level of IL-17A on postnatal day 15 had the highest predictive value for ROP.Conclusion(1)Long time of oxygen inhalation,small gestational age and low birth weight are the main risk factors for ROP in premature infants;(2)Both IL-17A and VEGF-A have early predictive value for ROP in preterm infants,and serum IL-17A on the 15th day after birth has the highest predictive value.Therefore,the occurrence of ROP can be predicted early through dynamic monitoring of serum IL-17A level,early prevention,timely intervention and early treatment,so as to reduce the incidence and improve the prognosis.