Related Research Of Neutrophil-to-lymphocyte Ratio And Postnatal Weight Gain Of Severe Retinopathy Of Prematurity

Purposes: Retinopathy of prematurity(ROP)is a vasoproliferative disorder of the retina occurring principally in infants with small gestational age or low birth weight.ROP is a preventable disease that can causing blindness.Early prevention,timely examnation and early treatment is the keypoint to prevent ROP from developing blindness.Screening and diagnosis of ROP always depends on the subjectivity of Ophthalmology specialists which causes variability.Thus,the present situation stimulates the ophthalmologists to seek for the objective parameter of ROP.This study aims to investigate the correlation between the neutrophil / lymphocyte ratio(NLR),white blood cells,C reactive protein,weight growth of 6 weeks after birth and serious relationship ROP in very low birth weight infants(ELBWI),based on the role of infection / inflammation and insulin like growth factor(IGF)-1 in the pathogenesis of ROP.Methods: 1:1 retrospective case-control study.Enrolled cases were the ELBWI,born in First Hospital of Jilin University between January 1,2014 and January 1,2017.Experimental group consist of all the ELBWI who later development of severe ROP,and receiving intervention treatment in our hospital.Controls received inpatient ROP examinations during the same time period and developed no ROP or wild ROP.Exclusion criteria: 1)GA > 32 weeks;2)death,abandon treatment or without regularly follow-up examination until retinal vascularization;3)incomplete information of complete blood within first 12 h postnatal;4)born with malignant cancer,hematologic diseases or other serious infections which influence the value of blood;5)received hormones,antibiotics,or blood transfusion before the blood samples were collected.The data collected was the basic information(sex,gestational age,birth weight,delivery mode,the number of fetuses,1 min and 5 min Apgar score),laboratory examination data within 12 h postnatal(NLR,white blood cells,C reactive protein,p H from blood gas analysis).Acute respiratory distress syndrome,patent ductus arteriosus,neonatal anemia,bronchopulmonary dysplasia,intracranial hemorrhage are also recorded as the risk factors for ROP.Analyse the correlation between each parameter and severe ROP.Results: A total of 60 patients with ELBWI were included in the experimental group and the control group with each group of 30 cases.Unvariate analysis showed that the differences of NLR(P=0.019),gestational age(P < 0.01),2w after birth weight growth rate(P < 0.001),delivery mode(P < 0.001),1 minute Apgar score(P=0.003),blood transfusion(P=0.076),acidemias(p H < 7.30,P=0.022),bronchopulmonary dysplasia(P=0.011),intracranial hemorrhage(P=0.002)between experimental group and control groupthe were statistically significant.Multivariate logistic regression analysis,the value of NLR(OR 3.557;95% CI,1.279-10.002;P=0.015),weight growth rate of the first 2 postnatal week(OR 0.845;95% CI,0.747-0.956;P=0.008),gestational age(OR 0.579;95% CI,0.381-0.881;P=0.011),1min Apgar score(OR 0.697;95% CI,0.510-0.952;P=0.023)is the independent risk factors for severe ROP.The predictive accuracy of the multivariate model including four independent predictors was 88.33%.Conclusions: 1)the value of NLR,weight growth rate of the first 2 postnatal week(%),gestational age and 1 minute Apgar score can predict the occurrence of severe ROP;2)delivery mode,blood transfusion,acidosis,bronchopulmonary dysplasia and intracranial hemorrhage may be a risk factor for severe ROP;3)The extremely very low birth weight infants patients with multiple risk factors should be paid enough attention to the ROP screening.