早产儿视网膜病变的彩色多普勒超声诊断.DOC

早产儿视网膜病变的彩色多普勒超声诊断与临床眼科随访对比研究 包 蕾，王 荞，方 静，余加林 （重庆医科大学附属儿童医院新生儿诊治中心 重庆400014） 摘 要：目的 研究彩色多普勒血流成像（CDFI）检查技术在早产儿视网膜病变(ROP)的诊断和随访中所具有的临床价值。方法 选择2008年3月至2009年2月我科收治的胎龄小于37周或出生体质量小于2 000 g的早产儿、低体重儿为研究对象，在生后4－6周采用RetCam数字视网膜照相机及间接眼底镜等眼科检查进行ROP筛查，共检查49人，98只眼，同时行双眼彩色多普勒超声检查，并将两者对照分析。结果 眼科检查确诊ROP患眼41只，包括Ⅰ期8只，Ⅱ期19只，Ⅲ期6只，瘢痕期8只，未发现Ⅳ、Ⅴ期的患儿。CDFI与眼科检查对照特异性为85.5%，，敏感度为76.7%。其中Ⅱ期、Ⅲ期表现为：眼底视网膜中央动脉（CRA）Vd)减低，血流阻力指数（RI）增高，在眼底正中视乳头区域可见强回声短条状结构突向玻璃体内，Ⅰ期ROP的8只眼CDFI未发现明显特征性改变。结论 在本组研究中，Ⅰ期ROP的CDFI表现不典型，而Ⅱ－Ⅲ期患儿眼底视网膜血管病变CDFI具有特征性的图像表现，CDFI对于ROP高危人群的常规初筛有较好的临床实用价值。 关键词：早产儿；视网膜病变；超声；彩色多普勒 中图法分类号： 文献标识码：A Comparative study on color Doppler flow imaging diagnosis and clinical ophthalmology follow-up in retinopathy of prematurity Bao lei，Wang qiao Fang jing Yu jialin（neonatal dignosis and treatment center Children’s hospital of chongqing medical university ,Chongqing,400014,china） Abstract：0bjective To investigate the value of color Doppler flow imaging(CDFI)in diagnosis and clinical follow-up in retinopathy of prematurity. Methods From March 2008 to February 2009, 49 premature infants(98 eyes gestational age≤37 weeks, or birth weight≤2 000g) underwent ROP screening of both eyes using RetCam digital retinal camera and indirect ophthalmoscope in the fourth to sixth postnatal week．at the same time ,8－14MHz CDFI were carried out on them. Results Using RetCam digital retinal camera and indirect ophthalmoscope，ROP was not found in 57 eyes, but found in 41 eyes, including 8 eyes at stage Ⅰ，19 eyes at stage Ⅱ，and 6 eyes at stage Ⅲ, 8 eyes at regressed disease, no eye at stage Ⅳ andⅤ. Using color Doppler flow imaging, the specificity was 85.5% for diagnosis of ROP. CDFI were confirmed ROP by RetCam digital retinal camera and indirect ophthalmoscope,the sensitivity was 76.7%. Characteristic changes was not found at stage Ⅰ Using CDFI,. CRA in normal subjects was VS 0.065±0.012 m/s, Vd 0.015±0.008 m/s,RI0.58±0.045, in patients was VS 0.078±0.011 m/s,Vd 0.009±0.005 m/s,