A Study On The Value Of Blood Cell Index In Early Prediction Of Retinopathy Of Prematurity

Objective:Retinopathy of prematurity(ROP)is a type of proliferative retinopathy that occurs in immature or low birth weight infants and is the leading cause of blindness in children worldwide.With the development and progress of neonatal medicine in China,the survival rate of premature infants and very low birth weight neonates in China has been significantly improved,and the incidence of ROP has increased accordingly.This study aims to explore the early prediction value of blood cell indexes for ROP,and to provide a new and convenient monitoring index for clinicians.Methods:A retrospective analysis was made of preterm infants who were admitted to the Neonatal Treatment Center of the First Affiliated Hospital of Nanchang University and underwent fundus photography from January 2015 to May 2020.According to the results of fundus photography,the children in the ROP group were divided into ROP group and non-ROP group,and the ROP group were divided into mild and severe ROP according to the region and grade of lesions.Collect children situation in the perinatal period(premature rupture of membranes,gestational diabetes,infections during pregnancy,intrauterine asphyxia,amniotic fluid meconium contamination,etc.),postnatal conditions(neonatal pneumonia,neonatal bronchial pulmonary hypoplasia,neonatal sepsis,fungal infection and neonatal respiratory distress syndrome,neonatal bilirubin levels,high,with oxygen,oxygen cure time,number of blood transfusions),And within 24 hours after birth,1 week after birth,3 weeks after birth of blood routine data(white blood cells,red blood cells,hemoglobin,red blood cell volume distribution width,platelets,mean platelet volume distribution width,neutrophils,lymphocytes,monocytes,neutrophils and lymphocytes ratio,lymphocytes and mononuclear cells ratio,platelets and lymphocytes ratio).The differences of various indicators in different groups were compared,and multiple Logistic regression analysis was used to evaluate the independent risk factors for ROP.By drawing ROC curve,the value of blood cell index in early diagnosis of ROP was evaluated,and the sensitivity and specificity of ROP diagnosis were found.Result:1.At 24 hours after birth,compared with the non ROP group,the red blood cell count,hemoglobin,neutrophil count and NLR ratio of ROP group were significantly decreased,while the LMR ratio was significantly increased,the differences were statistically significant(P < 0.05).2.At 1 week postnatal,the red blood cell count,hemoglobin,platelet count,lymphocyte count and LMR ratio of ROP group were significantly lower than those of non ROP group,while the monocyte count,neutrophil count and NLR ratio were significantly higher than those of non ROP group(P < 0.05).3.At 3 weeks postnatal,the red blood cell count,hemoglobin,lymphocyte count and LMR ratio of ROP group were significantly lower than those of non ROP group,while the neutrophil count and NLR ratio were significantly higher(P < 0.05).4.Gestational age,birth weight,BPD,NLR at birth,NLR at 1 week postnatal,LMR at 1 week postnatal,NLR at 3 weeks postnatal,and LMR at 3 weeks postnatal are risk factors for ROP.5.NLR at birth [1.680(1.1,2.0)vs 0.750(0.5,1.3)],the first week postnatal[1.900(1.6,2.5)vs 1.540(1.2,2.1)],the third week postnatal [1.280(0.7,1.5 vs 0.760(0.5,1.3)] in severe ROP group were significantly higher than those in mild ROP group.LMR value at birth [5.290(3.4,7.2)vs 7.240(5.7,10.2)],the first week postnatal [2.010(1.4,2.6)vs2.290(1.7,2.7)],the third week postnatal [2.660(1.8,5.3)vs3.550(2.6,4.3)] was significantly less than that of mild ROP.6.In the first week postnatal,the area under the ROC curve of NLR and LMR was the largest,and the difference was statistically significant compared with other periods(P < 0.05),but there was no significant difference between the two groups(P > 0.05).In the first week postnatal,the area under the curve of NLR was 0.756(95% CI: 0.697 ～ 0.815),and the best predictive value was 1.470;the area under the curve of LMR was 0.786(95% CI: 0.732 ～ 0.839),and the best predictive value was2.930;Conclusion:1.NLR and LMR are correlated with the incidence of ROP and the severity of the disease.2.Gestational age,BPD,NLR at birth,NLR at 1 week postnatal,LMR at 1 week postnatal,NLR at 3 weeks postnatal and LMR at 3 weeks postnatal are risk factors for ROP.3.NLR and LMR in the first week have certain predictive value for the early prediction of ROP.