동맥관개존증과 그 치료 방법이 미숙아망막병증에 미치는 영향
Influence of Patent Ductus Arteriosus and Its Treatment on Retinopathy of Prematurity
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목적: 동맥관개존증(PDA)의 병발 및 이에 대한 치료 방법이 미숙아망막병증(ROP)의 발생 및 진행에 미치는 영향을 확인한다. 대상과 방법: 본원 신생아 중환자실 입원 중 ROP에 대해 선별검사를 시행한 408명의 의무기록을 후향적으로 분석하였다. 결과: 전체 대상 중 ROP는 23.5%에서 발생하였고(96/408) 치료가 필요한 경우는 7.4%였다(30/408). 대조군과 ROP군의 출생 시 체중과 재태연령의 평균은 1406.1 g과 30.67주, 979.8 g과 27.46주였다(p˂0.001). 전체 환자 및 극소저체중출생아 모두에서 ROP의 발생빈도는 PDA군이 더 높았으나 PDA는 극소저체중출생아에서만 독립적인 위험인자였다(p=0.033). 두 군 사이에 문턱 질환의 발생 빈도차이는 유의하지 않았다(p=0.757). 또한 PDA의 치료 방법에 따른 ROP와 문턱 질환의 발생 빈도 차이도 유의하지 않았다(p=0.441,0.276). 결론: 극소저체중출생아에서 PDA가 병발된 경우 ROP의 발생 빈도가 높아지므로 ROP 선별검사를 보다 철저히 해야 하나 PDA 치료방법에 따라서는 ROP 발생 및 진행에 유의한 차이가 없었다.
Abstract
Purpose: This study investigated the influence of patent ductus arteriosus (PDA) and its treatment on incidence and progression of retinopathy of prematurity (ROP). Methods: The authors retrospectively reviewed the medical records of 408 infants who underwent screening examinations for ROP at the Neonatal Intensive Care Unit of our hospital. Results: The total incidence of ROP was 23.5% (96 out of 408) and the patients that needed treatment were 7.4% (30 out of 408). The mean birth weight and gestational age was 1406.1 grams and 30.67 weeks in patients without ROP, and 979.8 grams and 27.46 weeks in patients with ROP, respectively. In both total and very low birth weight (VLBW) patients,the incidence of ROP was higher in the PDA group than the non-PDA group, but the PDA group was an independent risk factor only in the VLBW group (p = 0.033). The incidence of threshold disease was not significantly different between the PDA and control groups (p = 0.757). There was no significant difference of incidence of ROP and threshold disease among the 3 treatment groups for PDA. Conclusions: In VLBW patients, the presence of PDA increased the risk of ROP and its progression, thus more attention is needed for PDA patients. However, there was no significant difference in ROP incidence and progression according to different PDA treatment methods.
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