METHODS: In this retrospective matched case-control study, infants with TR-ROP were individually matched, according to gestational age and birth weight, with one or two untreated infants who developed no or spontaneously regressed ROP. Longitudinal data on platelet count (PLT), mean platelet volume (MPV), daily weight and platelet transfusions were collected. Platelet mass index (PMI) and weight standard deviation score (WSDS) were also calculated. Conditional logistic regression analysis was performed to adjust for matching.
RESULTS: Fourteen cases, presenting type I ROP, and 25 matched controls were included. The odds of developing TR-ROP decreased as PLT increased during 31st week of postmenstrual age (PMA) or during 1st and 2nd week of postnatal age (PNA). The odds of developing TR-ROP were 16.7 times higher in infants receiving at least one platelet transfusion compared with those who were not transfused. The odds of developing TR-ROP increased by 31.2% as the mean volume of platelet transfusion per infant increased by 1 ml. The odds of developing TR-ROP decreased as PMI increased during 1st week PNA, and as weight and WSDS increased during 4th -6th week PNA. Analysis of MPV, number of thrombopenic episodes per infant, number of platelet transfusions per infant and days with WSDS < -2 showed no association with TR-ROP.
CONCLUSIONS: To our knowledge, this is the first study ascertaining an association of platelet transfusions with type I ROP. Prospective cohort studies are required to confirm our findings.
方法:在这项回顾性配对病例对照研究中,有TR-ROP的婴儿单独匹配,根据胎龄和出生体重,一个或两个未经治疗的婴儿没有发生或自发消退的ROP。血小板计数(PLT)的纵向数据,平均血小板体积(MPV),收集每日体重和血小板输注.还计算了血小板质量指数(PMI)和体重标准偏差评分(WSDS)。进行条件逻辑回归分析以调整匹配。
结果:14例,呈现I型ROP,包括25个匹配的对照。在月经后第31周(PMA)或出生后第1周和第2周(PNA),随着PLT的增加,发生TR-ROP的几率降低。与未输血的婴儿相比,接受至少一次血小板输注的婴儿发生TR-ROP的几率高16.7倍。随着每个婴儿的平均血小板输注量增加1ml,发生TR-ROP的几率增加了31.2%。在第1周PNA期间,随着PMI的增加,发生TR-ROP的几率降低,在第4-6周PNA期间,体重和WSDS增加。MPV分析,每个婴儿的血栓减少发作次数,每个婴儿的血小板输注次数和WSDS<-2的天数显示与TR-ROP无关。
结论:据我们所知,这是第一项确定血小板输注与I型ROP相关的研究.需要前瞻性队列研究来证实我们的发现。