未熟児網膜症と成長後の全身合併症

The association between retinopathy of prematurity and chronic general complications

　未熟児網膜症（retinopathy of prematurity：ROP）の活動期および瘢痕期病変と児の成長後の全身合併症の関連について検討した。対象は，超未熟児20例を含む極小未熟児44例で，主な成長後の全身合併症には精神発達遅滞，脳性麻痺，身体発育遅延，言語障害などがあり，これらはROP発症群で有意に多く（p＜0.05），1型3期中期以上の重症ROPでは全例に合併した。また，明瞭な白色瘢痕組織を示す厚生省分類瘢痕期1度とそれ以上の瘢痕組を残した児にも，成長後の全身合併症は高頻度に存在した（p＜0.01）。しかし出生体重別の検討では，発生率に有意差がみられた全身合併症はなかった。以上の結果からROPの発症と重症度が，児の長期予後を推測する指標の一つになると考えられる。

We evaluated the relationship between the severity of retinopathy of prematurity (ROP) and the chronic general complications of children who had low weight at birth. There were 44 very low birth weight infants, including 20 of extremely low birth weight in the present study. The general complications detected after growth were mental retardation, cerebral palsy, physical developmental retardation, disturbance of speech, etc. The incidence of general complications was significantly higher in the infants who had developed ROP (p＜0.05), and all infants in whom ROP progressed to moderate stage 3 or further were found to have general complications. The incidence was significantly higher in infants with a clear whitish scar or severer cicatricial changes (p＜0.01). However, there was no significant difference in the incidence of general complications between extremely low birth weight infants and the others. The results show that one can predict the long-term chronic general complications in high-risk infants by the incidence and severity of ROP.