单次血清胰岛素样生长因子-1检测对早产儿视网膜病变早期分层价值的研究

Value of a Single Serum Insulin-Like Growth Factor-1 Measurement for Early Stratification of Retinopathy of Prematurity

摘要: 目的：探讨单次血清胰岛素样生长因子-1 (insulin-like growth factor-1, IGF-1)水平与早产儿视网膜病变(retinopathy of prematurity, ROP)发生及早期分期之间的关系，评价其在早期轻症ROP分层中的临床意义。方法：回顾性分析2025年8月至2026年3月于珠海市妇幼保健院新生儿科住院、接受眼底筛查并完成血清IGF-1检测的早产儿临床资料。根据眼底筛查结果将早产儿分为非ROP组和ROP组，并进一步按照ROP分期进行亚组分析。收集患儿孕周、出生体重、性别、分娩方式、单双胎、矫正胎龄及血清IGF-1水平等资料。以ln(IGF-1)为因变量建立线性回归模型，校正矫正胎龄后分析不同组别间IGF-1水平差异。结果：共纳入早产儿88例，其中非ROP组76例，ROP组12例。ROP组中1期6例、2期6例，未纳入3期及以上、Plus病变或需治疗ROP病例。ROP组孕周及出生体重均低于非ROP组，双胎比例高于非ROP组，差异均有统计学意义(均P < 0.05)。ROP组与非ROP组血清IGF-1水平比较差异无统计学意义[25.2 (22.6, 36.9) ng/mL比27.3 (21.1, 39.9) ng/mL，P = 0.754]。进一步按ROP早期分期分析，1期与2期患儿血清IGF-1水平亦未见显著差异。校正矫正胎龄后，不同ROP分组间血清IGF-1水平差异仍无统计学意义。结论：单次血清IGF-1水平与ROP发生及早期分期未观察到显著统计学关联。对于以1~2期为主的早期轻症ROP患儿，单次血清IGF-1检测对疾病分层的辅助价值有限。

Abstract: Objective: To investigate the association between single serum insulin-like growth factor-1 (IGF-1) measurement and the occurrence and early staging of retinopathy of prematurity (ROP) in preterm infants, and to evaluate its clinical value in the stratification of early mild ROP. Methods: Clinical data of preterm infants who were hospitalized in the Department of Neonatology of Zhuhai Maternal and Child Health Hospital, underwent fundus screening, and completed serum IGF-1 testing between August 2025 and March 2026 were retrospectively analyzed. According to fundus screening findings, preterm infants were divided into the non-ROP group and the ROP group. Subgroup analysis was further performed according to ROP stage. Gestational age, birth weight, sex, mode of delivery, twin status, postmenstrual age, and serum IGF-1 level were collected. A linear regression model with ln(IGF-1) as the dependent variable was used to compare IGF-1 levels among groups after adjustment for postmenstrual age. Results: A total of 88 preterm infants were included, including 76 infants in the non-ROP group and 12 infants in the ROP group. Among infants with ROP, 6 had stage 1 disease and 6 had stage 2 disease. No infant had stage 3 or more advanced ROP, plus disease, or treatment-requiring ROP. Compared with the non-ROP group, infants in the ROP group had lower gestational age and birth weight and a higher proportion of twin pregnancy (all P < 0.05). Serum IGF-1 level did not differ significantly between the ROP and non-ROP groups [25.2 (22.6, 36.9) ng/mL vs. 27.3 (21.1, 39.9) ng/mL, P = 0.754]. No significant difference in serum IGF-1 level was observed between infants with stage 1 and stage 2 ROP. After adjustment for postmenstrual age, serum IGF-1 levels remained comparable among groups. Conclusion: Single serum IGF-1 measurement was not significantly associated with the occurrence or early staging of ROP. For early mild ROP mainly consisting of stage 1 and stage 2 disease, single serum IGF-1 measurement appears to have limited value for disease stratification.