摘要
目的通过新生儿听力筛查并结合易感基因筛查进行结果分析，以了解高危新生儿听力损伤发生情况及主要高危因素。方法采集2007年11月至2008年8月因听力障碍收住院的648例高危新生儿为研究组，同时按1：3比例在同期正常新生儿中随机抽取1 944例作为对照组；采用瞬态诱发耳声发射进行听力筛查，初筛未通过者用进行复筛，复筛未通过者在3个月左右转诊至洛阳市听力筛查诊断中心行听性脑干诱发电位/多频稳态诱发电位/畸变耳声发射/声导抗多种方法组合测试，进行听力学诊断；采用新生儿遗传疾病筛查采样卡采集足跟血，用限制性酶切结合直接测序方法对3种常见耳聋易感基因（m.1555A〉G、GJB2、SLC26A4）突变进行筛查。结果共采集听力障碍高危儿648例，其中男419例，女229例。正常新生儿初筛未通过率2.42%（47/1 944），高危新生儿初筛未通过率18.83%（122/648），两组差异显著（χ2=214.71，P〈0.05）。听力障碍高危儿听力损伤发生率6.17‰（4/648），正常新生儿听力损伤发病率1.03‰（2/1 944），两组差异显著（u=2.34，P〈0.05）；高危新生儿基因筛查阳性率为18.52%（12/648），听力障碍确诊率6.17‰（4/648），基因筛查阳性率远高于确诊率。结论听力损伤高危因素主要为早产合并低体重、新生儿缺氧缺血性脑病、高胆红素血症；高危新生儿听力损伤发生率高于正常新生儿；高危新生儿应定期进行听力复查，并及时给予听力学诊断，建立一个详细的追踪随访系统。
Objective To analyze results of neonatal hearing screening combined with results of susceptible genes, so as to investigate prevalence of hearing impairment of highrisk neonates and its main influencing factors. Methods 648 highrisk neonates hospitalized due to hearing disorder over a period from November, 2007 to August, 2008 were selected as hearingimpaired subjects. At the same time, 1 944 normal neonates in the same period according to ratio subject：normal control=1：3 were randomly selected as the controls. The transient evoked otoacoustic emissions （TEOAE） was used to screen the hearing of the neonates. Those neonates who didn’t pass the primary TEOAE screening received rescreening. Then, those neonates who didn’t pass the rescreening were referred to Luoyang Municipal Hearing Screening and Diagnosis Center at age of 3 months for combined testings such as auditory brain stem evoked potentials （ABR）/multifrequency steadystate evoked potential （ASSR）/distortion otoacoustic emission （DPOAE） / acoustic impedance method to diagnoze hearing disorder of the neonate. Meanwhile, the heel blood samples of the neonates with Neonatal Genetic Diseases Screening Sampling Card （utility model patents 200720103139.4） were taken and the restriction enzyme digestion method of direct sequencing was used to screen mutations of 3 common deafness susceptible genes （m.1555A〉 G, GJB2, SLC26A4）. Results From November, 2007 to August, 2008, 648 hearingimpaired highrisk nonates （including 419 male neonates and 229 female neonates） were collected. The proportion of newborns who didn’t pass the primary screening in the control group was 2.42% （47/1944）, and that in the highrisk neonates group was 18.83% （122/648）, there was a significant difference between the two groups （P〈0.05）. The incidence of hearing impairment in the highrisk neonates group was 6.17‰（4/648）,while that of hearing impairment in the control group was 1.03 ‰ （2 /1 9
出处
《中国妇幼健康研究》
2010年第2期217-219,共3页
Chinese Journal of Woman and Child Health Research
关键词
听力筛查
新生儿
听力障碍
高危因素
hearing screening
neonate
hearing dosorder
risk factor
