摘要
目的：探讨高胆红素血症对新生儿听力的影响,比较两种听力检查方法对新生儿听力损伤的诊断价值。方法：对40例新生儿的80耳进行脑干听觉诱发电位（BAEP）和畸变产物耳声发射（DPOAE）检查,对听力检测异常的患儿在3~6月龄进行复检;分析血清胆红素水平与听力异常的发生及异常程度的相关性。结果：高胆组〔血清未结合胆红素（USB）：268~583.1μmol/L〕新生儿BAEP异常明显高于对照组（USB〈256μmol/L）,二组BAEP初筛异常发生率分别为57.5%和15.0%;高胆组1/2以上的BAEP异常为中重度而对照组均为轻中度,6个月内复查高胆组仍有10.0%的耳未通过BAEP检查而对照组完全通过。BAEP异常组的USB显著高于BEAP正常组〔（317.08±108.25）vs（208.41±48.37）μmol/L,P〈0.01〕,但BAEP异常的程度与USB无相关性。DPOAE和BAEP检测听力结果的符合率为78.75%,中重度听力受损二者一致性更好。结论：新生儿高胆红素血症可引起脑干听觉诱发电位的改变,但血清胆红素浓度与脑干听觉诱发电位的改变程度缺乏相关性。DPOAE和BAEP联合检查能更准确的评估婴幼儿的听力损失,二者在中重度听力受损的评估上有很高的一致性。
Objective：To study the effect of hyperbilirubinemia to the neonatal hearing impairment and evaluate two hearing screening methods.Methods：40 neonates were divided into hyperbilirubinemia group（USB=256μmol/L） and control group（USB256μmol/L） by peak level of serum bilirubin（USB）.All cases received the initial detections of brainstem auditory evoked potential（BAEP） and distortion product otoacoustic emission（DPOAE） before discharge,and abnormal ones were rechecked during 3-6 m of the age.Results：The rate of abnormal BAEP of Hyperbilirubinemia group（57.5%） was higher than control group（15.0%） in initial detection.There was still 4 ears（10.0%） failed to pass re-test BAEP.USB level was significantly increased in neonates with abnormal BAEP than ones with normal BAEP,but no significant different was found between grading classification of BAEP and USB level.The compliance rate of DPOAE was 78.75% with BAEP.There was better consistency between two methods in severe hearing loss.Conclusion：Neonatal hyperbilirubinemia is high risk to hearing loss.The abnormal degree of BEAP is not correlate to USB level.Abnormal BEAP is mostly temporary in newborn without Kernicterus manifestations.DPOAE combined with BAEP is a preferable way of hearing screening among hyperbilirubinemia neonates.
出处
《中国妇幼保健》
CAS
北大核心
2011年第20期3160-3162,共3页
Maternal and Child Health Care of China
关键词
婴儿
新生儿
高胆红素血症
听力筛查
Infant
Neonatal
Hyperbilirubinemia
Hearing screening
