摘要
目的探讨高胆红素血症对新生儿神经行为与听觉功能的影响。方法对54例高胆红素血症新生儿(患儿组)及15例正常新生儿(正常组)进行神经行为评估(NBNA)、畸变产物耳声发射(DPOAE)及听性脑干反应(ABR)检查,再按NBNA评分结果将患儿组分为<35分与≥35分两组,分别与正常组比较。结果①54例患儿平均NBNA评分为35.11±1.50分,显著低于正常儿(≥37分)(P<0.001),其中,<35分组18例(平均33.5±0.99分)、≥35分组36例(平均35.92±0.97分),且NBNA评分与非生物听定向反应得分成正相关(r=0.569)。②<35分组及≥35分组ABR波Ⅴ潜伏期、Ⅲ-Ⅴ及Ⅰ-Ⅴ波间期较对照组显著延长(P<0.05),但<35分组与≥35分组间差异无统计学意义(P>0.05);三组间DPOAE通过率及各频率振幅差异无统计学意义(P>0.05)。③12例患儿首次评估一周后再次行NBNA评估,得分显著增加(P<0.05),19例42天后复查ABR,除反应阈和Ⅰ-Ⅲ波间期与首次检测结果无明显差异外,其他各波潜伏期及波间期均明显缩短(P<0.05),DPOAE无明显改变(P>0.05)。结论高胆红素血症对新生儿神经系统尤其是听觉系统有损伤,可直接影响NBNA评分及ABR结果。NBNA与ABR联合应用,更有利于全面了解患儿病情,尤其是听觉系统受累情况。
Objective To explore the relationship between neonatal behavioral neurological assessment and auditory system function in hyperbilirubinemia newborns. Methods 54 neonates with hyperbilirubinemia and 15 nomal neontes recieved neonatal behavioral neurological assessment （NBNA） , auditory brainstem response（ABR） and distortion product otoacoustic emissions（DPOAE）. Then according to the NBNA scores, the subjects were divided into groups with 〈35 scores and ≥35 scores. The results were then compared with nomal group,and followed up if there are abnomal in the examines. Results There were 18（36 ears） in group with 〈35 scores and 36 neonates（72 ears） in the groups with 935 scores. The neonates with hyperbilirubinemia had significantly lower scores compared with the nomal neonates, and the scores of NBNA showed significantly and closely positive correlation with non biological drectional hearing respone . The wave V latencies and Ⅲ--Ⅴ,Ⅰ-Ⅴ interwave intervals of the ABR were significantly different and prolonged in comparison with the control group （P〈0.05）. However similar results were found between the 〈35 .scores and 935 scores groups in all of the parameters of ABR . The inducing rate and amplitude of DPOAE showed no significant difference among the 3 groups （P〉0.05）. During the follow up, the ABR latencies and interwove intervals except for interwove latency Ⅰ -- Ⅲ were significantly shorter,and had a significantly higher NBNA scores. The inducing rate and amplitude of DPOAE also showed no significant difference. Conclusion Hyperhilirubinemia is toxic to the nervous system, especially the auditory system which can directly influence the ABR and NBNA results. The application of the combined NBNA and ABR can be useful to diagnose the neonatal hyperbiliruhinemia.
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2011年第5期409-412,共4页
Journal of Audiology and Speech Pathology
关键词
高胆红素血症
新生儿神经行为评估
听性脑干反应
畸变产物耳声发射
Hyperbilirubinemia
Neonatal behavioral neurological assessment （NBNA）
Auditory brainstem response（ABR）
Distortion product otoacoustic emissions（DPOAE）
