摘要
目的 探讨高胆红素血症新生儿脑干听觉诱发电位(BAEP)参数和振幅整合脑电图(aEEG评分变化与脑损伤的关系。方法 选取2019年1月至2020年12月商丘市第一人民医院收治的120例高胆红素血症患儿,均行头颅磁共振成像(MRI),根据MRI结果分为胆红素脑损伤组(35例)和胆红素非脑损伤组(85例)。并选取同期60名健康新生儿作为对照组。入组新生儿均行BAEP与aEEG,记录BAEP参数和aEEG评分,抽取所有入组患儿的股静脉血,检测患儿的血清相关指标[总红胆素(TBiL)、间接胆红素(IBiL)、直接胆红素(DBiL)、白蛋白],计算总胆红素/白蛋白的比值(B/A)。比较各组间的指标差异,分析BAEP参数和aEEG评分与血清学指标的关系,评价BAEP参数和aEEG评分与脑损伤的关系。结果 胆红素非脑损伤组和对照组BAEP PLⅠ波、V波及IPLⅠ~Ⅲ波、Ⅲ~Ⅴ波、Ⅰ~Ⅴ波参数值均低于胆红素脑损伤组(P<0.05);胆红素非脑损伤组和对照组aEEG评分均高于胆红素脑损伤组(P<0.05)。胆红素非脑损伤组和对照组TBiL、IBiL、DBiL以及B/A水平均低于胆红素脑损伤组(P<0.05);TBiL与B/A与BAEP PLⅤ波,IPLⅠ~Ⅲ波、Ⅲ~Ⅴ波、Ⅰ~Ⅴ波参数值呈正相关,与aEEG评分呈负相关(P<0.05)。结论 高胆红素血症对患儿的听觉神经及脑功能可造成损伤,BAEP与aEEG可作为脑损伤早期监测手段。
Objective To investigate how the alterations in brainstem auditory evoked potential(BAEP parameters and amplitude-integrated electroencephalogram(aEEG)scores relate to brain injury in neonates with hyperbilirubinemia. Methods A total of 120 children with hyperbilirubinemia admitted to our hospital between January 2019 and December 2020 were included. All children underwent brain MRI, and were then divided into bilirubin-induced brain injury group(n =35) and hyperbilirubinemia without brain injury group according to MRI findings(n =85). Sixty healthy newborns during the same period were recruited as the control group.All the enrolled neonates underwent BAEP and aEEG, and recorded for BAEP parameters and aEEG scores.Femoral venous blood serum samples were collected from all enrolled infants for measurement of related indexes[total bilirubin(TBi L),indirect bilirubin(IBiL),direct bilirubin(DBiL),albumin(ALB)]. Total bilirubin/albumin(B/A) ratio was calculated. The values were compared between groups. We analyzed the relationship among BAEP parameters and aEEG scores and serological indices, as well as the relationship between BAEP parameters and aEEG scores and the brain injury. Results The BAEP parameter [peak latencies(PL)of wavesⅠ and Ⅴ,inter-peak latencies of waves Ⅰ-Ⅲ, Ⅲ-Ⅴ and Ⅰ-Ⅴ] in the hyperbilirubinemia without brain injury group and the control group were lower than those in the bilirubin-induced brain injury group(P<0.05).The aEEG scores in the hyperbilirubinemia without brain injury group and the control group were higher than those in the bilirubin-induced brain injury group(P<0.05). The values of TBiL,IBiL,DBiL and B/A ratio in the hyperbilirubinemia without were lower in the brain injury group and the control group than those in the bilirubininduced brain injury group(P<0.05). The values of TbiL and B/A ratio were correlated positively with BAEP parameters(PL of wave Ⅴ,IPL of waves Ⅰ-Ⅲ,Ⅲ-Ⅴ and Ⅰ-Ⅴ),and negatively with aEEG score(P<0.05).Conclusion Hyper-bilirubinemia can
作者
付亚楠
Fu Yanan(Neonatal Intensive Care Unit,Shangqiu First People′s Hospital,Henan 476100,China)
出处
《实用医技杂志》
2022年第7期714-717,共4页
Journal of Practical Medical Techniques
关键词
高胆红素血症
婴儿
新生
诱发电位
听觉
脑干
脑损伤
振幅整合脑电图
Hyperbilirubinemia
Infant
newborn
Evoked potentials
auditory
brain stem
Brain injuries
Amplitudeinte-grated electroencephalogram
