新生儿高胆红素血症听觉多频稳态诱发反应分析
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南通市卫生局科技计划项目(W0518)


Multiple-frequency auditory steady-state evoked responses of newborn with hyperbilirubinemia
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    目的:通过听觉多频稳态诱发反应分析,探讨高胆红素血症对新生儿中枢神经的影响-方法:对280例血总胆红素(TBC)≥220.6 μmol/L(12.9 mg/dl)的足月新生儿临床资料及听觉多频稳态诱发反应(ASSR)的检测结果进行回顾性分析-结果:TBC≤310.0 μmol/L 195例,ASSR均正常;> 520.0 μmol/L 18例均发生胆红素脑病,其中ASSR中重度以上异常16例;310.1~519.9 μmol/L67例,均无脑病临床表现,但ASSR出现异常,其中轻-中度异常63例(94.0%),中重度以上异常2例-听觉多频稳态诱发反应异常程度与TBC及TBC与白蛋白比(TB/A)有关(P < 0.01),与高胆红素病因构成无关(P > 0.05)-结论:听觉多频稳态诱发反应可早期发现亚临床胆红素神经中毒症,建议血胆红素浓度≥307.8 μmol/L时,ASSR应列入常规检查-

    Abstract:

    Objective: To study the influence of hyperbilirubinemia upon newborns central nervous system by pass multiple-frequency auditory steady-state evoked responses analysis. Methods: Clinical data and examination results of multiple-frequency auditory steady-state evoked responses (ASSR) of 280 cases,blood total bilirubin consistency (TBC) higher than 220.6 μmol/L(12.9 mg/dl) month newborns,were retrospectively reviewed. Results: One hundred and ninty-five cases with TBC less than 310.0 μmol/L,had normal ASSR;18 cases with TBC higher than 520.0 μmol/L all took place encephalpathy of bilirubin,among them,16 cases of ASSR were heavy degree abnormal;67 cases with TBC less than 519.9 μmol/L or higher than 310.1 μmol/L,had no encephalopathy clinical performance,but ASSR appeard an abnormality,among them,63 cases (94.0%) were light-mid-degree abnormal,2 cases were heavy degree abnormal. The abnormality degree of ASSR is related with TBC,TBC and albumin ratio(TB/A)(P < 0.01),but wasn’t related to the constituent of pathogenesis of hyperbilirubinemia(P > 0.05). Conclusion: ASSR can suggest preclinical nervous poisonsing of hyperbilirubinemia in early stage,when TBC is higher than 307.8 μmol/L,ASSR should be included as a normal test.

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康爱建,顾红兵.新生儿高胆红素血症听觉多频稳态诱发反应分析[J].南京医科大学学报(自然科学版),2011,(10):1448-1450

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  • 收稿日期:2011-05-11
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