婴幼儿巨细胞病毒感染脑干听觉诱发电位分析

Clinical Observation of Brainstem Auditory Evoked Potential in Infants with Cytomegalovirus Infections

目的 :探讨原发性巨细胞病毒 (CMV)感染婴幼儿脑干听觉诱发电位 (BAEP)的变化及其在早期病情监测中的作用。方法 :对 38例CMV感染患儿 (CMV组 )及 2 7例对照组患儿进行BAEP测定 ,并测定CMV组V波反应阈。结果 :CMV组BAEP异常率占 74 %。表现为以Ⅰ、Ⅲ、Ⅴ波潜伏期及Ⅰ～Ⅲ峰间差值延长为主 ,与对照组比较 ,差异有显著性 (P <0 .0 1)。CMV组Ⅴ波反应阈值平均为 ( 4 6± 2 1)dBnHL ,异常率为 5 8% ,主要表现为轻度增高。Ⅴ波反应阈与I波呈正相关 (二者的相关系数r=0 .936 ,P <0 .0 0 1)。结论 :原发性CMV感染可影响婴幼儿的神经系统尤其听力发育 ,有必要加强BAEP的早期监测 。

Objective: To assess the role of brainstem auditory evoked potential (BAEP) in early detection of the primary cytomegalovirus (CMV) infections. Methods: The BAEP and V wave threshold were examined in 38 infected infants, and BAEP measured in 27 controls. Results: The abnormal rate of BAEP was 74 % in infected group, prominently presenting the prolongation of the peak latency (PL) of the Ⅰ, Ⅲ, Ⅴwaves and the inter peak latency (IPL) of the Ⅰ-Ⅲ. There was a significant difference in the abnormal rate of BAEP between the infected group and control group ( P <0.01). In infected group, the V-wave thresholds disappeared in 2 cases, averaged 46± 21 dBnHL. The abnormal percentage was 58 %, mainly presenting a mild increase. There was a positive correlation between the V wave threshold and the PL of Ⅰwave. The longer the PL of I was, the higher the V wave threshold. The correlation was r =0.936, P <0.001. Conclusion: CMV infections may be associated with a broad range of subtle neurosonographic and audiologic impairments during early infancy. BAEP is useful in the evaluation of the infants with primary CMV infections.