人巨细胞病毒感染40例患儿与脑干听觉诱发电位异常关系的探讨

Relationship between abnormal brainstem auditory evoked potential and cytomegalovirus infection in 40 human cytomegalo virus cases.

[目的]探讨人巨细胞病毒感染的患儿与脑干听觉诱发电位(brajnstem auditory evoked potential,BAEP)异常关系及临床观察.[方法]收集了南京医科大学附属儿童医院2003年7月～2004年11月间40例经病原学诊断为人巨细胞病毒(hu-man cytomegalo virus,HCMV)感染的新生儿及婴幼儿进行脑干听觉诱发电位BAEP的测定.[结果]HCMV感染的患儿与BAEP存在异常关系.①V波反应阈值增高:在40例HCMV感染的患儿中重度增高2例4耳、中度增高1例2耳、轻度增高7例9耳,并以轻度增高为主.②BAEP异常表现:在40例HCMV感染的患儿中,BAEP异常13例,异常率32.5%,其中绝对潜伏期延长10例(25%)、Ⅰ波延长7例(17.5%);Ⅲ波延长1例(2.5%);Ⅴ波延长2例(5%).波间期延长5例(12.5%)中,Ⅰ-Ⅲ延长2例(5%),Ⅲ-Ⅴ延长1例(2.5%)、I-V延长2例(5%).V/I比率≤O.5 1例(2.5%),左右两耳侧间差＞0.4毫秒1例(2.5%).[结论]应用BAEP对HCMV感染患儿的检测,可早期发现患儿听力障碍的程度和性质,对协助推断听觉传导听路病毒侵犯的部位具有重要的价值.

[Objective] To investigate the relationship among patients infected by cytomegalovirus and abnormal brainstem auditory evoked potentaial（BAEP） and clinical observation. [Method] The brain stem auditory evoked potential（BAEP）was taken in forty infants or newborns infected by abnormal human cytomegalo virus（HCMV）,diagnosed by etiology in our hospital from July, 2003 to November, 2004, [Results] There existed relationship between patients infected by cytomegalovirus and abnormal BAEP. First, wave reaction threshold increased. Of 40 HCMV infected infants, most showed slight increase, with 2 cases heavily-increase （4 ears）, 1 medium-increase （2 ears） and 7 slightly-increased （9 ears ）. Second, BAEP showed abnormality. Of 40 HCMV infected infants, 13 cases were abnormal BAEP wave（32.5 %）. Among them, absolute latent period was prolonged （10 cases,25 %）, wave Ⅰ wave was prolonged 7 cases（17.5%）, wave Ⅲ 1 case（2.5%） ,wave Ⅴ was 2 cases（5%）. Of the 5 cases with wave interphase prolonged, Ⅰ - Ⅲ was prolonged 2 cases （5 %）, Ⅲ- Ⅴ 1 case （2.5 % ）,Ⅰ -Ⅴ 2 cases （5 %）. Ⅴ / Ⅰ ratio≤0. 5 was 1 case （2.5 %）. The difference between two ears〉0. 4mswasl case（2.5 %）. [Conclusion] Applying BAEP to examine the patients infected by HCMV, the degree and quality of hearing impairment can be discovered in the early period, the site attacked by virus on the auditory conduction pathway can be infered.