2298例新生儿听力筛查假阳性的初步分析

Analysis on the reasons of false positive rate of hearing screeing for 2298 newborns

目的探讨和分析新生儿听力筛查中初筛和复筛未通过的原因。方法应用瞬态诱发耳声发射(transientevokedotoacousticemission,TEOAE)和自动判别听性脑干听觉诱发电位(automatedauditorybrainstemresponse,AABR)对2003年12月-2006年1月在我院产科出生的2298例活产新生儿进行新生儿普遍听力筛查。初次接受听力筛查为出生后2～3天,只进行TEOAE测试;出生后42天进行第二次听力筛查,复筛时应用TEOAE和AABR进行测试。复筛仍“未通过”者,在出生后3个月时做诊断性检查评估听力水平。结果2298例新生儿在住院期间全部接受初次筛查,其中2152例通过了初筛,通过率为93.6%。初筛“未通过”的146例中有96例新生儿在42天进行复筛,复筛通过79例,通过率为82.3%。复筛仍未通过的17例,其中3例已经确诊为听力损失,在2298例新生儿中听力损失的发病率为0.13%。另有14例正在进行随访,尚未诊断。初筛的假阳性率占5.7%。结论总结听力筛查中出现假阳性的原因;归纳TEOAE和AABR的优势和不足。

Objective To investigate and analyze the causes why the newboms failed the initial and secondary heating screening. Method Transient evoked otoacoustic emission （TEOAE） and automated auditory brainstem response（AABR） were used to examine the hearing of 2298 live birth newborns of our hospital＇s maternity from Dec. 2003 to Jan. 2006.TEOAE was used for initial hearing screening in 2 - 3 days after birth, but both TEOAE and AABR were used for the secondary hearing screening in 42 days after birth. Diagnostic hearing tests were used to assess the hearing of those who failed the secondary hearing screening 3 months after birth. Results All the 2298 newborns underwent the initial hearing screening when they were in hospital.2152 of them passed, the ratio was 93.6%. 96 infants who failed initial hearing screening underwent the secondary screening 42 days after birth. 79 of them passed, the ratio is 82.3%.3 of the 17 cases who failed secondary screening were diagnosed with hearing loss, the morbidity of 2298 newboms was 0.13%.The other 14 newboms were still followed up. The false positive rate was 5.7%. Conclusion： Summing up the reasons of the false positive rate of hearing screening and the advantage and disadvantage of OAE and AABR were discussed.The combined use of TEOAE and AABR in hearing screening helped identify infants with hearing loss and prevents misdiagnosis and missed diagnosis.