50例新生儿缺氧缺血性脑病脑干诱发电位的变化及随访

Changes of BAEP in newborns with hypoxic ischemic encephalopathy

目的通过测试脑干听觉诱发电位(BAEP)了解大脑听觉中枢和外周性传导在缺氧缺血性脑病(H IE)损伤中的变化。方法H IE组50例,其中轻度36例,重度14例,进行BAEP的测试,并与52例正常对照组进行比较分析。结果H IE组BAEP异常率58%,正常组BAEP异常率1.9%,两组比较差异有统计学意义。轻度H IE异常率44.4%,以周围性损伤为主,表现为波I缺失,及潜伏期(PL)延长,听阈值升高;重度H IE异常率78.6%,以中枢性损伤为主,BAEP异常有重叠出现,表现为各波的全部缺失,潜伏期(PL)及波间潜伏期(IPL)的延长。H IE组同时做脑电图检查46例,异常27例,异常率58.7%,与BAEP的改变不平行。经治疗后6个月随访,周围性BAEP异常完全恢复正常,4例中枢性BA-EP异常仍未恢复。结论BAEP对评估H IE新生儿听觉中枢和外周性传导损伤有重要价值,对外周性听神经传导通路的损害是可逆的,H IE患儿应早期检查BAEP,及早发现听力障碍,能避免影响婴幼儿的语言发育及智力发育。

Objective To make a researsh on the changes of cerebral auditory centre and the peripheral transmission in newborns with HIE. Methods We tested the BAEP （ brain - stem auditory evoked potential） of 50 cases being diagnosed as neonatal HIE. Of the 50 cases, the mild HIE was 36 cases, the serious HIE was 14 cases. The result were compared to the BAEP of 52 normal neonates. Results In HIE group,the rate of abnormity of BAEP was 58% ,in normal group,the rate of abnormity was 1.9%. There was statistical difference between the two groups. In the mild HIE group,the rate of abnormity was 44.4% ,peripheral auditory damage was main, I wave deletion and the peak latencies of wave were prolonged, autory threshold rising. In the serious HIE group, the rate of abnormity was 78.6% , central auditory damage was main, abnormity BAEP always had duplication,each wave disappeared, the peak latencies （PL） and the inter- peak latencies （IPL） were prolonged. In the group of HIE there were 46 cases tested by encephalogram ,27 cases were abnomal ,the abnomality rate was 58.7% ,it was parallel comparing the change of BAEP. Having being treated,6 months later,the peripheral auditory damage infants of BAEP were restored normal. Four cases of the central damage are not restored yet. Conclusion BAEP has significant meaning in evaluating the autory and brainstem functions of newborns with HIE. The peripheral auditory damage is reversible. So we suggest that the BAEP of neonatal HIE should be tested as early as possible. Early discovery, early treating is active to prevent affecting the development of the infant＇s language and mind.