新生儿缺氧缺血性脑病听觉脑干诱发反应及诱发性耳声发射的临床意义

Clinical Significance of the Auditory Brainstem Evoked Response and Evoked Otoacoustic Emissions in Neonates with Hypoxic Ischemic Encephalopathy

对36例(72耳)新生儿缺氧缺血性脑病(HIE)以及22例(44耳)正常新生儿进行听觉脑干诱发反应(ABR)及诱发性耳声发射(EOAES)检测。HIE病人ABR异常34耳(47.2％),EOAES异常31耳(51.4％)。对照组异常耳数0和3耳(6.8％)。通过检测发现在轻度HIE病人中EOAES异常耳数较ABR高(17∶12),提示轻度HIE病人耳蜗外毛细胞受损率高。并随着脑部损害加重异常耳数明显增加。同时提示重度HIE病人脑干受损及毛细胞受损率相当高。两种方法属无创性,并能客观地反映听力及脑干功能、及耳蜗外毛细胞受损情况。通过检测能准确确定受损部位,及时给予治疗可减少后遗症的发生。

Thirty-six neonates (72 ears) with hypoxic ischemic encephalopathy (HIE) and 22 normal neonates(44 ears) were examined by using acoustic brainstem evoked response (ABR ) and evoked otoa-coustic emissoins(EOAE) tests. The results showed that the number of abnormal ears of the patients was 34(47. 2%) when using ABR test,and 37(51. 4%) when using EOAE test,but only 0 and 3 ab- normal ears(6. 8%) in control group respectively. In the mild HIE infants the number of abnormal ears was more in EOAE test than in ABR test (17 : 12)twhich showed that the cochlear hairy cells were more seriously damaged in this group. These tests also showed that more seriously damaged the brain was,more abnormal ears the patients had. So the infants with severe HIE had higher injury rate of the cochlear hair cells and brainstem. The two tests are noninvasive. The functions of audition and brainstem could be reflected by using the tests. The injured area could be found earlier through the tests. Then the patients will be treated earlier and the sequelae of HIE will be reduced.