低出生体重早产儿闪光视觉诱发电位变化及相关影响因素探讨

Study of the variation of flash visual evoked potential in preterm low birth weight infants and its related influencing factors

目的探讨低出生体重早产儿闪光刺激视觉诱发电位(FVEP)变化及相关影响因素。方法对2007年11月至2008年12月本院住院、围产期有合并症的低出生体重儿和极低出生体重儿进行FVEP检测,与无合并症的低出生体重早产儿(低体重对照组)及健康足月儿进行对比。对有合并症早产儿的围产因素进行Logistic回归分析,筛选出与主波P1异常相关的影响因素,列出回归方程。结果极低体重儿组N1、P1、N2波潜伏期均值分别为(181.4±26.7)ms、(217.3±26.5)ms和(249.2±26.5)ms,低体重儿组分别为(177.6±18.7)ms、(217.6±23.2)ms和(250.1±20.4)ms,低体重对照组分别为(158.9±32.1)ms、(199.9±13.3)ms和(232.9±16.7)ms,足月儿组分别为(159.5±18.3)ms、(200.3±13.9)ms和(231.6±15.7)ms。极低体重儿组和低体重儿组各波潜伏期均较足月儿组长,主波P1波潜伏期较足月儿和低体重对照组长,差异有统计学意义(P均<0.001)。极低体重儿组、低体重儿组P1波异常率较低体重对照组高(75.6%、58.4%比5.0%,P<0.001)。114例有合并症早产儿主波异常的主要相关影响因素是脑损伤(OR=3.955)。结论围产期有合并症的低体重早产儿和极低出生体重儿FVEP检查异常率较高;FVEP异常改变与脑损伤病变关系密切。

Objective To study the variation of flash visual evoked potential（FVEP）in preterm low birth weight infants and its related influencing factors.Methods FVEP was performed in low birth weight and very low birth weight infants hospitalized with perinatal complications from November 2007 to December 2008,and a group of preterm low birth weight infants without any complication as well as normal term infants group served as controls.A logistic regression analysis for the perinatal factors was applied subsequently in the premature infants with abnormal main wave P1 and then regression equation was established by related factors screening.Results The mean latency periods of N1,P1,N2 wave were（181.4±26.7）ms,（217.3±26.5）ms,（249.2±26.5）ms in the very low birth weight group,and（177.6±18.7）ms,（217.6±23.2）ms,（250.1±20.4）ms in the low birth weight group,comparing to（158.9±32.1）ms,（199.9±13.3）ms,（232.9±16.7）ms in the low birth weight controls.We observed that the latency period of each wave were longer in the very low birth weight or low birth weight infants than that in the terms.Meanwhile,the latency periods of main wave P1 were detected longer in testing groups than in that of the controls.And there were significant differences respectively（P〈0.001）.As to the abnormal rate,it＇s also detected higher in testing groups than in the low birth weight controls.The major related influencing factors in low birth weight infants with abnormal main wave was brain injury.Conclusion Abnormal rate of FVEP was detected higher in the preterm low birth weight infants with complications in the perinatal period,and the variation was closely related to brain injury.