DPOA对不同胎龄高胆红素血症早产儿听力的筛查研究

DPOA on the different gestational age hyperbilirubinemia in premature children hearing screening

目的:观察高胆红素血症对不同胎龄早产儿听力的影响,探讨畸变产物耳声发射(DPOAE)检测技术对高胆红素血症早产儿听力筛查的意义。方法:对2011年1月至2012年12月沈阳市妇婴医院收治的256例不同胎龄的高胆红素血症早产儿(高胆红素血症组)及363例不同胎龄的血清总胆红素正常的早产儿(对照组)进行DPOAE测试,未通过者出生后42 d后复查,仍不能通过者于出生后3个月再次复查并行脑干诱发电位检查。结果:高胆红素血症组DPOAE初筛总通过率、复筛总通过率、第三次筛查总通过率及脑干诱发电位检查异常率与对照组相比,差异均有统计学意义(P<0.05)。高胆红素血症组中不同胎龄早产儿脑干诱发电位检查异常率比较,差异有统计学意义(P<0.05)。结论:高胆红素血症可引起早产儿听力障碍,胎龄越小影响越明显;DPOAE可作为筛查高胆红素血症早产儿听力障碍的基本方法。

Objective：To investigate the impacts of hyperhilirubinemia on the hearing of preterm children born at different weeks of gestational age, and to determine the value of distortion product otoaeoustic emission （DPOAE） in hearing screening for premature children with hyperbilirubinemia. Methods： Between January 2011 and December 2012, a series of preterm children born at different weeks of gestational age at Shenyang Maternity and Children Hospital, including 256 with hyperbilirubinemia （Hyperbiliruhinemia group） and 363 with normobilirubinemia （Normobilirubinemia group ）, underwent DPOAE testing. We arranged a second DPOAE test on day 42 or later after birth for those who failed the first attempt, and a third one plus a test for brainstem auditory evoked potentials （BAEP） at 3 months or later after birth for those who failed the second attempt. Results： The success rates of DPOAE screening at the first, second and third attempts and the rate of abnormal BAEP in the Hyperbilirubinemia group were statistically different from those in Normobilirubinemia group （ all P 〈 0.05 ）. With the Hyperhilirubinemia group, the rate of abnormal BAEP also varied among preterm children born at different weeks of gestational age （ P 〈 O. 05 ）. Conclusion： Hyperbilirubinemia may cause hearing impairment in preterm children, particularly in those born at earlier weeks of gestational age. DPOAE can be used in primary screening of disordered hearing in preterm children with hyperhilirubinemia.