耳声发射和听性脑干反应在先天性巨细胞病毒感染新生儿听力筛查中的应用

Screening Application of Otoacoustic Emissions and Auditory Brainstem Response in Newborn with Congenital Cytomegalovirus Infection

目的：探讨耳声发射和听性脑干反应在先天性巨细胞病毒感染新生儿听力筛查中的临床可行性和效果。方法：选择2012年12月—2013年7月在本院出生,并诊断为先天性巨细胞病毒感染并接受新生儿听力初筛和复筛的新生儿48例为观察组,同期在我院产科分娩的足月新生儿50例为对照组,听力筛查分为出生后（2～3）天为初筛,出生后42天为复筛,两阶段筛查初筛采用瞬态声诱发耳声发射（TEOAE）,复筛采用瞬态声诱发耳声发射（TEOAE）、畸变产物耳声发射（DPOAE）和听性脑干反应（ABR）共同筛查,复筛未通过者,于生后3个月再次来院进行筛查。结果：观察组48例（96耳）,初筛通过82耳（通过率85.4%）;对照组50例（100耳）,初筛通过95耳（通过率95.5%）,两组差异有统计学意义（χ2=5.138,P〈0.05）。复筛时观察组48例（96耳）,复筛TEOAE通过85耳（通过率88.5%）;复筛DPOAE通过83耳（通过率86.5%）;复筛ABR通过82耳（通过率85.4%）;对照组49例,其中1例未来复筛（98耳）,复筛TEOAE通过96耳（通过率98.0%）;复筛DPOAE通过98耳（通过率100%）;复筛ABR通过98耳（通过率100%）;两组差异在TEOAE、DPOAE、ABR均有统计学意义（依次χ2=6.879,P〈0.01;2=14.223,P〈0.01;χ2=15.403,P〈0.01）。结论：先天性巨细胞病毒感染新生儿听力障碍发生率明显高于对照组,此类患儿进行听力两阶段筛查非常重要,临床上应给予高度重视。

Objective：To investigate the effect of otoacoustlc emissions and auditory brainstem responses on hearing screen of newborn with congenital cytomegalovirus infection. Methods ：48 newborns with congenital cytomegalovims infection were collected as the observed group and 50 normal newborns as served the control group between Dec 2012 and July 2013 in our hospital. All subjects accepted the first newborn hearing screen on posmatal day 2 -3 by transiently evoked otoacousfic emission （TEOAE） and reexamination on postnatal day 42 by TEOAE, distortion productotoacoustic e- mission （DPOAE） and auditory brainstem response （ABR） screening mode. If fail to pass the reexamination the sub- jects would accept the third screening on postnatal months 3. Results：The passing rate of TEOAE at the first screening in the observation group （96 ears ） and control group （ 100 ears） was 85.4% （82/96） and 95.5% （95/100）, respectively; there was a significant difference between two groups （χ2 =5. 138,P 〈0.05）. At reexamination, the passing rate of TEOAE, DPOAE and ABR in observed group was 88.5%, 86.5% and 85.4%, respectively; and the passing rate of TEOAE, DPOAE and ABR was 98%, 100% and 100%, respectively in control group. There was a significandy differ- ence in TEOAE （χ2 =6.879, P〈0.01, DPOAE （χ2 =14.223,P 〈0.01 =and ABR （χ2 =15.403,P 〈0.01 = between the two groups. Conclusions：Incidence of hearing impairment in newborns with congenital cytomegalovirus infection is higher than that in normal newborns, so hearing screening at two stage is very important.