新生儿血清胆红素水平与脑干听觉诱发电位的相关性研究

Relationship between neonatal serum bilirubin level and auditory brainstem responses

为探讨高胆红素血症新生儿的脑功能状态 ,早期评估其预后 ,对 80例新生儿黄疸行血清胆红素测定 ,并进行脑干听觉诱发电位 (ABR)检查。结果显示 ,血清胆红素 137～ 171μmol/ L36例 ( 组 ) ,其中 2 0例 ABR异常 ,异常率 5 5 .6 % ;～ 2 0 5 μmol/ L30例 ( 组 ) ,其中 2 8例 ABR异常 ,异常率 93.3% ;～ 2 5 7μmol/ L14例 ( 组 ) ,其 ABR全部异常。 组与 组比较 ,ABR异常率差异有高度显著性 (P<0 .0 1) , 组与 组比较 ,差异无显著性(P>0 .0 5 )。胆红素浓度恢复正常后 3个月复查 ,恢复率为 组 10 0 % , 组 42 .9% , 组均未恢复 ,组间比较差异有高度显著性 (P<0 .0 1)。认为 ABR与新生儿血清胆红素浓度呈相关性 ,当血清胆红素浓度达到 171μmol/ L时 ,应予以高度重视 ,以免导致永久性中枢神经损伤。

To evaluate the prognosis of newborns with hyperbilirubinemia as early as possible by study the brain function of those newborns,serum bilirubin concentration(SBC)and auditory brainstem responese (ABR)were detected in 80 newborns with hyperbilirubinemia.Results showed that among the 36 cases with the SBC in the range of 137 to 171 μmol/L(the first group),there were 20 cases with abnormal ABR,the rate of abnormal incidence was 55.6% Among the 30 cases with the SBC in the range of 171 to 205 μmol/L(the second group),there were 28 cases with abnormal ABR,the rate of abnormal incidence was 93.3%.There were 14 cases with the SBC in the range of 205 to 257 μmol/L(the third group)whose ABRwere all abnormal.The difference was highly significant between the first and the second group(P<0.01),it was no significant between the second and the third group(P>0.05).After three months,the cases with abnormal ABR were detected again.The results showed that the rate of resumption of the first group was 100%,the rate of resumption of the second group was 42.9%,but the ABR of the third group were still all abormal.The differences were highly significant(P<0.01).It suggests that ABR are associated with the neonatal SBC,it should be highly watched out when SBC rise to 171 μmol/L,or which woud result in perpetual damage on the centrical nervous svstem in newborns.