早产儿高胆红素血症患儿血清UCB等检测指标水平对BAEP的影响

Effect of serum UCB and other indexes levels on BAEP in hyperbilirubinemia premature infants

目的探讨早产儿高胆红素血症患儿血清间接胆红素（UCB）等检测指标水平与脑干听觉诱发电位（BAEP）的关系。方法选取2013年2月-2014年12月该院收治的早产儿高胆红素血症患儿110例,根据血清胆红素水平将患儿分为A组（UCB≤342μmol/L）、B组（342μmol/L427μmol/L）,检测各组患儿血清神经元特异性烯醇化酶（NSE）以及BAEP水平。结果 3组血清NSE水平比较差异有统计学意义（P〈0.05）;Krukal-Wallis检验显示,3组V波反应阈分布比较,差异有统计学意义（P〈0.05）;3组除Ⅰ-Ⅴ异常比较差异无统计学意义（P〉0.05）外,Ⅰ、Ⅲ、Ⅴ波以及Ⅰ-Ⅲ波间期、Ⅲ-Ⅴ波间期比较差异均有统计学意义（P〈0.05）;血清UCB受试者工作特征曲线（ROC曲线）下面积为0.817,截止点为309.12μmol/L,预测患儿听力受损的灵敏度和特异度分别为88.00%和75.50%,而血清NSE ROC曲线下面积为0.965,截止点为14.93 ng/ml,预测患儿听力受损的灵敏度和特异度分别为92.20%和100.00%。结论高胆红素可对患儿听力造成损害,血清NSE具有较好的临床预测听力损害的价值。

Objective To investigate the correlation between serum indexes such as unconjugated bilirubin（ UCB） and brainstem auditory evoked potentials（ BAEP） in hyperbilirubinemia premature infants. Methods From February 2013 to December 2014,a total of110 hyperbilirubinemia premature infants admitted to this hospital were collected. According to serum bilirubin levels,the patients were divided into Group A（ UCB≤342 μmol / L）,Group B（ 342 μmol / L UCB≤427μmol / L）,and Group C（ UCB 427 μmol / L）. Serum neuron- specific enolase（ NSE） and BAEP levels were detected in each group. Results Serum NSE levels in the three groups had significant difference（ P 〈0. 05）; Krukal- Wallis test showed that wave V response threshold in the three groups had significant difference（ P 〈0. 05）. In the three groups,wave I,III,V and wave I- III interval,wave III- V interval had significant difference（ P〈 0. 05）,except that wave I- V anomalies had no significant difference（ P 〉0. 05）. In receiver operating characteristic curve（ ROC curve） of serum UCB,the area under curve was 0. 817,the cut- off point was 309. 12 μmol / L,and sensitivity and specificity for predictive hearing impairment were88. 00% and 75. 50%,while the area under curve in ROC curve of serum NSE was 0. 965,the cut- off point was 14. 93 ng / ml,sensitivity and specificity for prediction of hearing impairment were respectively 92. 20% and 100. 00%. Conclusion Hyperbilirubinemia can cause hearing impairment in children,and serum NSE has high value for predicting hearing impairment in clinic.