足月新生儿的BAEP特点及其相关危险因素分析

BAEP features and related risk factors of full-term neonates

目的探讨具有新生儿听力障碍相关危险因素的足月新生儿脑干听觉诱发电位(brain auditory evoked potential,BAEP)的特点及影响BAEP的主要相关危险因素,以期为临床预防及治疗提供依据。方法收集自2014年7月至2015年6月在安徽省立医院收治并在我科进行BAEP检查的394例足月新生儿资料,以BAEP正常组数值为对照,进行统计学分析。结果 394例足月新生儿中185例患儿检出BAEP异常(单侧异常者84例,双侧异常者101例);BAEP波I潜伏期异常者126侧,波III潜伏期异常者173侧,波V潜伏期异常者209侧;BAEP异常组中高胆红素血症、呼吸窘迫等缺氧因素、CMV等宫内感染、足月小样儿及败血症发病率分别为55.8%、22.8%、17.3%、4.8%、3.0%;其中,呼吸窘迫及窒息所致缺氧性损伤在异常组所占比例明显高于正常组(31.4%vs.15.3%,χ~2=13.43,P<0.001);足月小样儿在异常组所占比例也明显高于正常组(7.6%vs.2.4%,χ~2=4.65,P<0.05)。结论具有危险因素的足月新生儿BAEP异常主要表现在波III、波V潜伏期延长;在高胆红素血症、呼吸窘迫等缺氧因素所致相关损伤、CMV等宫内感染、足月小样儿及败血症等可能是影响BAEP的危险因素中,呼吸窘迫等缺氧因素所致的相关损伤及足月小样儿可能是影响BAEP的主要相关危险因素。

Objective The aim of this study is to characterize the brain auditory evoked potential(BAEP)recorded in full-term new born infants with risk factors,and to evaluate the association between abnormal BAEP results with these risk factors.Methods A retrospective cohort study was conducted on full-term neonates with risk factors including hyperbilirubinemia,hypoxia,cytomegalovirus-infected mother,low birth weight,neonatal sepsis,et al.A total of 394 neonates with risk factors admitted in Anhui Provincial Hospital from July 2014 to June 2015 were included in the analysis and BAEP results were evaluated statistically.Results 185 cases showed abnormal BAEP results,among which,84 were unilaterally and 101 were bilaterally.126 cases showed abnormality in the latency of wave I,while 173 cases in the latency of wave Ⅲ and209 cases in the latency of wave V.Hyperbilirubinemia,hypoxia,cytomegalovirus-infected mother,low birth weight,and neonatal sepsis were found in 55.8%,22.8%,17.3%,4.8%and 3.0%,respectively,of the study subjects.Neonates with hypoxia caused by respiratory distress and asphyxia(P<0.001)or low birth weight(P<0.05)were significantly associated with higher incidence of abnormal BAEP results.Conclusion Abnormal BAEP results in full-term neonates with risk factors were mainly characterized by increased latencies of wave Ⅲ and V.Hyperbilirubinemia,hypoxia,cytomegalovirus-infected mother,low birth weight,and neonatal sepsis were the major risk factors associated with altered BAEP.Hypoxia and low birth weight significantly impact the BAEP in neonates.