新生儿高胆红素血症听性脑干反应的特点

Characteristics of Auditory Brainstem Response in Neonatal Hyperbilirubinemia

目的研究不同病因引起的新生儿高胆红素血症听性脑干反应的特点。方法在我院2018年7月—2019年8月收治的新生儿高胆红素血症患者中选取65例作为研究对象,按照不同病因(母乳性黄疸、ABO溶血、新生儿感染、G-6-PD缺乏、不明原因、多种病因)进行分组,另选取17例正常新生儿的相关数据进行对比,分析不同病因引起新生儿高胆红素血症的出现时间、高峰时间、高峰值,对不同病因高胆红素血症新生儿的听性脑干反应进行分析。结果不同病因高胆红素血症新生儿的黄疸出现时间在2~4 d,高峰时间在5~11 d,其中母乳性黄疸的高峰时间较晚,高峰值在300~410μmol/L;临床中母乳性黄疸19例,多种病因14例,不明原因12例,ABO溶血9例,新生儿感染7例,G-6-PD缺乏4例,其中G-6-PD缺乏(1例),不明原因(1例)、多种病因(3例)存在异常耳,平均反应阈较高。结论在新生儿高胆红素血症中G-6-PD缺乏、不明原因、多种病因三种病因的患儿听性脑干反应平均反应阈较高,异常耳的发生率也较高,可见听性脑干反应异常即可诊断为新生儿高胆红素血症,但听性脑干反应正常不代表未患有肝胆红素血症,因此听性脑干反应可排查新生儿高胆红素血症,但不能最终进行确诊。

Objective To study the characteristics of auditory brainstem response of neonatal hyperbilirubinemia caused by different causes.Methods 65 cases of neonatal hyperbilirubinemia patients treated in our hospital from July 2018 to August 2019 were selected as the research object,according to different causes(breast milk jaundice,ABO hemolysis,neonatal infection,G-6-PD deficiency,unexplained,multiple causes)were grouped,and the relevant data of 17 normal newborns were selected for comparison,and the occurrence time,peak time,and peak value of neonatal hyperbilirubinemia caused by different causes were analyzed.The auditory brainstem responses of neonates with different causes of hyperbilirubinemia were analyzed.Results The occurrence of jaundice in neonates with different causes of hyperbilirubinemia was between 2~4 days,and the peak time was 5~11 days.The peak time of breast milk jaundice was significantly later,and the peak value was 300~410μmol/L;Clinically,19 cases of breast milk jaundice,14 cases of various etiologies,12 cases of unknown cause,9 cases of ABO hemolysis,7 cases of neonatal infection,4 cases of G-6-PD deficiency,including G-6-PD deficiency(1 case),Unexplained(1 case),multiple causes(3 cases)have abnormal ears,the average response threshold is higher.Conclusion In neonates with hyperbilirubinemia,children with G-6-PD deficiency,unexplained causes,and multiple etiologies with three etiologies have higher average response thresholds for auditory brainstem response and higher incidence of abnormal ears It can be seen that the abnormal auditory brainstem response can be diagnosed as neonatal hyperbilirubinemia,but the normal auditory brainstem response does not mean that he does not have hepatic bilirubinemia,so the auditory brainstem response can be checked for neonatal high Bilirubinemia,but the final diagnosis cannot be made.