华南地区788例孤独症谱系障碍儿童脑干听觉诱发电位的研究

Research on the brainstem auditory evoked potential in 788 children with autism spectrum disorders in South China

目的研究华南地区患孤独症谱系障碍(ASD)且听力阈值正常儿童的脑干听觉诱发电位的特征。方法回顾性分析2013—2018年在广州市妇女儿童医疗中心确诊为ASD儿童的脑干听觉诱发电位结果。将其与年龄及性别分布相匹配(P>0.05)的健康儿童诱发电位的听阈值、波潜伏期、波间期、Ⅰ-Ⅲ/Ⅲ-Ⅴ波间期比值及Ⅴ/Ⅰ波幅比值的异常率进行比较分析。如受试者一侧耳的听阈超过30 dBnHL,则该侧耳BAEP数据将被排除在两组之外。结果总共纳入符合入组标准的788例患儿及150例健康对照组儿童。ASD组共有1 530耳以及对照组300耳的BAEP资料纳入最终分析。两组入选受试者在90 dB声刺激下均能分化出良好波形。1)ASD儿童的Ⅰ波潜伏期、Ⅲ波、V波潜伏期以及Ⅰ-Ⅲ波间期均较同龄儿童延长,且差异具有统计学意义(Z=-2.006、-3.986、-2.552、-2.405,P<0.05);2)ASD儿童Ⅰ-Ⅲ/Ⅲ-Ⅴ波间期比值异常率(3.14%)明显高于对照组,且差异具有统计学意义(P<0.001)。结论 ASD儿童脑干听觉诱发电位存在特异性改变,尤其脑干传导时间的异常延长,提示ASD患儿存在脑干功能的障碍,可能导致相关信息传递的损害。

Objective To investigate the characteristics of brainstem auditory evoked potential(BAEP) in children with autism spectrum disorder(ASD) and normal hearing threshold in South China. Methods The BAEP records of ASD children in Guangzhou Women and Children′s Medical Center between 2013 and 2018 were retrospectively reviewed. Healthy controls matched by age and gender were also recruited. The thresholds, wave absolute latencies(AL),wave inter peak intervals(IPL),Ⅰ-Ⅲ/Ⅲ-Ⅴ inter peak interval ratio and Ⅴ/Ⅰ amplitude ratio of BAEP between both groups were analyzed and compared. And the BAEP data of the children would be excluded from both groups if the hearing threshold of his/her ear exceeded 30 dB nHL. Results A total of 788 ASD children and 150 healthy controls were included. BAEP data of 1 530 ears in ASD group and 300 ears in control group were included in final analysis. All participants in the two groups could differentiate into well-defined waveforms of BAEP at 90 dB nHL sound stimulation. 1) The absolute latencies of wave Ⅰ,wave Ⅲ,wave V and inter peak intervals of Ⅰ-Ⅲ of ASD children were significantly longer than those of children in control group(Z=-2.006,-3.986,-2.552,-2.405,P<0.05).2) The abnormal ratio of Ⅰ-Ⅲ/Ⅲ-Ⅴ inter peak interval of ASD group(3.14%) was significantly higher than that of the control group(P<0.001). Conclusions There are distinct changes in BAEP in ASD children, especially the abnormal prolongation of brainstem conduction time, suggesting that ASD children may have brainstem dysfunction, which may lead to the damage of related information transmission.