正常新生儿听性脑干反应测试结果分析

Auditory Brainstem Responses in Normal Newborns

目的 分析新生儿听性脑干反应（ａｕｄｉｔｏｒｙ ｂｒａｉｎｓｔｅｍ ｒｅｓｐｏｎｓｅｓ，ＡＢＲ）的基本特征，为国内开展新生儿ＡＢＲ检测及听力筛选提供依据。方法 对８０名正常新生儿（１６０耳）的ＡＢＲ测试结果进行分析，并与正常听力青年人测试结果进行比较。结果 １３０ ｄＢ ｐｅＳＰＬ强度短声刺激下，正常新生儿波 Ⅰ、波Ⅲ、波Ⅴ的检出率均为 １００％。波Ⅴ反应阈为 ６１．９４±６．８７ ｄＢ ｐｅＳＰＬ，显著高于正常听力青年人。新生儿波潜伏期和波间期均较正常听力青年人延长，波间期Ⅲ－Ⅴ／Ⅰ－Ⅲ比值显著低于正常听力青年人。结论７０ｄＢｐｅＳＰＬ短声是较为适宜的新生儿ＡＢＲ听力筛选的声刺激；性别及左、右耳差异不影响新生儿ＡＢＲ筛选；新生儿听觉通路存在一个不断完善的成熟过程，但其脑干上、下部的发育并不是完全同步的。

Objective To quantify the characteristics of the auditory brainstem responses(ABR) in the normal newborns, in order to provide a data for newborn hearing screening. Methods The ABR to click stimuli was investigated in a group of eighty normal newborns aged from 3 to 8 day and compared to those observed from the normal hearing youths. Results Wave, Ⅰ,Ⅲ and Ⅴ were identifiable in alI of 160 ears at 130 dB Pe- SPL. The threshold of wave Ⅴ to click stimuli was 61 .94±6.87 dB peSPL, significantly higher than that in adults. Both latencies for wave Ⅰ,Ⅲ and Ⅴ and interwaves latencies Ⅰ-Ⅲ, Ⅲ- Ⅴ and Ⅰ- Ⅴ were significantly tonger than those for the adults under identical test conditions. The ratio of interwaves latency Ⅲ- Ⅴ to Ⅰ- Ⅲ for normal newborn was 0.71±0.12, statisitically smaller than that in adults. Conclusion Click level 70 dB pe- SPL appeared to be a feasible criterion of threshold of ABR for newborn hearing screening. There were no significant effects of sex and ear in newborn hearing screening. The auditory system of the newborns was not equally mature. The neurological system is the primary source of differences between newborns and adults.