Agrawal V K, Shukla R, Misra P K, Kapoor R K, Malik G K
Department of Pediatrics, King George's Medical College, Lucknow.
Indian Pediatr. 1998 Jun;35(6):513-8.
To determine the initial Brainstem Auditory Evoked Response (BAER) abnormalities in neonates with hyperbilirubinemia and the possible reversibility of abnormal BAER after therapy.
Prospective cohort study.
Tertiary care hospital.
30 term neonates with hyperbilirubinemia (S. bilirubin < 15 mg/dl) as cases and 25 normal term neonates as controls.
Duration of study was from August 1995 to August 1996. BAER were recorded before therapy at peak hyperbilirubinemia, after therapy, and the age of 2-4 months using electric response audiometer (Nihon Neuropack Four Machine). Denver Development Screening Test (Denver II) was performed at 1 year of age.
Seventeen out of thirty (56.7%) neonates with hyperbilirubinemia showed abnormalities on initial BAER. Commonest abnormality seen was raised threshold of wave V in 12 neonates (40%). Other abnormalities observed were absence of all waves at 90 dB (23.3%), prolongation of latencies of various waves (26.7%) and prolongation of various intervals (26.7%). Abnormalities in BAER correlated significantly with bilirubin level. After therapy abnormalities reverted back to normal in 10 cases but persisted in 7 out of 17 (41.17%) cases with initial abnormal BAER. Development screening at 1 yr was abnormal in 3 infants all of whom had persistent abnormalities in BAER.
Serial BAER is a useful, non invasive tool to detect neurodevelopment delay secondary to neonatal hyperbilirubinemia.
确定高胆红素血症新生儿最初的脑干听觉诱发电位（BAER）异常情况以及治疗后异常BAER的可能可逆性。
前瞻性队列研究。
三级护理医院。
30例足月高胆红素血症新生儿（血清胆红素<15mg/dl）作为病例组，25例正常足月新生儿作为对照组。
研究时间为1995年8月至1996年8月。使用电反应听力计（日本光电Neuropack Four机器）在高胆红素血症高峰期治疗前、治疗后以及2 - 4个月龄时记录BAER。1岁时进行丹佛发育筛查测试（丹佛II）。
30例高胆红素血症新生儿中有17例（56.7%）在最初的BAER检查中显示异常。最常见的异常是12例新生儿（40%）V波阈值升高。观察到的其他异常包括90dB时所有波消失（23.3%）、各波潜伏期延长（26.7%）以及各间期延长（26.7%）。BAER异常与胆红素水平显著相关。治疗后，10例异常恢复正常，但17例最初BAER异常的病例中有7例（41.17%）持续异常。1岁时的发育筛查中，3名婴儿异常，他们的BAER均持续异常。
连续BAER是检测新生儿高胆红素血症继发神经发育延迟的一种有用的非侵入性工具。
