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早产儿的低钠血症和感音神经性听力损失

Hyponatremia and sensorineural hearing loss in preterm infants.

作者信息

Ertl T, Hadzsiev K, Vincze O, Pytel J, Szabo I, Sulyok E

机构信息

Department of Obstetrics and Gynecology, Pécs University Faculty of Medicine, Pécs, Hungary.

出版信息

Biol Neonate. 2001 Feb;79(2):109-12. doi: 10.1159/000047076.

Abstract

In a case-control study the role of hyponatremia in the hearing loss of preterm infants was investigated. One hundred and sixty-four premature infants treated at the neonatal intensive care unit were screened with transient evoked otoacoustic emission (TEAOE). In 32 infants TEAOE results indicated the need for further investigations. Auditory brainstem response was performed and 22 of 32 cases had bilateral hearing impairment (HI). The birth weight and gestational age in the HI group were 1,425 +/- 528 g and 30.4 +/- 3.7 weeks. The matched control group consisted of 25 infants with a mean birth weight and gestational age of 1,410 +/- 280 g and 31.1 +/- 2.1 weeks. Significant differences were found between the HI and control groups: Apgar score (p < 0.05), pH value (p < 0.01) and pO(2) level (p < 0.05) were lower; the total dose of aminoglycosides (p < 0.01), furosemide usage (p < 0.01), the maximum pCO(2) level (p < 0.01), incubator stay (p < 0.05) and hyponatremia (p < 0.01) were higher, and the duration of hyponatremia (p < 0.05) was longer in the HI group. Multivariate logistic regression revealed that aminoglycoside treatment and hyponatremia were the two most significant factors in the development of hearing impairment. These results suggest that hyponatraemia is an additional risk factor for hearing loss in preterm infants.

摘要

在一项病例对照研究中,调查了低钠血症在早产儿听力损失中的作用。对在新生儿重症监护病房接受治疗的164名早产儿进行了瞬态诱发耳声发射(TEAOE)筛查。32名婴儿的TEAOE结果表明需要进一步检查。进行了听性脑干反应,32例中有22例患有双侧听力障碍(HI)。HI组的出生体重和胎龄分别为1425±528 g和30.4±3.7周。匹配的对照组由25名婴儿组成,平均出生体重和胎龄分别为1410±280 g和31.1±2.1周。HI组和对照组之间存在显著差异:阿氏评分(p<0.05)、pH值(p<0.01)和pO₂水平(p<0.05)较低;氨基糖苷类药物的总剂量(p<0.01)、呋塞米的使用(p<0.01)、最高pCO₂水平(p<0.01)、在暖箱中的停留时间(p<0.05)和低钠血症(p<0.01)较高,且HI组低钠血症的持续时间(p<0.05)更长。多因素逻辑回归显示,氨基糖苷类药物治疗和低钠血症是听力障碍发生的两个最显著因素。这些结果表明,低钠血症是早产儿听力损失的一个额外危险因素。

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