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围产期窒息后脑干听觉结果及其与神经发育的相关性。

Brainstem auditory outcomes and correlation with neurodevelopment after perinatal asphyxia.

作者信息

Jiang Ze D, Liu Xian Y, Shi Bin P, Lin Li, Bu Cui F, Wilkinson Andrew R

机构信息

Department of Pediatrics, Children's Hospital, Fudan University, Shanghai, China.

出版信息

Pediatr Neurol. 2008 Sep;39(3):189-95. doi: 10.1016/j.pediatrneurol.2008.06.013.

Abstract

We used brainstem auditory-evoked responses and neurodevelopmental assessment to detect abnormalities and correlations between such responses and neurodevelopmental outcomes in 78 children (aged 4-12 years) who survived perinatal asphyxia. Twenty children had brainstem auditory-evoked response abnormalities, including increased threshold, reduced wave V amplitude, decreased V/I amplitude ratio, and prolonged I-V interval. Thirty-seven exhibited neurodevelopmental deficits, including cerebral palsy and developmental delay. The remaining 41 exhibited no deficits. Brainstem auditory-evoked response abnormalities were evident in 15 of 37 (40.5%) children with neurodevelopmental deficits, but in only 5 of 41 (12.2%) with no deficits, which differed significantly (chi(2) = 8.2, P < 0.05). The sensitivity, specificity, positive predictive value, and false-negative rate of brainstem auditory-evoked responses to reflect neurodevelopmental outcomes were 40.5%, 87.8%, 75.0%, and 59.5%, respectively. These findings suggest that in children who survive perinatal asphyxia, brainstem auditory impairment occurs more frequently in those with versus those without neurodevelopmental deficits. Brainstem auditory-evoked responses display a moderate correlation with clinically determined neurodevelopmental outcomes. Despite limitations, brainstem auditory-evoked response is valuable for assessing auditory and neurodevelopmental outcomes after perinatal asphyxia.

摘要

我们采用脑干听觉诱发电位和神经发育评估,来检测78名围产期窒息存活儿童(4至12岁)的异常情况,以及这些反应与神经发育结局之间的相关性。20名儿童存在脑干听觉诱发电位异常,包括阈值升高、V波幅降低、V/I波幅比值降低以及I-V间期延长。37名儿童存在神经发育缺陷,包括脑瘫和发育迟缓。其余41名儿童无缺陷。37名有神经发育缺陷的儿童中有15名(40.5%)存在脑干听觉诱发电位异常,而41名无缺陷的儿童中只有5名(12.2%)存在异常,差异有统计学意义(χ² = 8.2,P < 0.05)。脑干听觉诱发电位反映神经发育结局的敏感性、特异性、阳性预测值和假阴性率分别为40.5%、87.8%、75.0%和59.5%。这些发现表明,在围产期窒息存活的儿童中,有神经发育缺陷的儿童比无神经发育缺陷的儿童更容易出现脑干听觉损伤。脑干听觉诱发电位与临床确定的神经发育结局呈中度相关。尽管存在局限性,但脑干听觉诱发电位对于评估围产期窒息后的听觉和神经发育结局具有重要价值。

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