Gupta A K, Raj H, Anand N K
Department of Pediatrics, Safdarjang Hospital, New Delhi.
Indian J Pediatr. 1990 Sep-Oct;57(5):705-11. doi: 10.1007/BF02728718.
The technique of ABR testing was applied to 25 infants with neonatal hyperbilirubinemia at levels exceeding that for exchange transfusion, in an attempt to study potential influence of bilirubin toxicity on the auditory brainstem pathway. The test was performed at a mean conceptional age of 40.4 +/- 0.6 weeks just after discharge. Twenty normal term neonates of comparable birth weights and conceptional ages, who had no hyperbilirubinemia, were also examined for comparison. Fifty six percent (n = 14) of the hyperbilirubinemic neonates had some abnormality in the ABR pattern, the major one being a transient increase in the threshold of wave V (7, fail-30; 5, fail-45). Wave V, however, was consistently present at 30 dBnHL click stimulus in all the normal neonates (pass-30; normal threshold). Further, mean ABR latencies (wave III, V) and 1-V interpeak latency (brainstem conduction time) were significantly prolonged in jaundiced neonates as compared with controls (P less than 0.01). ABR changes were strongly correlated with the serum bilirubin levels (P less than 0.001). On follow up retesting at 3 months, however, all infants were found to have normal ABR latencies and threshold. Neonatal jaundice was associated with significant transient aberrations of ABR, suggestive of a transient toxic brainstem encephalopathy.
将听性脑干反应（ABR）测试技术应用于25名新生儿高胆红素血症水平超过换血标准的婴儿，以研究胆红素毒性对听觉脑干通路的潜在影响。测试在出院后平均孕龄40.4±0.6周时进行。还检查了20名出生体重和孕龄相近、无高胆红素血症的正常足月儿作为对照。56%（n = 14）的高胆红素血症新生儿ABR模式存在一些异常，主要异常是V波阈值短暂升高（7例，阈值升高30dBnHL；5例，阈值升高45dBnHL）。然而，在所有正常新生儿中，在30dBnHL短声刺激下V波始终存在（阈值30dBnHL通过；阈值正常）。此外，与对照组相比，黄疸新生儿的平均ABR潜伏期（III波、V波）和I-V峰间期（脑干传导时间）显著延长（P<0.01）。ABR变化与血清胆红素水平密切相关（P<0.001）。然而，在3个月时进行的随访复测中，所有婴儿的ABR潜伏期和阈值均正常。新生儿黄疸与ABR的显著短暂异常有关，提示存在短暂性中毒性脑干脑病。
