Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China.
Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China.
Eur J Paediatr Neurol. 2014 Mar;18(2):193-200. doi: 10.1016/j.ejpn.2013.11.004. Epub 2013 Nov 18.
Whether hyperbilirubinemia suppresses electrophysiological activity of the neonatal auditory brainstem remains to be investigated.
To determine whether hyperbilirubinemia suppresses the brainstem auditory electrophysiology in term neonates.
Maximum length sequence brainstem auditory evoked response (MLS BAER) was recorded shortly after confirming hyperbilirubinemia in 58 term neonates. Wave amplitudes of the response were analyzed in detail.
Compared with age-matched term controls, the neonates with hyperbilirubinemia showed a significant reduction in the amplitudes of MLS BAER waves III and particularly V at all click rates 91-910/s. The reduction tended to be more significant at higher than lower rates. Wave I amplitude was reduced at 910/s. V/I amplitude ratio was decreased at all click rates. Therefore, the amplitudes of MLS BAER, particularly later, waves were all reduced. The amplitudes of all MLS BAER waves tended to be reduced with the increase in total serum bilirubin level. All wave amplitudes were correlated with the level of total serum bilirubin at some or most click rates.
Brainstem auditory electrophysiology is suppressed in neonates with hyperbilirubinemia, which related to the severity of hyperbilirubinemia. Wave amplitudes are valuable BAER variables to detect functional impairment of the brainstem and auditory pathway in neonatal hyperbilirubinemia, and are recommended to be used in assessing bilirubin neurotoxicity to the neonatal brain.
高胆红素血症是否会抑制新生儿听觉脑干的电生理活动仍有待研究。
确定高胆红素血症是否会抑制足月新生儿的脑干听觉电生理。
在确认 58 例足月新生儿高胆红素血症后不久，记录最大长度序列脑干听觉诱发电位（MLS BAER）。详细分析反应的波幅。
与年龄匹配的足月对照组相比，高胆红素血症新生儿在所有刺激率 91-910/s 时，MLS BAER 波 III，尤其是 V 的波幅明显降低。在较高的刺激率下，降低趋势更为显著。在 910/s 时，波 I 的振幅降低。在所有刺激率下，V/I 振幅比降低。因此，MLS BAER 的波幅，特别是后期波的振幅均降低。随着总血清胆红素水平的升高，所有 MLS BAER 波的振幅均有降低的趋势。所有波的振幅均与总血清胆红素水平在某些或大多数刺激率下相关。
高胆红素血症新生儿的脑干听觉电生理受到抑制，与高胆红素血症的严重程度有关。波幅是检测新生儿高胆红素血症中脑干和听觉通路功能损害的有价值的 BAER 变量，建议用于评估胆红素对新生儿大脑的神经毒性。
