Can Emrah, Verim Ayşegül, Başer Engin, İnan Nurkan
* Edirne State Hospital, Neonatal Intensive Care Unit , Edirne , Turkey.
Int J Audiol. 2015 Feb;54(2):89-95. doi: 10.3109/14992027.2014.938779. Epub 2014 Aug 26.
To evaluate the prevalence of auditory neuropathy (AN) in late preterms treated with phototherapy for hyperbilirubinemia.
Prospective observational study comprising late preterms treated with phototherapy for hyperbilirubinemia. Newborns were screened with combined transient-evoked otoacoustic emissions (TEOAEs) / automated auditory brainstem responses (AABR). Infants who failed screening underwent diagnostic (ABR). Infants were all re-evaluated with AABR at one year.
Eighty-five infants with a mean serum total bilirubin concentration of 22.3 ± 1.76 mg/dl; severe-hyperbilirubinemia (SH), and 102 infants with a mean serum total bilirubin concentration of 18.6 ± 1.26 mg/dl; non-severe hyperbilirubinemia (NSH) were included.
From 85 late preterms with SH, six (7.1%) failed screening and underwent diagnostic ABR for six weeks. AN was diagnosed in two (2%) infants with SH. Four (3.9%) of the 102 controls with NSH demonstrated failure at TEOAE/AABR. No AN was diagnosed in the control group at the diagnostic ABR. No statistically significant difference was found between infants treated with phototherapy for SH and NSH with regard to AN/AD either in the postnatal period or at one year. No correlation was found between serum bilirubin levels and ABR latencies or thresholds.
AN (2%) in late preterms treated with phototherapy for severe-hyperbilirubinemia was not higher than in those with non-severe hyperbilirubinemia.
评估接受光疗治疗高胆红素血症的晚期早产儿中听觉神经病(AN)的患病率。
对接受光疗治疗高胆红素血症的晚期早产儿进行前瞻性观察研究。新生儿采用瞬态诱发耳声发射(TEOAEs)/自动听性脑干反应(AABR)联合筛查。筛查未通过的婴儿接受诊断性听性脑干反应(ABR)检查。所有婴儿在1岁时再次进行AABR评估。
纳入85例平均血清总胆红素浓度为22.3±1.76mg/dl的重度高胆红素血症(SH)婴儿,以及102例平均血清总胆红素浓度为18.6±1.26mg/dl的非重度高胆红素血症(NSH)婴儿。
85例患有SH的晚期早产儿中,6例(7.1%)筛查未通过,接受了为期6周的诊断性ABR检查。2例(2%)患有SH的婴儿被诊断为AN。102例NSH对照组中有4例(3.9%)TEOAEs/AABR检查未通过。对照组在诊断性ABR检查中未诊断出AN。在出生后或1岁时,接受光疗治疗SH和NSH的婴儿在AN/AD方面未发现统计学上的显著差异。血清胆红素水平与ABR潜伏期或阈值之间未发现相关性。
接受光疗治疗重度高胆红素血症的晚期早产儿中AN(2%)的患病率并不高于非重度高胆红素血症的晚期早产儿。