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高胆红素血症对接受光疗的新生儿听觉脑干反应的影响。

Effects of Hyperbilirubinemia on Auditory Brainstem Response of Neonates Treated with Phototherapy.

作者信息

Salehi Negin, Bagheri Fereshte, Ramezani Farkhani Hamid

机构信息

Department of Audiology, School of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Otorhinolaryngol. 2016 Jan;28(84):23-9.

Abstract

INTRODUCTION

One of the most common pathologies in neonates is hyperbilirubinemia, which is a good marker for damage to the central nervous system. The sensitivity of the auditory system to bilirubin has been previously documented, with much discrepancy in its effects on Auditory Brainstem Response results. Thus the objective of this study was to evaluate the effects of hyperbilirubinemia on Auditory Brainstem Response of neonates treated with phototherapy.

MATERIALS AND METHODS

Forty-two term neonates with hyperbilirubinemia, who underwent phototherapy participated in this cross sectional study. The recording of Auditory Brainstem Response was made shortly after confirming that the total serum bilirubin level was greater than 15 µg/dl. Latency of waves I, III, V and inter-peak latencies of the waves were measured. To test the hypothesis about the difference of means between the two groups, continuous variables were compared using either the t-test (normal distribution) or the Mann-Whitney test (non-normal distribution).

RESULTS

There was a significant increase in the absolute latencies of waves III and V, and I-III and I-V inter-peak latencies of the sample group compared to the control group in both ears (P<0.05). However, wave I absolute latency and III-V inter-peak interval did not show a significant difference between the two study groups (P>0.05).

CONCLUSION

The results of this study underline the importance of the Auditory Brainstem Response Test as an efficient tool for monitoring the auditory brainstem pathway in neonates who are at risk of neurotoxicity and for diagnosing the earliest stages of auditory damage caused by high levels of bilirubin.

摘要

引言

新生儿最常见的病症之一是高胆红素血症,它是中枢神经系统损伤的一个良好指标。此前已有文献记载听觉系统对胆红素的敏感性,但其对听觉脑干反应结果的影响存在很大差异。因此,本研究的目的是评估高胆红素血症对接受光疗的新生儿听觉脑干反应的影响。

材料与方法

42名接受光疗的足月高胆红素血症新生儿参与了这项横断面研究。在确认血清总胆红素水平大于15µg/dl后不久进行听觉脑干反应记录。测量I、III、V波的潜伏期以及各波之间的峰间潜伏期。为检验两组均值差异的假设,连续变量采用t检验(正态分布)或曼-惠特尼检验(非正态分布)进行比较。

结果

与对照组相比,样本组双耳的III波和V波绝对潜伏期以及I-III和I-V峰间潜伏期均显著增加(P<0.05)。然而,I波绝对潜伏期和III-V峰间间期在两个研究组之间未显示出显著差异(P>0.05)。

结论

本研究结果强调了听觉脑干反应测试作为一种有效工具的重要性,可用于监测有神经毒性风险的新生儿的听觉脑干通路,并诊断由高水平胆红素引起的听觉损伤的最早阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4aa/4735613/689e8dcf9aa3/ijo-28-023-g001.jpg

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