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高胆红素血症新生儿的脑干听觉诱发电位测定(BERA)

Brainstem Evoked Response Audiometry (BERA) in Neonates with Hyperbillirubinemia.

作者信息

Soni Annanya, Kanaujia Surendra Kumar, Kaushik Sandeep

机构信息

Department of ENT, GSVM Medical College, Room No 100, PG Girls Hostel, Kanpur, India.

Department of ENT, GSVM Medical College, Kanpur, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2016 Sep;68(3):334-8. doi: 10.1007/s12070-014-0811-6. Epub 2014 Dec 3.

Abstract

(1) To study the BERA changes in neonates with unconjugated hyperbilirubinemia. (2) To compare the BERA changes in the neonates with unconjugated hyperbilirubinemia before and after therapy. Thirty consecutive term appropriate for gestational age (AGA) neonates presenting to NICU with total serum bilirubin requiring intervention (using the American Academy of Pediatrics guidelines) were included in the study as cases and thirty normal term AGA neonates with uneventful peri-natal period and a maximum measured serum bilirubin <12 mg/dl in case of term baby were included as controls after obtaining informed consent. Initial BERA was done within 3-24 h of hospitalization after obtaining informed consent from parents, at the time of discharge and at 3 month followup. Machine used for recording BERA was intelligent hearing system version 3.3. In our study out of the 30 cases 10 (33.3 %) cases were found to have BERA changes in the form of absent wave forms, raised threshold, prolonged latencies or prolonged inter peak latencies. In our study, it was observed that there was statistically significant correlation (p value < 0.005) between increasing bilirubin level and BERA changes. Correlation of the findings of this study with previous few studies indicates that BERA can be used as a useful non invasive tool to determine auditory functions in the neonate especially changes of early bilirubin toxicity.

摘要

(1) 研究未结合型高胆红素血症新生儿的脑干听觉诱发电位(BERA)变化。(2) 比较未结合型高胆红素血症新生儿治疗前后的BERA变化。本研究纳入30例连续足月适于胎龄(AGA)、因血清总胆红素需要干预(按照美国儿科学会指南)而入住新生儿重症监护病房(NICU)的新生儿作为病例组,另纳入30例围产期情况正常、足月AGA且足月婴儿最大测得血清胆红素<12mg/dl的新生儿作为对照组,两组均获得知情同意。在获得家长知情同意后,于住院3 - 24小时内、出院时及3个月随访时进行初始BERA检测。用于记录BERA的仪器为智能听力系统3.3版。在我们的研究中,30例病例中有10例(33.3%)出现BERA变化,表现为波形缺失、阈值升高、潜伏期延长或峰间潜伏期延长。在我们的研究中,观察到胆红素水平升高与BERA变化之间存在统计学显著相关性(p值<0.005)。本研究结果与之前一些研究的相关性表明,BERA可作为一种有用的非侵入性工具,用于确定新生儿的听觉功能,尤其是早期胆红素毒性的变化。

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