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极早产儿和晚期早产儿听觉脑干反应的变化

Changes in Auditory Brainstem Response in very preterm and late preterm infants.

作者信息

Seethapathy Jayashree, Boominathan Prakash, Uppunda Ajith Kumar, Ninan Binu

机构信息

Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India.

Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India.

出版信息

Int J Pediatr Otorhinolaryngol. 2019 Jun;121:88-94. doi: 10.1016/j.ijporl.2019.03.008. Epub 2019 Mar 9.

Abstract

AIM

Aim of this study was to compare the absolute and interpeak latencies of Auditory Brainstem Responses (ABR) in very preterm and late preterm infants at 1 month and 3 months of corrected age.

METHOD

ology: ABR traces were obtained from 80 preterm infants (40 very preterm and 40 late preterm) at 1 month and 3 months of corrected age in a prospective, comparative cohort study. Auditory click stimuli at 70 dBnHL and 30 dBnHL, with repetition rate of 11.1/s were used. Absolute latencies of peak I, III, V and interpeak latencies of peak I-V, I-III and III-V were analyzed and compared between preterm groups at 1 month and 3 months of corrected age. Wilcoxon Signed Ranks test was used to compare the ABR variables. Mann Whitney test was used to make inferences between groups.

RESULTS

There was a statistically significant difference in absolute latencies and interpeak latencies between very preterm and late preterm infants at 1 month of corrected age (p < 0.05). Absolute latency of peak I was similar among both groups of preterms. Absolute latencies of peak III, V and interpeak latencies I-III, III-V and I-V were prolonged in very preterm infants at 1 month of corrected age. However, these latencies were significantly reduced at 3 months of corrected age. This indicated accelerated maturation/myelination of the central auditory nervous system in very preterm infants. Absolute latencies of peak III and V and interpeak interval I-V was reduced in late preterm infants at 3 months of corrected age and this was statistically significant. This reduction in latency was considered to be a normal age dependent change.

CONCLUSION

Findings of the current study revealed that there was no deviation in the pattern of auditory maturation among preterms; it followed the typical 'caudal to rostral' form of maturation. Very preterm infants have less mature neuronal development compared with late preterm infants at 1 month of corrected age which catches up at 3 months of corrected age.

摘要

目的

本研究旨在比较极早产儿和晚期早产儿在矫正年龄1个月和3个月时听觉脑干反应(ABR)的绝对潜伏期和峰间潜伏期。

方法

在一项前瞻性比较队列研究中,对80名早产儿(40名极早产儿和40名晚期早产儿)在矫正年龄1个月和3个月时进行ABR检测。使用70 dBnHL和30 dBnHL的听觉点击刺激,重复率为11.1/s。分析并比较矫正年龄1个月和3个月时早产儿组之间峰I、III、V的绝对潜伏期以及峰I-V、I-III和III-V的峰间潜伏期。采用Wilcoxon符号秩检验比较ABR变量。采用Mann Whitney检验进行组间推断。

结果

在矫正年龄1个月时,极早产儿和晚期早产儿之间的绝对潜伏期和峰间潜伏期存在统计学显著差异(p<0.05)。两组早产儿的峰I绝对潜伏期相似。在矫正年龄1个月时,极早产儿的峰III、V绝对潜伏期以及峰I-III、III-V和I-V的峰间潜伏期延长。然而,在矫正年龄3个月时,这些潜伏期显著缩短。这表明极早产儿的中枢听觉神经系统成熟/髓鞘形成加速。在矫正年龄3个月时,晚期早产儿的峰III和V绝对潜伏期以及峰间间隔I-V缩短,且具有统计学意义。潜伏期的这种缩短被认为是正常的年龄依赖性变化。

结论

本研究结果表明,早产儿的听觉成熟模式没有偏差;它遵循典型的“尾端到头端”成熟形式。在矫正年龄1个月时,极早产儿的神经元发育比晚期早产儿更不成熟,而在矫正年龄3个月时则赶上了晚期早产儿。

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