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胎龄小于 30 周的早产儿校正出生后 4 个月时的脑干听觉通路功能。

Brainstem auditory pathway function at four months of corrected postnatal age in preterm infants born below 30 week gestation.

机构信息

Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China.

Division of Neonatology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China.

出版信息

Brain Dev. 2020 Aug;42(7):496-502. doi: 10.1016/j.braindev.2020.04.004. Epub 2020 Apr 23.

Abstract

OBJECTIVE

Functional status of the brainstem auditory pathway was examined at four months of corrected postnatal age in infants born below 30 week gestation to assess the effect of very or extremely preterm birth on postnatal development of the pathway.

METHODS

Thirty-four preterm infants born at 24-29 week gestation (GA24-29w) were studied at four months of corrected postnatal age. Normal controls were 38 postnatal age-matched term infants. Maximum length sequence brainstem auditory evoked response (MLS BAER) were recorded and analysed with 60 dB nHL clicks.

RESULTS

Compared with term control group, GA24-29w group manifested higher BAER threshold (p < 0.05), longer MLS BAER wave latencies at all click rates 91-910/s (p < 0.01-0.001), and lower wave amplitudes at most click rates (p < 0.05-0.01). No significant differences were found between the two groups in I-V interval at any click rates. I-III interval was shorter while III-V interval was longer in GA24-29w group than in term group at higher rates (all p < 0.05). III-V/I-III interval ratio in GA24-29w group was greater at 455 and 910/s clicks (p < 0.05 and 0.01). These interval variables showed similar changes when 4 GA24-29w infants with threshold elevation were excluded.

CONCLUSIONS

At four months of corrected postnatal age, infants born below 30 week gestation manifested elevated BAER threshold, increased wave latencies, and reduced amplitude. They also manifested a small decrease in I-III interval but a small increase in III-V interval at high rates. Very or extremely preterm birth exerts a mild or moderate effect on postnatal development of the brainstem auditory pathway.

摘要

目的

在纠正出生后 4 个月的胎龄时,检查胎龄小于 30 周的婴儿的脑干听觉通路的功能状态,以评估极早产或超早产对通路出生后发育的影响。

方法

研究了 34 名胎龄 24-29 周(GA24-29w)的早产儿,他们在纠正出生后 4 个月时进行了检查。正常对照组为 38 名与出生时年龄相匹配的足月婴儿。使用 60dB nHL 点击记录并分析最大长度序列脑干听觉诱发电位(MLS BAER)。

结果

与足月对照组相比,GA24-29w 组的 BAER 阈值较高(p<0.05),所有点击率(91-910/s)的 MLS BAER 波潜伏期较长(p<0.01-0.001),大多数点击率的波幅较低(p<0.05-0.01)。在任何点击率下,两组之间的 I-V 间期均无显著差异。在较高的速率下,GA24-29w 组的 I-III 间期较短,III-V 间期较长(均 p<0.05)。GA24-29w 组在 455 和 910/s 点击时,III-V/I-III 间隔比更大(p<0.05 和 0.01)。当排除 4 名阈值升高的 GA24-29w 婴儿后,这些间隔变量显示出类似的变化。

结论

在纠正出生后 4 个月时,胎龄小于 30 周的婴儿表现出 BAER 阈值升高、波潜伏期延长和振幅降低。他们在高速率时还表现出 I-III 间隔略有减小,但 III-V 间隔略有增加。极早产或超早产对脑干听觉通路的出生后发育有轻度或中度影响。

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