Department of Pediatrics, Aichi Medical University, 1-1 Yazako Karimata, Nagakute, Aichi 480-1195, Japan.
Department of Pediatric Neurology, Bobath Memorial Hospital, 1-6-5 Higashinakahama, Joto-ku, Osaka 536-0023, Japan.
Early Hum Dev. 2021 Mar;154:105319. doi: 10.1016/j.earlhumdev.2021.105319. Epub 2021 Jan 26.
To clarify auditory brainstem response (ABR) in preterm infants with bilirubin encephalopathy and the relationships between ABR and clinical variables.
We retrospectively reviewed the ABR waveforms of 56 preterm infants with BE and graded them as "no response", "abnormal interwave separation", or "normal". Patient backgrounds, the peak total bilirubin level, the bilirubin/albumin ratio, verbal communication ability, and newborn hearing screening test results from an automated ABR evaluation had been collected during an earlier nationwide survey.
The frequency of abnormal ABR findings decreased with age. Verbal communication tended to be poorer in patients with more severe ABR abnormalities. ABR findings improved in 7 of 29 infants with available serial ABR data. Both gestational age and the peak total bilirubin level were relatively lower in patients with than in those without improved ABR findings. Newborn hearing screening using automated ABR evaluation yielded data consistent with manual ABR findings in 16 of 20 patients who underwent both examinations.
ABR abnormalities in preterm infants with bilirubin encephalopathy may improve over time, especially in those with a lower gestational age and peak total bilirubin level. Newborn hearing screening using automated ABR may fail to detect abnormalities in some infants.
阐明胆红素脑病（bilirubin encephalopathy，BE）早产儿的听性脑干反应（auditory brainstem response，ABR）情况，并探讨 ABR 与临床变量之间的关系。
我们回顾性分析了 56 例 BE 早产儿的 ABR 波形，并将其分为“无反应”、“波间间隔异常”或“正常”。在全国范围内的早期调查中，收集了患者背景、总胆红素峰值、胆红素/白蛋白比值、言语交流能力和自动 ABR 评估的新生儿听力筛查测试结果。
异常 ABR 发现的频率随年龄而降低。言语交流能力在 ABR 异常更严重的患者中较差。在有可获得的连续 ABR 数据的 29 例婴儿中，有 7 例 ABR 发现得到改善。与 ABR 发现无改善的患者相比，有改善的患者的胎龄和总胆红素峰值相对较低。在接受了自动 ABR 和手动 ABR 检查的 20 例患者中，16 例新生儿听力筛查使用自动 ABR 评估得出的数据与手动 ABR 结果一致。
胆红素脑病早产儿的 ABR 异常可能随时间改善，尤其是胎龄和总胆红素峰值较低的患者。新生儿听力筛查使用自动 ABR 可能无法检测到一些婴儿的异常。
