Zheng Zong, Liu Hong-Yan, Yang Shan-Pu, DU Li-Zhong
Department of Pediatrics, People's Hospital of Yuhuan, Taizhou, Zhejiang 317600, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2021 May;23(5):499-504. doi: 10.7499/j.issn.1008-8830.2102049.
To study brainstem auditory evoked potential (BAEP) in neonates with hyperbilirubinemia using short auditory stimuli (60 dBnHL), and to investigate the differences in the inter-aural latency difference (ILD) of wave V between neonates with different total serum bilirubin (TSB) levels.
A prospective study was conducted in neonates with hyperbilirubinemia who were admitted to the Department of Neonatology, Yuhuan People's Hospital of Zhejiang Province, from May 2019 to October 2020. The neonates were divided into a severe group (=50) and a mild group (=50) according to their TSB levels. The mild group was divided into two subgroups: 7-10 days (=20) and 11-14 days (=20) according to their age. ILD was compared between the neonates with different TSB levels, and its diagnostic value was analyzed.
Compared with the mild group, the severe group had significantly higher proportions of neonates with abnormal hearing threshold and abnormal ILD ( < 0.05) and a significantly larger ILD of wave V ( < 0.05). The latency of wave V (left ear) in the 7-10 days subgroup was significantly longer than that in the 11-14 days subgroup ( < 0.05), but there was no significant difference in the ILD of wave V between the two groups ( > 0.05). The receiver operating characteristic (ROC) analysis showed that ILD had predictive value for hearing impairment caused by neonatal hyperbilirubinemia ( < 0.05), with an area under the ROC curve of 0.727 as well as a sensitivity of 52.4% and a specificity of 90.9% at the optimal cut-off value of 0.365 ms.
Serum bilirubin in neonates affects the ILD of BAEP wave V, especially in those with severe hyperbilirubinemia. ILD at the optimal cut-off value of ≥0.4 ms shows potential value in the diagnosis of hearing impairment caused by neonatal hyperbilirubinemia.
采用短声刺激(60 dBnHL)研究高胆红素血症新生儿的脑干听觉诱发电位(BAEP),并探讨不同总血清胆红素(TSB)水平新生儿V波双耳潜伏期差值(ILD)的差异。
对2019年5月至2020年10月浙江省玉环市人民医院新生儿科收治的高胆红素血症新生儿进行前瞻性研究。根据TSB水平将新生儿分为重度组(n = 50)和轻度组(n = 50)。轻度组根据年龄分为两个亚组:7 - 10天(n = 20)和11 - 14天(n = 20)。比较不同TSB水平新生儿的ILD,并分析其诊断价值。
与轻度组相比,重度组听力阈值异常和ILD异常的新生儿比例显著更高(P < 0.05),V波的ILD显著更大(P < 0.05)。7 - 10天亚组左耳V波潜伏期显著长于11 - 14天亚组(P < 0.05),但两组V波ILD差异无统计学意义(P > 0.05)。受试者工作特征(ROC)分析显示,ILD对新生儿高胆红素血症所致听力损害具有预测价值(P < 0.05),在最佳截断值为0.365 ms时,ROC曲线下面积为0.727,灵敏度为52.4%,特异度为90.9%。
新生儿血清胆红素影响BAEP V波的ILD,尤其是重度高胆红素血症患儿。最佳截断值≥0.4 ms的ILD在新生儿高胆红素血症所致听力损害诊断中显示出潜在价值。