Castello E, Tedeschi A, Brera S
Dipartimento Regionale Testa Collo, Ospedale S. Martino, Genova.
Acta Otorhinolaryngol Ital. 1995 Aug;15(4):265-72.
A.B.R. was employed to examine auditory pathways in a group of 78 newborn infants at risk and one of 20 normal infants. The impaired newborn group suffered of various risk factors or pathologies: 20 premature infants, 12 undersize (small for date), 12 with breathing distress, 11 hiv positive, 5 with neonatal jaundice, 4 suffered of convulsion, 4 at risk for hereditary deafness, 4 born by mothers with mellitus diabetes, 2 with dolichocefalia, 1 with the Albers-Schomberg syndrome, 1 with congenital heart disease and 1 with congenital glycogenosis. The results of A.B.R. of the risk group were compared statistically employing the "t Student's test" with those of the group of normal infants. The influence of risk factors in the first group on alterated A.B.R. parameters was then examined using a step-by-step logistic regression analysis method. The result showed a significant increase in a latency of waves V and III and inter-waves I-V and III-V in risk infants, while wave I and I-III internals were normal. These findings appear to demonstrate that in infants at risk, brainstem acoustic pathways are more sensitive to damage than the cochlea and acoustic nerve. This could be explained by the different degree of maturation that exists between the central acoustic pathways and the coclea and acoustic nerve. Analysis of the influence of pathologies and risk factors on A.B.R. indicate that birth weight followed by chronological age and length of the gestation period are significant in the development of A.B.R. alterations. The Albers-Schomberg syndrome, dolicocephalia, microcephalia, congenital glicogenosys, hiv infection, breathing difficulty and neonatal jaundice proved to be the main pathologies responsible for bringing about A.B.R. alterations.
采用听觉脑干反应(A.B.R.)检测了一组78名有风险的新生儿以及20名正常新生儿的听觉通路。有损伤的新生儿组存在各种风险因素或病症:20名早产儿、12名低体重儿(小于胎龄)、12名有呼吸窘迫、11名艾滋病毒呈阳性、5名有新生儿黄疸、4名有惊厥、4名有遗传性耳聋风险、4名母亲患有糖尿病、2名有长头畸形、1名患有阿尔伯斯-舍恩伯格综合征、1名有先天性心脏病、1名有先天性糖原贮积病。采用“t检验”将风险组的听觉脑干反应结果与正常婴儿组的结果进行统计学比较。然后使用逐步逻辑回归分析方法研究第一组中的风险因素对听觉脑干反应参数改变的影响。结果显示,风险婴儿的V波和III波潜伏期以及I-V波和III-V波间期显著增加,而I波和I-III波间期正常。这些发现似乎表明,在有风险的婴儿中,脑干听觉通路比耳蜗和听神经对损伤更敏感。这可以通过中枢听觉通路与耳蜗和听神经之间存在的不同成熟程度来解释。对病症和风险因素对听觉脑干反应影响的分析表明,出生体重、随后的实足年龄和妊娠期长度在听觉脑干反应改变的发展中具有重要意义。阿尔伯斯-舍恩伯格综合征、长头畸形、小头畸形、先天性糖原贮积病、艾滋病毒感染、呼吸困难和新生儿黄疸被证明是导致听觉脑干反应改变的主要病症。