不同微量血胆红素值与畸变产物耳声发射的相关性研究  

Correlation between serum bilirubin and distortion product otoacoustic emission

作　　者：林新祝 刘生荣 郑直 李雅丹 赖基栋 

机构地区：[1]厦门市妇幼保健院林巧稚妇儿医院新生儿科,厦门361000 [2]厦门市妇幼保健院林巧稚妇儿医院听力筛查中心,厦门361000

出　　处：《发育医学电子杂志》2013年第2期83-86,共4页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的 探讨不同微量血胆红素值与畸变产物耳声发射(DPOAE)的相关性,并提出胆红素干预的阈值.方法 选择2007年1月至2009年12月在我院出生的足月顺娩新生儿630例,分别测定微量血胆红素值与DPOAE的通过率,所有病例均排除高危因素,从85μmol/L开始,到444.6μ mol/L,每增加17.1μmol/L为一个测定段,共有21个测定段,每段有30例.根据微量血胆红素值与第1次筛查出现不能通过的例数进行相关和回归分析.结果 630例新生儿第1次DPOAE筛查未通过有25例,其中10例左耳,12例右耳,3例为双侧,占3.97％；最后确诊耳聋病例有2例,其中1例左耳,1例为双侧,均为轻度耳聋,占0.32％.在微量血胆红素值239.4μmol/L时(第10测定段),出现第1例DPOAE未通过病例,以后随着微量血胆红素值的增高,DPOAE未通过病例逐渐增多,直线回归方程:Y=-2.0105+0.2587X,P=0.0009,所以两个变量间有直线回归关系.回归系数b=0.2587,即胆红素测定段数每变动1,DPOAE异常例数平均变动0.2587个.结论 微量血胆红素值为239.4～256.5μmol/L(第10测定段)为干预的阈值,即应给予及时干预,以期尽快降低胆红素值,避免胆红素神经毒性的出现.Objectives To explore the correlation between serum bilirubin and distortion product otoacoustic emission(DPOAE),and get the threshold of bilirubin for intervention.Methods 630 cases of term infants,spontaneous labor,from January 2007 to December 2009,were tested for serum bilirubin and distortion product otoacoustic emission.From 85μmol/l to 444.6μmol/l of bilirubin,every 17.1μmol/l was regarded as a range interval which included 30 cases.Regression analysis was applied for correlation analysis of serum bilirubin and cases who didn't past the first DPOAE test.Results Theres 25 cases(3.97%)who didn't past the first test among 630 cases,10 cases for left ear,12 cases for right ear,and 3 cases for both.2 cases(0.32%)were finally diagnosed as deafness,one for left ear,and the other for both ears.The first case who didn't past the first DPOAE test at the time when bilirubin reached 239.4μmol/L(tenth range interval).With the increase in bilirubin value,the number of cases who failed to the test increased.The linear regression equation was written as Y=-2.0105+0.2587X(P=0.0009),suggesting the relationship of linear regression between two variables.Conclusion When serum biliruhin reached 239.4-256.5μmol/L,we should take measures to decrease level of bilirubin and avoid bilirubin-associated neurotoxicity.

关 键 词：微量血胆红素 畸变产物耳声发射 脑干听觉诱发电位 听力损害 

分 类 号：R722.1[医药卫生—儿科]