诱发电位对新生儿高胆红素血症亚临床神经中毒症的评估意义  

Significance of evoked potential in evaluating sub-clinical neurotoxicosis in neonates with hyperbilirubinemia

作　　者：李丽[1] 王秋月[1] 王桂芳[1] 

机构地区：[1]新乡市中心医院儿科,河南省新乡市453000

出　　处：《中国临床康复》2004年第21期4286-4287,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨诱发电位在新生儿高胆红素血症亚临床神经中毒症临床应用中的价值。方法:采用脑干听觉诱发电位(BAEP),闪光视觉诱发电位(F-VEP)检测50例新生儿高胆红素血症尚未出现胆红素脑病时的神经电生理变化(其中单独检测BAEP25例,同时检测BAEP和F-VEP25例),与同期因轻度呼吸道和肠道疾病而就诊的住院足月适龄儿的BAEP,VEP资料作为对照组。结果:高胆红素血症患儿BAEP的I,III,V波的出波率及各波分化良好率均明显低于对照组,差异均有显著性意义(P<0.005～0.025);I,III,V波的潜伏期均明显延长,与对照组比较,差异有显著性意义(P均<0.001);I～III,III～V,I～V波间期与对照组比较无显著延长;F-VEP主波潜伏期为(235.5±40.5)ms与对照组比较,差异有显著性意义(t=5.85,P<0.001)。结论:BAEP和VEP检测在新生儿高胆红素血症中的早期诊断中有较高的敏感性,尤其是对于其听力损伤和神经系功能改变特异性较强。AIM:To explore the value of evoked potential in evaluating the sub clinical neurotoxicosis in neonates with hyperbilirubinemia. METHODS:Electroneurophysiological changes were detected by brainstem auditory evoked potential(BAEP) and flash visual evoked potential(F VEP) tests in 50 neonates with hyperbilirubinemia before bilirubin encephalopathy occurred(25 neonates were detected with BAEP only,and another 25 neonates with BAEP and F VEP),at the same time,the data of BAEP and F VEP of hospitalized neonates with mild respiratory and bowel diseases were taken as the control group. RESULTS:The I,III,V wave rates of BAEP and better differentiation rate in neonates with hyperbilirubinemia were significantly lower than those in the control group(P< 0.005-0.025); the latencies of I,III,V waves were prolonged obviously, significantly different from those in the control group(P< 0.001);the intervals of I-III,III-V,I-V waves were not prolonged significantly as compared with those in the control group;the latency of the main wave of F VEP was(235.5±40.5) ms,significantly different from that in the control group(t=5.85,P< 0.001).CONCLUSION:BAEP and VEP tests have higher sensibilities in the early diagnosis of hyperbilirubinemia in neonates,especially in the diagnosis of auditory injury and nerve system functional changes.

关 键 词：诱发电位 新生儿 高胆红素血症 亚临床神经中毒症 诊断 

分 类 号：R722.17[医药卫生—儿科]