先天性巨细胞病毒感染患儿的听力筛查  

Hearing screening in infants with congenital cytomegalovirus infection

作　　者：莫薇[1] 章毅英[1] 雷云秋[1] 孙伟[1] 邵佩芬[1] 孙越峰[1] 周媛媛[1] 赵正言[1] 

机构地区：[1]浙江大学医学院附属儿童医院耳鼻喉科,浙江杭州310003

出　　处：《浙江大学学报（医学版）》2005年第4期358-360,共3页Journal of Zhejiang University(Medical Sciences)

基　　金：浙江省计生委科研基金资助项目(720030127)

摘　　要：目的:探讨先天性巨细胞病毒(CMV)感染对婴幼儿听力的影响.方法:应用耳声发射(DPOAE)、听觉脑干诱发电位(ABR), 对38例先天性CMV感染儿(感染组)及16例非感染儿(对照组),于新生儿期进行听力筛查及评估.结果:感染组38例66耳(86.8%)通过首次筛查,6个月内复查58耳(76.3 %)通过;6个月以后随访52耳(68.4%)通过.对照组16例31耳(96.9%)通过.感染组38例76 耳,极重度听力损失13耳(17.1%),重度听力损失5耳(6.6%),中重度听力损失6耳(7 .9%).感染组婴幼儿ABRⅤ波反应阈值明显高于对照组(P<0.005).在随访中感染组听力损失,新生儿期3例(7.9%),3～4个月9例(23.7%),6个月以后3例(7.9%). 结论:先天性CMV感染可引起速发性与迟发性听力损失.采用检测先天性CMV 感染与新生儿听力筛查相结合的方法进行听力筛查及评估,可早期发现听力异常.Objective： To investigate the impact of congenital cytomegalovirus infection on the hearing ability in infants. Methods ： By using the tools of distortion product otoacoustic emission （DPOAE） and auditory brain-stem response （ABR）,the hearing ability of 38 infants with congenital cytomegalovirus infection and 16 cases of normal controls during neonatal periods was screened with a follow-up study at 6 and 24 months. Results： In infants with congenital cytomegalovirus infection,86.8% （66/76） ears at neonatal stage and 76.3% （58/76） ears at 6 months passed the tests; while in normal controls, 96.9 % （31/32） ears passed the tests. The reaction threshold of ABR V in infants with congenital cytomegalovirus infection was higher than that in normal controls （P 〈 0. 005）. Furthermore,in infants with congenital cytomegalovirus infection, 13 ears （17.1%） were extreme hearing loss, 5 ears （6.6%） were severe hearing loss,and 6 ears （7.9%） were moderately severe hearing loss. The incidence of hearing loss during the follow-up was 7.9% （3/38） at neonatal stage,23.7% （9/38） at 3-4 months,and 7.9% （3/38） after 6 months. Conclusion： The congenital cytomegalovirus infection could cause the prompt and late-onset hearing loss. The combination of the laboratory evidence with the dynamic hearing screening may contribute to the early detection of hearing loss in infants with congenital cytomegalovirus infection.

关 键 词：测听法 诱发反应 巨细胞病毒感染/先天性 听力障碍/病因学 随访研究 诱发电位 听觉 脑干 耳声发射 

分 类 号：R725.1[医药卫生—儿科]