高胆红素血症新生儿脑血流速度与脑干听觉诱发电位的相关性研究  

Study on the relationship between auditory brainstem response potential and cerebral blood flow rate in the newborns with hyperbilirubinemia

作　　者：陈为兵[1] 李宜国 顾芳香[1] 王少玲[1] 王照红[1] 

机构地区：[1]日照市人民医院新生儿科,山东省276800 [2]东港区三庄医院

出　　处：《实用诊断与治疗杂志》2007年第10期743-744,747,共3页Journal of Practical Diagnosis and Therapy

摘　　要：目的:探讨高胆红素血症新生儿脑血流速度与脑干听觉诱发电位的关系,为早期干预、治疗提供依据。方法:测定患儿血清胆红素,并检查脑干听觉诱发电位,使用经颅多普勒检测双侧大脑中动脉、大脑前动脉、大脑后动脉的收缩峰流速、舒张期末流速、平均流速及脉动指数。将脑干听觉诱发电位异常患儿41例为观察组,重度异常患儿22例为观察组。脑干听觉诱发电位正常的76例为对照组。将对照组与观察组对脑血流速度和脑干听觉诱发电位进行相关性分析。结果:高胆红素血症患儿中,脑干听觉诱发电位总的反应阈值为(59.36±25.18)dBnHL,总的异常率为45.19%。观察组、与对照组相比,血清总胆红素值和脑血流速度差异有统计学意义(P<0.01),而观察组与对照组相比,差异无统计学意义(P>0.05)。结论:血清总胆红素值越高,颅内动脉血流速度越快,其脑干听觉诱发电位异常程度越严重,提示听力损伤越严重;在综合治疗同时,改善患儿脑血流速度,可能为早期干预听力损伤的方法之一。Objective To observe the relationship between auditory brainstem response potential and cerebral blood flow rate in the newborns with hyperbilirubinemia in order to provide the evidence for the early treatment. Methods The serum bilirubin and auditory brainstem response potential were determined. The bilateral middle, anterior and posterior cerebral artery examined with transcranial Doppler, and the mean blood velocity, systolic peak blood velocity, diastolic peak blood velocity and pulsalitity index were recorded. There were 41 cases of abnormal,22 cases of severe abnormal and 76 cases of normal auditory brainstem response potential in group Ⅰ , Ⅱ and control group,respectively. The relationship was analyzed between auditory brainstem response potential and cerebral blood flow rate among the three groups. Results The total reaction threshold of auditory brainstem response potential was （56.36±19.18）dBnHL, and total exceptional rate was 45.19%. Compared to the other two groups, group Ⅱ was significantly different between cerebral blood flow rate and serum bilirublin （P（0.01）, while there was no statistic difference between group I and control group（P〉0.05）. Conclusion The hearing impairment is positively related to the serum bilirubin, the cerebral blood flow rate and the auditory brainstem response potential. Early improving the cerebral blood flow rate might be a method to prevent the hearing impairment besides the comprehensive treatment.

关 键 词：高胆红素血症 新生儿 脑干听觉诱发电位 脑血流速度 

分 类 号：R722.1[医药卫生—儿科]