高胆红素血症新生儿听力筛查结果与血清胆红素水平的相关性  

Correlation between hearing screening results and serum bilirubin level in neonates with hyperbilirubinemia

作　　者：李丽娟 杨引通 秦燕 LI Li-juan;YANG Yin-tong;QIN Yan(Department of Otolaryngology Head and Neck Surgery,Xi'an People's Hospital(Xi'an Fourth Hospital),Xi'an 710004,Shaanxi,CHINA)

机构地区：[1]西安市人民医院(西安市第四医院)耳鼻咽喉头颈外科,陕西西安710004

出　　处：《海南医学》2023年第15期2191-2194,共4页Hainan Medical Journal

基　　金：陕西省西安市科技计划项目(编号:J201802030)。

摘　　要：目的探讨高胆红素血症新生儿(NHB)听力筛查结果与血清胆红素(SB)水平的相关性。方法回顾性分析2018年2月至2019年2月西安市人民医院耳鼻咽喉头颈外科收治的320例NHB患儿的临床资料。根据SB水平分为轻中度组(SB≤342μmol/L,n=96)、重度组(342μmol/L<SB≤427μmol/L,n=148)和极重度组(SB>427μmol/L,n=76),采用脑干听觉诱发电位(AABR)和瞬态耳声发射(TEOAE)联合作为初筛检查方法,对于初筛未通过的患儿采用1000 Hz鼓室声导抗测试进行复筛,比较三组患儿的听力异常率,同时比较黄疸发生时间≤48 h(n=164)及>48 h(n=156)两组间的听力异常率,并采用Pearson相关性分析SB水平与听力筛查结果间的关系。结果重度组及极重度组患儿的SB水平分别为(401.74±20.38)μmol/L、(458.59±26.25)μmol/L,高于轻中度组的(328.64±10.27)μmol/L,同时血清白蛋白(ALB)水平及PH低于轻中度组,差异均有统计学意义(P<0.05);轻中度组患儿初筛及复筛的异常率(8.33%)最低,重度组(21.62%)次之,极重度(34.21%)最高,且极重度组听力异常率高于轻中度组与重度组,差异均有统计学意义(P<0.05);黄疸出现≤48 h组患儿的听力异常率为29.27%,明显高于黄疸出现>48 h组的11.54%,差异有统计学意义(P<0.05);经Pearson相关性分析结果显示,NHB患儿的听力异常率与SB水平呈正相关(r=0.578,P<0.05),与黄疸出现时间呈负相关(r=-0.443,P<0.05)。结论轻中度NHB及黄疸发生时间>48 h的患儿听力异常率较低,且随着SB水平的升高,黄疸发生时间的提前,NHB新生儿听力异常的风险会随之增加。Objective To investigate the correlation between hearing screening results and serum bilirubin(SB)level in neonates with hyperbilirubinemia(NHB).Methods The clinical data of 320 neonates with NHB who were admitted to the Department of Otolaryngology Head and Neck Surgery,Xi'an People's Hospital from February 2018 to February 2019 were retrospectively analyzed.According to SB level,the neonates were divided into mild to moderate group(SB≤342μmol/L,n=96),severe group(342μmol/L<SB≤427μmol/L,n=148),and extremely severe group(SB>427μmol/L,n=76).All neonates underwent preliminary screening by auto auditory brainstem response(AABR)combined with transient evoked otoacoustic emission(TEOAE).Those with unqualified preliminary screening results were screened again using 1000 Hz of tympanic tympanometry.The hearing abnormality rate was compared among the three groups and between neonates with jaundice onset time≤48 h(n=164)and those with jaundice onset time>48 h(n=156).The relationship between SB level and hearing screening results was analyzed by Pearson correlation analysis.Results SB levels in the severe group and the extremely severe group were(401.74±20.38)μmol/L and(458.59±26.25)μmol/L,which were significantly higher than(328.64±10.27)μmol/L in the mild to moderate group,while the serum albumin(ALB)level and PH were significantly lower than those in the mild to moderate group,with statistically significant differences(P<0.05).The abnormal rates of primary screening and re-screening were the lowest in the mild to moderate group(8.33%),followed by the severe group(21.62%)and then the extremely severe group(34.21%),and the abnormal rate of hearing in the extremely severe group was significantly higher than that in the mild to moderate group and the severe group,with statistically significant differences(P<0.05).The abnormal rate of hearing in the jaundice onset time≤48 h group was 29.27%,which was significantly higher than 11.54%in the jaundice onset time>48 h group(P<0.05).Pearson correlation analysis r

关 键 词：新生儿 高胆红素血症 听力筛查 脑干听觉诱发电位 瞬态耳声发射 血清胆红素 听力异常 相关性 

分 类 号：R722[医药卫生—儿科]