儿童孤独症谱系障碍脑干听觉诱发电位检测分析  

Analysis of brainstem auditory evoked potentials in children with autism spectrum disorder

作　　者：刘烨[1] 熊才运 周浩[2] 罗林荫 刘宇清[3] 骆文龙[4] 叶惠平 LIU Ye;XIONG Caiyun;ZHOU Hao;LUO Linyin;LIU Yuqing;LUO Wenlong;YE Huiping(Department of Otolaryngology,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550002,China;Department of Developmental and Behavioral Pediatrics,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550002,China;Department of Audiology,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550002,China;Department of Otolaryngology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]贵州省人民医院耳鼻喉科,贵阳550002 [2]贵州省人民医院发育行为儿科,贵阳550002 [3]贵州省人民医院听力科,贵阳550002 [4]重庆医科大学附属第二医院耳鼻喉科,重庆400010

出　　处：《重庆医学》2024年第3期399-404,共6页Chongqing medicine

基　　金：贵州省科技厅临床专项基金项目(LC[2021]018)。

摘　　要：目的探讨儿童孤独症谱系障碍脑干听觉诱发电位(BAEP)的临床特点。方法回顾性分析2021年1—8月贵州省人民医院确诊的30例儿童孤独症谱系障碍(ASD)、22例发育迟缓(DD)患儿的BAEP检测结果,选取同期确诊为新发癫痫但认知发育正常的37例患儿作为对照组,比较3组BAEP结果,分析BAEP各波与孤独症评定量表(ASRS)评分的相关性,绘制受试者工作特征(ROC)曲线分析BAEP各波的诊断效能。结果ASD组Ⅰ、Ⅴ波和DD组Ⅲ、Ⅴ波较对照组明显延长(P<0.05)。ASD组BAEP异常率以Ⅲ~Ⅴ波最高[63.33%(19/30)],其次是Ⅴ波[50.00%(15/30)];DD组以Ⅲ波及Ⅲ~Ⅴ、Ⅰ~Ⅴ波最为常见,均为27.27%(6/22)。ASD组与DD组各波异常率比较,差异有统计学意义(P<0.05)。ASD组BAEP双耳各波与ASRS评分无明显相关性(P>0.05)。ROC曲线分析显示,ASD组与对照组Ⅲ、Ⅴ、Ⅰ~Ⅲ、Ⅲ~Ⅴ、Ⅰ~Ⅴ波和DD组与对照组Ⅰ、Ⅲ、Ⅴ、Ⅲ~Ⅴ、Ⅰ~Ⅴ波曲线下面积>0.6,具有较好的区分效度。结论ASD患儿BAEP以Ⅰ、Ⅴ波异常为主,BAEP可作为ASD的早期预警指标之一。Objective To explore the clinical characteristics of brainstem auditory evoked potential(BAEP)in children with autism spectrum disorders.Methods BAEP test results of 30 children with autism spectrum disorder(ASD)and 22 children with developmental delay(DD)diagnosed in Guizhou Provincial People’s Hospital from January to August 2021 were retrospectively analyzed.A total of 37 children with epilepsy who were basically matched in gender and age and had normal cognitive development during the same period and did not take anti-epileptic drugs for the first time were selected as the control group.The results of BAEP in the three groups were compared,and the correlation between BAEP waves and Autism Rating Scale(ASRS)score was analyzed.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of BAEP waves.Results The results showed thatⅠ,Ⅴwaves in the ASD group andⅢ,Ⅴwaves in the DD group were significantly longer than those in the control group(P<0.05).The abnormal rate of BAEP in the ASD group was 63.33%(19/30)inⅢ-Ⅴwave,followed by 50.00%(15/30)inⅤwave.In the DD group,Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴwaves were the most common,which was 27.27%(6/22),respectively.The abnormal rate of BAEP was significantly different between the ASD group and the DD group(P<0.05).There was no significant correlation between the results of BAEP and ASRS scores in the ASD group(P>0.05).There was no significant correlation between the results of BAEP and ASRS scores in the ASD group(P>0.05).ROC curve analysis showed that area under the curve ofⅢ,Ⅴ,Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴwaves in the ASD group and control group,Ⅰ,Ⅲ,Ⅴ,Ⅲ-Ⅴ,Ⅰ-Ⅴwaves in the DD group and control group was more than 0.6,and had a good distinguishing validity.Conclusion BAEP in children with ASD is mainly abnormal in waveⅠand waveⅤ,and BAEP can be used as one of the early warning indicators of ASD.

关 键 词：儿童 孤独症谱系障碍 发育迟缓 脑干听觉诱发电位 早期识别 

分 类 号：R749.94[医药卫生—神经病学与精神病学]