高胆红素血症对新生儿脑干听觉诱发电位的影响

目的：探讨高胆红素血症新生儿的脑功能状态，以早期评估新生儿高胆红素血症的预后，方法：对高胆红素血症新生儿（n=40)进行脑干听觉诱发电位（ABR）检查，对ABR异常者3个月后复查。结果：40例黄疸患儿中，ABR异常31例，异常率77．5％，血清胆红素水平越高，ABR异常率越高（P＜0．05），ABR异常越严重（P＜0．05），胆红素浓度恢复正常后3个月，仍有48．4％的患儿ABR异常，结论：高胆红素血症不仅导致患儿暂时性脑功能障碍，而且对临床未发生胆红素脑病的患儿（胆红素＞171umol/L），亦可导致永久性中枢神经损伤。     

新生儿高胆红素血症对脑干听觉诱发电位的影响

目的　研究胆红素对脑干听觉诱发电位的影响。方法　对 36例各种原因所致高胆红素血症 (高胆 )患儿在胆红素高峰期进行脑干听觉诱发电位 (BAEP)检查 ,并与对照组比较。结果　高胆组Ⅰ波潜伏期 (PL)延长 2 3只耳 ,占 35 38% ,平均(1 98± 0 2 0 )ms,出波率 90 2 7% ,周围性损害 41 6 7% ,Ⅲ、Ⅴ波部分延长 ,平均 (4 84± 0 2 9)ms和 (6 94± 0 31)ms,出波率分别为 87 5 %和 86 11% ,但Ⅰ～Ⅲ ,Ⅲ～Ⅴ ,Ⅰ～Ⅴ波间期 (IPL)均正常 ,中枢性损害 18 0 6 % ,与对照组比较有显著性差异。结论　间接胆红素可透过血脑屏障对BAEP产生明显影响。提示BAEP是检测听力障碍和脑干听中枢损害的早期敏感指标和有效方法 ,早期干预对促进听觉、语言和智能的发育具有重要意义。     

新生儿高胆红素血症的脑干听觉诱发电位变化

为探讨胆红素对脑干的毒性作用，我们检测新生儿脑干听觉诱发电位（RAEP）59例，其中无核黄疸表现的病理性黄疸21例，生理性黄疸18例，正常对照组20例。复查BANP异常10例。病理组BAEP异常发生率为76．2％，生理组为27．8％。主要表现为潜伏期时间延长。BAEP异常患儿10例，于生后1－2岁复查，全部听力正常，生长发育良好，但BAEP表现除3例完全恢复正常外，余7例仍有轻度异常，但较新生儿期明显好转。BAEP测定结果提示，在无核黄疸表现的高胆红素血症患儿，其胆红素对脑干结构也有急性毒性作用，且随胆红素浓度升高而显著，但毒性作用可发生可逆的变化，对远期影响仍需继续观察。     

新生儿高胆红素血症脑干听觉诱发电位的临床意义

新生儿高胆红素血症脑干听觉诱发电位的临床意义刘宝琴孙力安张璋郑州市儿童医院（４５０００３）新生儿高胆红素血症（高胆）可引起胆红素脑病。该病对中枢神经系统的损害，尤其对听力损害已引起重视。为早期发现不同浓度胆红素对听力的影响，作者对１４９例高胆病儿进行...     

新生儿高胆红素血症与脑干听觉诱发电位的研究

为了及早发现胆红素对中枢神经系统的损害，以便指导对早期胆红素脑病的预防与治疗，我们对高胆红素血症患儿进行了脑子听觉诱发电位的监测。1对象与方法1．1对象：收集了1995年1～8月在我院新生儿病区住院的符合以下条件的38树新生儿高胆红素血症患儿：①足月儿；②无新生儿窒息；③已除外其它中枢神经系统疾患（如颅内出血、缺血缺氧性脑病等）；④无神经系统症状。1．2方法：对每个患儿在皮肤黄恒最明显时测定血清胆红素（使用美国Technico公司的RA1000全自动生化分析仪），并计算出游离胆红素值，在测定股红素的同一天由专人作脑干听…     

新生儿高胆红素血症脑干听觉诱发电位的观察

目的探讨新生儿高胆红素血症脑干听觉诱发电位（BAEP）变化及临床意义。方法对80例高胆红素血症患儿进行BAEP检测,并与60例正常对照组进行对照分析。结果高胆红素血症新生儿中BAEP异常率为26.75%。结论高胆红素血症可导致新生儿听神经损害,BAEP为高胆红素血症治疗及预后评价提供重要依据。     

175例新生儿高胆红素血症脑干听觉诱发电位分析

目的 探讨高胆红素血症对新生儿听神经及脑干功能的影响,为早期诊断及治疗提供依据.方法 将175例新生儿高胆红素血症按血清间接胆红素(UCB)水平分为A组(168耳,UCB＜342 μmol/L)及B组(182耳,UCB≥342 μmol/L),检测患儿的脑干听觉诱发电位(BAEP),比较两组Ⅴ波反应阈及BAEP结果.结...     

新生儿高胆红素血症脑干听觉诱发电位的临床观察

目的探讨新生儿高胆红素血症与脑干诱发电位的关系。方法选取嘉兴妇保院及桐乡市妇保院115例新生儿,检测其胆红素浓度与BAEP,并选取120例健康新生儿作为正常对照组。结果新生儿高胆红素组与对照组相比BAEP各波均有延长,有统计学意义;胆红素浓度越高,BAEP异常损害越严重。结论高胆红素血症可引起新生儿听力受损,BAEP可作为检测指标。     

Transcutaneous bilirubin measurement in healthy Saudi term newborns

Objectives:

To evaluate the accuracy of transcutaneous bilirubin (TcB) measurement in healthy, jaundiced Saudi term newborns.

Methods:

This prospective, cohort study was carried out from January 2009 to December 2012 on jaundiced, term infants admitted at the King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Paired TcB and total serum bilirubin (TSB) from healthy jaundiced term newborns were obtained. The correlation and the mean difference between the 2 methods were calculated, and Bhutani nomogram for prediction of TSB by TcB was used. Any bilirubin level at low and above the intermediate risk zone was considered significant.

Results:

We obtained 665 paired TcB and TSB measurements from 665 newborns. The mean age at bilirubin measurement was 44.2 ± 21 hour. Mean TSB was 147 ± 45 µmol/L, and TcB was 156 ± 50 µmol/L. Linear regression analysis showed a significant correlation between TcB and TSB (r: 0.84; 95% confidence interval [CI] = 0.82-0.86; p<0.001). The TcB tends to overestimate TSB. The mean difference between paired TcB and TSB was 17 µmol /L with a 95% CI of 40 ± 77 µmol/L. The TcB was sensitive, but less specific. The TcB sensitivity was 83% and specificity was 71% to predict TSB during the first 72 hours of life for the whole study group. The positive predictive value was 63%, and negative predictive value was 87%.

Conclusion:

As found in this study, among the jaundiced healthy term Saudi newborns, TcB measurement provided accurate estimates of TSB values. The TcB measurements can be used effectively to screen newborns for significant jaundice.Jaundice is one of the most common diagnoses during the neonatal period, which requires treatment with either phototherapy, or exchange transfusion. Cases of bilirubin induced neurologic dysfunction have been observed in otherwise healthy term and late preterm infants.1,2 The clinical evaluation of jaundice involves visual estimation of the color of the skin. However, quantification of total serum bilirubin (TSB) based on visual assessment of jaundice is subjective and inaccurate.3 Therefore, chemical methods for measurement of bilirubin in the sera of newborn infants are still the standard of care in the assessment of neonatal jaundice. However, blood sampling involves pain for newborn infants. In addition, it is important to minimize the quantity of blood that the infant loses through blood sampling. Over the last 2 decades, several studies addressed the value of transcutaneous bilirubin (TcB) measurement in newborns. The TcB measurement is quick, simple, less invasive, and cost effective. Most of the studies had validated TcB in relatively homogenous populations, such as Greek, Caucasian, Chinese, Hispanic, and Africans.4-7 Studies were varied in their assessment of the accuracy of TcB measurement; poor to excellent agreement between TSB and TcB has been reported.4-9 The aim of this prospective cohort study was to investigate the accuracy of TcB as measured by BiliCheck device (SpectRx, Inc., Norcross, GA, USA) in jaundiced, otherwise healthy, Saudi term infants who required TSB measurements.     

新生儿和婴幼儿闪光视透发电位

目的　探究闪光视诱发电位 (FVEP)应用于新生儿和婴幼儿视功能检查的可行性 ,获得正常新生儿和婴幼儿FVEP结果 ,为眼病筛查未通过的小儿及高危新生儿的进一步视功能诊断作参考。方法　　应用美国Nicolet公司的Viking -IV诱发电位仪对 4 1例正常新生儿 (日龄≤ 4d)和 18例 1月龄至 5月龄的婴幼儿进行FVEP检测。结果　分别得到新生儿组和婴幼儿组FVEP各波潜伏期参考值 ,以及左右眼潜伏期差别的正常范围参考值 ,发现FVEP各波潜伏期随年龄增长有缩短的趋势 ;闪光刺激频率对FVEP结果影响有显著意义 (P <0 0 5 )。结论　FVEP的主波P1潜伏期稳定可靠 ,将其作为主要参考值应用于新生儿和婴幼儿视功能检查是可行的 ,但在临床应用此方法时 ,一定要参照不同年龄段的FVEP值。     

新生儿和婴幼儿闪光视诱发电位

目的探究闪光视诱发电位(FVEP)应用于新生儿和婴幼儿视功能检查的可行性,获得正常新生儿和婴幼儿FVEP结果,为眼病筛查未通过的小儿及高危新生儿的进一步视功能诊断作参考.方法应用美国Nicolet公司的Viking-Ⅳ诱发电位仪对41例正常新生儿(日龄≤4 d)和18例1月龄至5月龄的婴幼儿进行FVEP检测.结果分别得到新生儿组和婴幼儿组FVEP各波潜伏期参考值,以及左右眼潜伏期差别的正常范围参考值,发现FVEP各波潜伏期随年龄增长有缩短的趋势;闪光刺激频率对FVEP结果影响有显著意义(P＜0.05).结论 FVEP的主波P1潜伏期稳定可靠,将其作为主要参考值应用于新生儿和婴幼儿视功能检查是可行的,但在临床应用此方法时,一定要参照不同年龄段的FVEP值.     

Short latency somatosensory evoked potentials and brainstem auditory evoked potentials in patients with head trauma

The SSEPs in 115 patients with head trauma were analysed by NT+ W value, da, db and b/a methods. The results revealed that the abnormal rates of the SSEPs were 94.8%. The pathological bases resulting in it were the direct and/or indirect lesion on the somatosensory pathway. The SSEPs recorded six months after the trauma indicated that the electric activities of neurons in some of the patients were still abnormal although they recovered well. The patients complicated with traumatic lesion of acoustic nerve, blood clots in external ear canal and pre-existing hearing loss had abnormal BAEPs that could not be used in diagnosing brainstem lesion. The patients without these complications in whom BAEPs were abnormal had an unfavourable outcome. The SSEPs and BAEPs simultaneously recorded could aid localization of the injury in the brain and enable discovery of the fact that the rigidity after decortication or decerebration is a result of severe injury of the cerebral hemisphere.     

The effect of lead on brainstem auditory evoked potentials in children

Objective To determine whether lead affects brainstem auditory evoked potentials (BAEPs) in low-to-moderate lead exposed children. Methods BAEPs were recorded from 114 asymptomatic children aged 1-6 years. Average values were calculated for peak latency (PL) and amplitude (Amp). Whole blood lead (PbB) levels were assessed by graphite furnace atomic absorption spectroscopy. Based on their PbB levels, subjects were divided into low lead (PbB&lt;100 μg/L) and high lead subgroups (PbB ≥100 μg/L). Results The PbB levels of the 114 subjects ranged from 32.0 to 380.0 μg/L in a positively skewed distribution. The median of PbB levels was 90.0 μg/L while the arithmetic average was 88.0 μg/L. Of the subjects, 43.0% (49/114) had levels equal to or greater than 100 μg/L. Bilateral PLs Ⅰ, Ⅴ, and Ⅲ of the left ear in the high lead subgroup were significantly longer than those in the low lead subgroup (P&lt;0.05). A positive correlation was found between PbB levels and bilateral PLs Ⅰ, Ⅴ and Ⅲ of the left ear (P&lt;0.05), after controlling for age and gender as confounding factors. A significant and positive correlation between PbB levels and PL Ⅰ of the left ear, even when PbB levels were lower than 100 μg/L, in the low subgroup (r=0.295, P=0.019) was also found.Conclusions Lead poisoning in children younger than 6 years old is a very serious problem to which close attention should be paid. The indications that lead prolongs partial PLs may imply that lead, even at PbB levels lower than 100 μg/L, impairs both the peripheral and the central portions of the auditory system. BAEPs may be a sensitive detector of subclinical lead exposure effects on the nervous system in children.     

兔急性颅内高压模型中体感诱发电位与听觉诱发电位的变化

目的 :探索颅内压 (ICP)升高过程中体感诱发电位 (SEPs)与脑干听觉诱发电位 (BAEPs)的变化规律。方法 :采用幕上不同部位放置球囊引起急性ICP增高的动物模型。将新西兰兔 30只分为 3组 :A组动物球囊置入右顶部硬膜下 ;B组动物球囊置入右颞底 ,C组以上部位动物各半 ,球囊内不注水。结果 :(1)A组SEPsP1波幅在ICP升至(1.48± 0 .35 )kPa即发生显著变化 ,而B组中ICP达 (8.10± 1.2 5 )kPa才出现波幅显著压缩。A组BAEPs在ICP升至(9.40± 1.6 0 )kPa时才出现IV ,V ,VII波的PL延长 ,而B组在ICP为 (3.11± 0 .80 )kPa时即见III波PL显著延长。 (2 )随ICP增高 ,P1波幅先随之升高 ,继而转为下降。结论 :SEPs与BAEPs的变化不仅受ICP高低的影响 ,还与病变的部位有关 ;SEPsP1波幅在ICP增高过程中呈先升后降的趋势     

兔急性颅内高压模型中体感诱发电位与听觉诱发电位的变化

OBJECTIVE: To study the changes in somatosensory evoked potentials (SEPs) and brainstem auditory evoked potentials (BAEPs) during intracranial hypertension. METHOD: A rabbit model of acute intracranial hypertension was developed. Thirty New Zealand rabbits were divided into 3 group. Both Group A and B were groups with intracranial hypertension; Group C was the control group. In Group A, balloons were placed to the right parietal lobe beneath the dura mater; in Group B, to temporal at the middle fossa near the brainstem. RESULT: (1) In Group A, when ICP rose to (1.48 +/- 0.35) kPa, P1 amplitude of SEPs was significantly changed, whereas latencies of Wave IV, V, and VII of BAEPs were prolonged when ICP rose to (9.40 +/- 1.60) kPa. In group B, P1 amplitude of SEPs was changed when ICP reached (8.10 +/- 1.25) kPa, and latency of Wave III of BAEPs was prolonged when ICP rose to (3.11 +/- 0.80) kPa. (2) P1 amplitude increased with ICP value when the balloon volume increased from V = 0.0 ml, ICP = (0.43 +/- 0.10) kPa to V = 0.4 ml, ICP = (2.44 +/- 0.65) kPa and then decreased afterward. CONCLUSIONS: (1) Changes in SEPs and BAEPs relate to not only ICP value but also the location of the balloon. (2) With the increasing of ICP, P1 amplitude increases firstly and then decreases.     

亚临床肝性脑病的脑干听觉诱发电位研究

探讨脑干听觉诱发电位对亚临床肝性脑病的诊断意义。方法对２９例肝硬化失代偿期患者及３０例正常对照者进行ＢＡＥＰ检测并行对照分析。结果病例组Ⅲ、Ⅴ波替伏期及Ⅰ－Ⅴ波峰间期延长,与对照组相比差异有显著性。     

脑干诱发电位对自闭症患儿早期诊断的初步探讨

目的通过观察儿童孤独症患者脑干听觉诱发电位（BAEP）的变化,探讨BAEP在自闭症患儿早期诊断中的临床意义。方法应用日本光电5504肌电诱发电位仪进行BAEP检测,检查36例2～6岁自闭症患儿和36例同年龄组正常儿童的BAEPⅠ～Ⅴ各波潜伏期及潜伏期差。结果与正常组比较,自闭症患儿BAEP中的波Ⅴ绝对潜伏期延迟（p〈0．05）。结论BAEP对,临床辅助诊断自闭症患儿有一定参考价值,为患儿早期诊断提供帮助,值得继续随访。     

新生儿胆红素脑病脑脊液胆红素及脑干听觉诱发电位检测的临床意义

目的探讨新生儿胆红素脑病脑脊液胆红素水平及脑干听觉诱发电位（BAEP）检查的临床意义。方法选取高胆红素血症新生儿为研究对象,分为胆红素脑病组（44例）和非胆红素脑病组（79例）,比较两组患儿脑脊液、血清胆红素水平以及BAEP变化。结果胆红素脑病组患儿脑脊液胆红素水平高于非胆红素脑病组[（11.0 ± 3 .9）mol／L VS（7. 4± 4.0）mol/L],差异有统计学意义（P〈0 .05）;胆红素脑病组BAEP异常发生率（61 4％）高于非胆红素脑病组（16 5％）,差异有统计学意义（P〈0 .01）。结论脑脊液胆红素水平检测可作为新生儿胆红素脑病早期诊断的可靠指标,胆红素脑病新生儿早期听觉损伤发生率高,需早期干预治疗。