肝酶诱导剂对高危儿胆红素和脑干听觉诱发电位的影响

目的：　探讨肝酶诱导剂早期干预对高危围产期新生儿(高危儿)胆红素水平和脑干听觉诱发电位(BAEP)的影响。方法：　应用苯巴比妥、尼可刹米口服方法进行早期干预。 86例高危儿随机分为干预组(Ⅲ组,44例)和未干预组(Ⅱ组,42例),同时以37例正常新生儿作对照组(Ⅰ组)。结果：　①生后96hⅡ组总胆红素[(249.0±75.2 ) μmol/L]显著高于Ⅲ组 [(181.0±54.1)μmol/L] (t =4.829,P<0.01) ,144h此差异更加显著[(308.0±93.1) μmol/Lvs (146.0±52.7) μmol/L] (t =9.985,P<0.01)。②Ⅱ,Ⅲ组BAEP异常率分别为69.1% ,18.2%,差异有显著性意义(χ2 =22.68,P<0.01)。结论：　肝酶诱导剂早期干预可明显降低高危儿胆红素水平和BAEP异常率

Effect of Liver Enzyme Inducer on Bilirubin Contents and Brainstem Auditory Evoked Potentials in High-Risk Infants

Objective To study the effect of early intervention (enzyme inducer) on bilirubin contents and brainstem auditory evoked potentials (BAEP) in high risk infants. Methods Eighty six high risk infants were randomly assigned to the treated group (Group Ⅲ) and untreated group (Group Ⅱ). Thirty seven normal neonates were used as the control group (Group Ⅰ). Group Ⅲ neonates were given phenobarbital and nikethamide at 24 h of birth. The total bilirubin contents were assayed in Group Ⅱ and Group Ⅲ. The BAEP was tested in the 3 groups. Results ① The mean total bilirubin content of Group Ⅱ [( 249.0 ± 75.2 ) μmol/L] was much higher than that of Group Ⅲ [( 181.0 ± 54.1 ) μmol/L] at 96 h of birth (t= 4.829 ,P< 0.01 ), and at 144 h the differences were even more significant [( 308.0 ± 93.1 ) μmol/L vs ( 146.0 ± 52.7 ) μmol/L](t= 9.985 ,P< 0.01 ). ② The incidence rate of abnormal BAEP was 69.1% in Group Ⅱ and 18.2% in Group Ⅲ. There was significant difference between the two groups (χ 2= 22.68 ,P< 0.01 ). Conclusions Early intervention using liver enzyme inducer may reduce bilirubin contents and the rate of abnormal BAEP in high risk infants.