68例核黄疸新生儿脑干听觉诱发电位的临床分析

目的：探讨脑干听觉诱发电位( BAEP)在新生儿核黄疸的变化,为新生儿核黄疸的早期诊断提供依据。方法68例核黄疸患儿,按照有无神经系统疾病分为两组,胆红素脑病组38例,胆红素非脑病组30例。两组均进行BAEP检测,对异常者进行随访复查。结果脑病组患儿中BAEP正常13例,异常25例,其中13例为重度,8例中度,4例轻度。非脑病组患儿中,BAEP正常21例,异常9例,其中2例为重度,2例为中度,5例轻度。随访显示,首次BAEP异常的34例中,25例转正常,6例持续异常伴有后遗症,3例失访。经治疗后两组黄疸消退后BAEP均有好转,表现为各波潜伏期均较前缩短(P<0．05),两组BAEP与较治疗前相比,差异均有统计学意义(P<0．05)。结论 BAEP异常是新生儿核黄疸的重要特征,黄疸患儿血清总胆红素>221μmol/L时,可出现神经系统受损,BAEP显示异常。

Clinical analysis of 68 cases of neonatal kernicterus of brainstem auditory evoked potential

Objective To explore the relationship between the changes of BAEP and kernicterus in neonates, in order to provide evi-dence for the diagnoses of it. Methods Sixty-eight hospitalized patients with neonatal jaundice were divided into two groups:38 neonates with bilirubin encephalopathy and 30 cases with bilirubin non-encephalopathy. All cases received initial BAEP within 24 hours of hospitaliza-tion. Then all abnormal cases were followed till one year old. Results 13 cases in neonates with encephalopathy group showed normal BAEP and 25 cases were abnormal with 13 severe cases, 8 moderate cases and 4 mild cases;21 cases in neonates with non-encephalopathy group showed normal BAEP and 9 cases were abnormal with 2 severe cases, 2 moderate cases and 5 mild cases. It showed that 34 cases had abnor-mal BAEP for the first time in follow-up with 25 turning to normal cases, 6 cases with clinic sequelae, and 3 cases lost following. When after treatment of jaundice, the abnormalities on initial BAER came back to normal in some cases, the difference being very significant ( P <0. 05). The incidence of BAEP had significant difference between prior to treatment and after treatment when jaundice come down(P<0. 05) in both groups. Conclusion Abnormal BAEP is an important character of neonatal kernicterus. When TSB>221 μmol/L, the nervous sys-tem can be damaged and BAEP is influenced.