新生儿听力筛查假阳性影响因素分析

目的探讨和分析新生儿听力筛查中假阳性的发生率和原因。方法应用瞬态诱发耳声发射(transient evoked otoacoustic emission,TEOAE)和自动判别听性脑干听觉诱发电位(automatedauditory brainstem response,AABR)对2003年3月至2005年12月在本院产科出生的4125例活产新生儿进行新生儿普遍听力筛查(universal newborn hearing screening,UNHS)。初筛时间为出生后2d~3d,用TEOAE进行;复筛应用TEOAE和AABR于出生后42d进行。复筛"未通过"者于3个月龄时,做诊断性检查评估听力水平,并跟踪随访1年以上。结果初筛4125例,通过3886例,通过率为94.21%;复筛239例,通过209例;复筛仍未通过20例,其中确诊听力损失为16例。在4125例新生儿中,听力损失的发病率为0.39%,初筛假阳性率为5.40%,整个筛查程序假阳性率为0.10%。结论虽然听力筛查的假阳性率不高,但绝对数量不可忽视,应重视假阳性出现的原因,并合理处置,降低其发生率。

To analyze reasons of false positive of hearing screening for 4 125 newborns

Objective To investigate and analyze the rate and reasons of false positive by newborn hearing screening.Methods Transient evoked otoacoustic emission(TEOAE)and automated auditory brainstem response(AABR)were used to examine the hearing of 4 125 live birth newborns of our hospital's maternity department from Mar.2003 to Dec.2005.TEOAE was used for preliminary hearing screening in 2 days-3 days after birth,and both TEOAE and AABR were used for the secondary hearing screening at 42 days after birth.Diagnostic hearing tests were used to assess the hearing of those who failed the secondary hearing screening in 3 months after birth.They were followed up for more than 1 year.Results All the 4 125 newborns were had the preliminary hearing screening.3 886 of them were passed,the ratio was 94.21%.239 infants failed preliminary hearing screening when they underwent the secondary screening at 42 days after birth.219 of them were passed,16 of cases who failed secondary screening were diagnosed with hearing loss,the morbidity of 4 125 newborns was 0.13%.The false positive rate was 5.4% and 0.1% of the preliminary screening and the whole process,respectively.Conclusion Although the false positive rate is very low,the number of false positives can not be ignored.It is important to sum up the reasons of the false positive of hearing screening and reduce its rate as possible as we can.