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。

37||The Change of Brainstem Auditory Evoked Potentials in Neonatal Hyperbilirubinemia

To investignte the bilirubin toxicity to brainstem, we measured brainstem auditory evokedpatentials (BAEP) in 59 neonates. Among the investigaed subjects, 21 were pathologcallyjaundiced without nuclear icterus, 18 were physiologically jaundiced and 20 were normal. 21 caseswere found with abnormal BAEP manifestations in all. The abnormal BAEP manifested mainly asprolongation of lateney. The incidence of abnormal BAEP was 76. 2% in pathologic group but 27.8% in physiological group. Among the 21 cases with abnormal BANP manifestation, 10 were rechecked by BAEP 1 or 2 years later and 7 cases were found not to be completely recovered. All ofthe 10 infants were normal in audition and growth development. Our findings suggested that inneonates with hyperbilirubinemia but without nuclear icteras, the increased level of hilirubin shouldacute toxicity to brainstem and the higher the level was, the more sevious the toxicity was. But thetoxicity of bilirubin to brainstem was reversible. The long - term impacts of bilirubin toxicity need tobe further studied.