早产低出生体重儿与听力损伤

目的:探讨早产低出生体重儿听力损伤特点及其相关因素。方法:52例早产低出生体重儿根据胎龄分为4组,即<30、30～31+6、32～33+6、34～36+6周组,对每组患儿进行听性脑干诱发电位(ABR)检测,异常者于3个月后随访。结果:各组ABR反应阈增高的差异无统计学意义(P>0.05),但χ2分割后A组与C组、A组与D组的差异有统计学意义(P<0.05);各组平均听反应阈、ABR全波缺失、重度异常耳发生率及听力损伤程度的差异均有统计学意义(P<0.05);听力损伤与母妊娠期有病毒感染史、出生体重低于1500g及Apgar评分1min<3分或5min<6分者有相关性(P<0.05);ABR异常的恢复率A组与C组、A组与D组的差异有统计学意义(P<0.05)。结论:胎龄越小ABR发生异常的程度越重。母妊娠期有病毒感染史、出生体重低于1500g和重度窒息(Apgar评分1min<3分或5min<6分者)是早产低出生体重儿听力受损的高危因素。ABR异常的小早产儿(胎龄<30周者)有着较高的恢复率。有必要对早产低出生体重儿进行早期的听力检测以及跟踪随访。

Study on hearing loss in premature low-birth weight infants

Objective:To evaluate the characteristic pattern and relation of hearing loss in premature low-birth weight infants.Methods:52 premature low-birth weight infants were observed.They were assigned in A group (<30 weeks),B group (30~31+6weeks),C group (32~33+6weeks) and D group (34~36+6weeks) by gestational age. Auditory brainstem response (ABR) analysis was carried out to all infants. Those hearing impairment infants were rechecked by ABR after 3 months.Results:There were no significant differences on the hearing threshold of ABR in different groups (P>0.05).On the hearing threshold of ABR,there were significant difference between A group and C group,also in A group and D group (P<0.05).The average hearing threshold of ABR,full wave deletion of ABR,incidence rate of severe abnormity and degree of hearing loss in different groups were different(P<0.05).Hearing loss was related to perinatal stage infection,birth weight<1 500 g,and Apgar score at 1 minute<3,or Apgar score at 5 minute<6) (P<0.05).On the recovery rate of abnormal ABR,there were significant difference between A group and C group,also in A group and D group (P<0.05).Conclusion:The shorter the gestational age is,the more severe degree of abnormal ABR is. The logistic regession analysis indicated the high risk factors to hearing loss were perinatal stage infection,birth weight<1 500 g,and severe asphyxia (Apgar score at 1 minute<3,or Apgar score at 5 minute<6). There was high recovery rate of abnormal ABR in small prematures (gestational age<30 weeks).It is necessary to carry out early hearing screening and periodic follow-up in premature low-birth weight infants.