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目的:探讨不同胎龄高危新生儿的听性脑干反应(ABR)特点。方法:对2010年7月-2011年4月新生儿重症监护病房(NICU)的212例新生儿和普通新生儿病区的652例新生儿进行ABR检测,分别测出Ⅰ、Ⅲ、Ⅴ各波的潜伏期(PL)、波间期(IPL)与振幅(AMP)。并根据出生胎龄将上述新生儿分为3组:Ⅰ组为胎龄≤34周108例,Ⅱ组为胎龄34-37周159例,Ⅲ组为胎龄≥37周596例,比较不同胎龄组高危新生儿的ABR特点。结果:ABR筛查异常率,早产儿Ⅰ组(胎龄≤34周)为55.6%,早产儿I组明显高于Ⅱ组(胎龄34-37周)(49.7%)或足月儿组(胎龄≥37周)(44.9%)(P<0.01)。早产儿Ⅱ组与足月儿组比较,差异无统计学意义(P>0.05)。双耳Ⅰ波潜伏期足月儿组分别与早产儿Ⅰ组或早产儿Ⅱ组比较,差异均具有统计学意义(P<0.01)。早产儿Ⅰ组与早产儿Ⅱ组比较,差异无统计学意义(P>0.05)。双耳Ⅴ波潜伏期三组间差异均有统计学意义(P<0.05)。双耳Ⅰ-Ⅴ波间期早产Ⅰ组与早产儿Ⅱ组或足月儿组比较,差异均有统计学意义(P<0.05);而早产儿Ⅱ组和足月儿组比较,差异无统计学意义(P>0.05)。结论:胎龄≤34周的早产儿ABR异常率较足月儿及胎龄34-37周的晚期早产儿高;ABRⅠ波潜伏期足月儿明显短于早产儿,Ⅴ波潜伏期胎龄≤34周的早产儿明显长于晚期早产儿和足月儿。听觉神经系统随着胎龄的增加而逐渐成熟。早产儿由于本身发育不成熟,常合并窒息、呼吸窘迫、肺炎等疾病,易发生听力损失,因此早产儿更应加强听力监测。
Objective: To investigate the characteristics of auditory brainstem response (ABR) in neonates with different gestational age and high risk. Methods: From July 2010 to April 2011, 212 newborns of neonatal intensive care unit (NICU) and 652 newborns of ordinary neonatal ward were tested by ABR. The waveforms of Ⅰ, Ⅲ and Ⅴ Latency (PL), wave interval (IPL) and amplitude (AMP). According to the gestational age at birth, the above newborns were divided into 3 groups: group Ⅰ was 108 cases of gestational age ≤34 weeks, group Ⅱ was 159 cases of gestational age 34-37 weeks, group Ⅲ was 596 cases of gestational age ≥37 weeks, ABR features of high risk neonates in gestational age group. Results: Abnormal rate of ABR screening in preterm infants Ⅰ group (gestational age≤34weeks) was 55.6%, preterm infants in group I was significantly higher than in group Ⅱ (34-37 gestational age) (49.7%) or term infants Gestational age ≥37 weeks) (44.9%) (P <0.01). There was no significant difference between preterm group Ⅱ and full term group (P> 0.05). There were significant differences between the full-term infants with I-wave latency in both ears and the pre-neonatal group I or II group (P <0.01). Preterm infants Ⅰ group and preterm infants Ⅱ group, the difference was not statistically significant (P> 0.05). There were significant differences among the three groups in the Ⅴ wave latency of both ears (P <0.05). There were significant differences in the Ⅰ-Ⅴ wave preterm labor between Ⅰ group and preterm groupⅡ or full-term infants (P <0.05), but there was no significant difference between Ⅱ group and full-term infants Significance (P> 0.05). Conclusion: Abnormal rate of ABR in preterm infants with gestational age ≤34weeks is higher than that in term infants and preterm infants with gestational age 34-37weeks. ABRⅠ wave latency in term infants is significantly shorter than that in preterm infants. Of preterm infants were significantly longer than those of late preterm and term infants. The auditory nervous system gradually matures as gestational age increases. Premature children due to their immature, often associated with suffocation, respiratory distress, pneumonia and other diseases, prone to hearing loss, prenatal hearing should therefore be strengthened.