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目的:通过听觉多频稳态诱发反应分析,探讨高胆红素血症对新生儿中枢神经的影响。方法:对280例血总胆红素(TBC)≥220.6μmol/L(12.9 mg/dl)的足月新生儿临床资料及听觉多频稳态诱发反应(ASSR)的检测结果进行回顾性分析。结果:TBC≤310.0μmol/L 195例,ASSR均正常;>520.0μmol/L 18例均发生胆红素脑病,其中ASSR中重度以上异常16例;310.1～519.9μmol/L67例,均无脑病临床表现,但ASSR出现异常,其中轻-中度异常63例(94.0%),中重度以上异常2例。听觉多频稳态诱发反应异常程度与TBC及TBC与白蛋白比(TB/A)有关(P<0.01),与高胆红素病因构成无关(P>0.05)。结论:听觉多频稳态诱发反应可早期发现亚临床胆红素神经中毒症,建议血胆红素浓度≥307.8μmol/L时,ASSR应列入常规检查。
OBJECTIVE: To investigate the effect of hyperbilirubinemia on neonatal central nervous system (CNS) by auditory multi-frequency steady-state evoked response analysis. Methods: The clinical data of 280 full-term neonates with blood total bilirubin (TBC) ≥220.6 μmol / L (12.9 mg / dl) and the auditory multivariate steady-state response (ASSR) were retrospectively analyzed. Results: TBC≤310.0μmol / L 195 cases, ASSR were normal;> 520.0μmol / L 18 cases were bilirubin encephalopathy, including ASSR moderate and severe abnormalities in 16 cases; 310.1 ~ 519.9μmol / L67 cases, no encephalopathy clinical However, there were abnormal ASSR in 63 cases (94.0%) with mild-moderate abnormality and 2 cases with moderate-severe abnormality. Auditory multifrequency steady-state response to abnormal reaction with TBC and TBC and albumin ratio (TB / A) (P <0.01), and has nothing to do with the cause of hyperbilirubinemia (P> 0.05). CONCLUSION: Subclinical bilirubin neurotoxicosis can be detected early in multi-frequency auditory steady-state response. ASSR should be included in the routine examination when serum bilirubin concentration is ≥307.8μmol / L.