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目的:探讨早产极低出生体重儿(VLBW)听性脑干诱发电位(ABR)的特征,及其与患儿生理特征的关系。方法:选取本院新生儿病区、新生儿重症监护室及听力专科就诊接受检查的早产VLBW儿纳入研究,共59例(118耳),登记围产期高危因素;选取30例(60耳)同期足月正常出生体重儿作为对照组。对所有患儿进行中耳分析,畸变产物耳声发射和ABR。结果:早产VLBW儿中听力异常的构成比明显大于正常人群,伴有其他高危因素的患儿(42例)阈值高于不伴有其他高危因素者(17例);相关分析显示,ABR阈值与出生体重、孕周、评估时年龄和调整年龄之间没有相关性(P>0.05);ABRⅠ、Ⅲ、Ⅴ波潜伏期和Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期等特征参数与患儿评估时年龄和调整年龄呈负相关(P<0.05);早产VLBW儿与足月儿在ABRⅠ、Ⅴ波潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ波间期等参数间存在差异。结论:早产VLBW儿导致听力损失的根本原因可能并不是胎龄和体重本身,而是与并发症有关;早产VLBW儿中,外周听觉功能异常率高;对于VLBW儿需建立耳声发射与自动ABR两者结合的听力筛查方式并定期随访。
Objective: To investigate the characteristics of auditory brainstem response (ABR) in preterm low birth weight infants (VLBW) and its relationship with the physiological characteristics of children. Methods: A total of 59 (118 ears) preterm VLBW children were enrolled in the neonatal ward, neonatal intensive care unit and hearing specialist. The high risk factors of perinatal period were enrolled in this study. 30 cases (60 ears) The same period full-term normal birth weight children as a control group. Middle ear analysis of all children, distortion product otoacoustic emissions and ABR. Results: The proportions of hearing loss in preterm VLBW children were significantly higher than those in normal people. The thresholds of 42 children with other risk factors were higher than those without other risk factors (17 cases). The correlation analysis showed that the ABR threshold and Birth weight, gestational age, age at assessment and age of adjustment were not correlated (P> 0.05). The parameters of ABR Ⅰ, Ⅲ, Ⅴ wave latency and Ⅰ-Ⅲ, Ⅲ-Ⅴ, Ⅰ-Ⅴ wave interval and other parameters There was a negative correlation between age and adjusted age (P <0.05). There was a significant difference in the ABR Ⅰ and Ⅴ wave latency, Ⅰ-Ⅲ and Ⅲ-Ⅴ wave interval between preterm VLBW and full-term children. CONCLUSIONS: The underlying cause of hearing loss in preterm VLBW children may not be related to the gestational age and body weight but to the complication. In preterm VLBW children, the abnormal rate of peripheral auditory function is high. For VLBW children, otoacoustic emissions and automatic ABR A combination of hearing screening and regular follow-up.