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目的探讨重度高胆红素血症新生儿脑干听觉诱发电位(BAEP)异常的危险因素。方法选择2008年11月至2009年10月本院新生儿科收治的重度高胆红素血症患儿。按照BAEP结果分为BAEP正常组和BAEP异常组。对BAEP异常的影响因素进行单因素分析,并对单因素分析有统计学意义的因素纳入Logistic回归模型进行多因素分析。结果 BAEP正常组799例,BAEP异常组168例。单因素分析结果显示,入院体重、血清胆红素(TSB)峰值、酸中毒、总胆红素/血浆白蛋白(B/A)比值是BAEP异常的影响因素。多因素Logistic回归分析结果显示,酸中毒(OR=2.046)、高B/A比值(OR=4.106)是重度高胆红素血症患儿BAEP异常的危险因素。结论新生儿重度高胆红素血症时听力损伤与出生后体重下降过多、酸中毒、B/A比值关系密切,故在降低血清胆红素的同时,应积极纠正酸中毒及低蛋白血症,并避免出生后体重下降过多。
Objective To investigate the risk factors of abnormal brainstem auditory evoked potential (BAEP) in neonates with severe hyperbilirubinemia. Methods From November 2008 to October 2009 our hospital neonates admitted to severe hyperbilirubinemia children. Divided into BAEP normal group and BAEP abnormal group according to BAEP results. Univariate analysis was performed on the influencing factors of BAEP abnormalities, and the factors that were statistically significant in the univariate analysis were included in the Logistic regression model for multivariate analysis. Results There were 799 cases of normal BAEP group and 168 cases of abnormal BAEP group. Univariate analysis showed that admission weight, peak serum TSB, acidosis, total bilirubin / plasma albumin (B / A) ratio were the influencing factors of BAEP abnormalities. Multivariate Logistic regression analysis showed that acidosis (OR = 2.046) and high B / A ratio (OR = 4.106) were risk factors for abnormal BAEP in children with severe hyperbilirubinemia. Conclusion Hearing impairment in neonates with severe hyperbilirubinemia is related to the excessive loss of body weight, acidosis and B / A ratio after neonatal severe hyperbilirubinemia. Therefore, while reducing serum bilirubin, we should actively correct acidosis and hypoproteinemia Symptoms and avoid excessive weight loss after birth.