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目的:通过对高胆红素血症新生儿听力筛查诊断结果临床分析,了解高胆红素血症对新生儿听力的影响,并就ABR和TEOAE联合筛查诊断早期发现高胆红素血症导致的听神经病进行大致探讨。方法:以2006年6月～2009年6月182例高胆红素血症新生儿为研究对象,按照血清胆红素水平分为A、B两组,按1∶3的比例随机抽取同期的正常新生儿546例为对照组;初筛复筛均采用筛查型OAE,复筛未通过新生儿转诊听力诊断中心行听力学评估和医学诊断。结果:A组(血清胆红素浓度≥342μmol/L)81例,男53例,女28例,听力筛查初筛未通过率30.86%(25/81),ABR异常率70.37%(57/81),确诊听力障碍23例,确诊率28.39%(23/81);其中11例为TEOAE初复筛通过、ABR检测为缺失或严重异常、高度怀疑听神经病的患儿现已纳入重点随访对象。B组(血清胆红素浓度<342μmol/L)101例,男66例,女35例,听力筛查初筛未通过率17.82%(18/101),ABR异常率43.56%(44/101),确诊听力障碍9例,确诊率8.91%(9/101)。对照组(血清胆红素浓度<220.6μmol/L)546例,男317例,女229例,听力筛查初筛未通过率8.79%(48/546),ABR异常率1.28%(7/546)。结论:高胆红素血症是导致新生儿听力障碍的高危因素,新生儿胆红素水平与听力损失程度成正相关。ABR和TEOAE联合应用对高胆红素血症新生儿特别是听神经病患儿听力的早期评估比单独TEOAE测试应用更准确和全面。
OBJECTIVE: To understand the effect of hyperbilirubinemia on newborn hearing by analyzing the diagnostic results of neonatal hearing screening in patients with hyperbilirubinemia, and to detect the early detection of hyperbilirubinemia by combined ABR and TEOAE screening Acute auditory neuropathy caused by the general discussion. Methods: A total of 182 neonates with hyperbilirubinemia from June 2006 to June 2009 were divided into two groups according to their serum bilirubin levels. The patients were randomly selected according to the ratio of 1: 3 Normal neonates 546 cases as the control group; screening screening rescreening OAE, re-screening did not pass the neonatal hearing diagnostic center line audiology and medical diagnosis. Results: There were 81 cases in group A (serum bilirubin ≥342μmol / L), 53 males and 28 females. The rate of failed screening in audiological screening was 30.86% (25/81), and the abnormal rate of ABR was 70.37% (57 / 81), diagnosed 23 cases of hearing impairment, the diagnosis rate of 28.39% (23/81); 11 cases of TEOAE primary screening through the ABR test for the deletion or severe abnormalities, highly suspected children with auditory neuropathy are now included in the key follow-up . There were 101 cases in group B (serum bilirubin concentration <342μmol / L), 66 males and 35 females. The rate of failed screening of hearing screening was 17.82% (18/101), and the abnormal rate of ABR was 43.56% (44/101) , Diagnosed hearing impairment in 9 cases, the diagnosis rate was 8.91% (9/101). In the control group (serum bilirubin <220.6μmol / L) 546 cases, 317 males and 229 females, the rate of failed screening for hearing screening was 8.79% (48/546), and the abnormal rate of ABR was 1.28% (7/546 ). CONCLUSION: Hyperbilirubinemia is a risk factor for neonatal hearing impairment. Neonatal bilirubin levels are positively correlated with the degree of hearing loss. The combination of ABR and TEOAE for early assessment of hearing in neonates with hyperbilirubinemia, especially in children with auditory neuropathy, is more accurate and comprehensive than TEOAE alone.