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目的探讨早产儿高胆红素血症患儿血清间接胆红素(UCB)等检测指标水平与脑干听觉诱发电位(BAEP)的关系。方法选取2013年2月~2014年12月该院收治的早产儿高胆红素血症患儿110例,根据血清胆红素水平将患儿分为A组(UCB≤342μmol/L)、B组(342μmol/L427μmol/L),检测各组患儿血清神经元特异性烯醇化酶(NSE)以及BAEP水平。结果 3组血清NSE水平比较差异有统计学意义(P<0.05);Krukal-Wallis检验显示,3组V波反应阈分布比较,差异有统计学意义(P<0.05);3组除Ⅰ-Ⅴ异常比较差异无统计学意义(P>0.05)外,Ⅰ、Ⅲ、Ⅴ波以及Ⅰ-Ⅲ波间期、Ⅲ-Ⅴ波间期比较差异均有统计学意义(P<0.05);血清UCB受试者工作特征曲线(ROC曲线)下面积为0.817,截止点为309.12μmol/L,预测患儿听力受损的灵敏度和特异度分别为88.00%和75.50%,而血清NSE ROC曲线下面积为0.965,截止点为14.93 ng/ml,预测患儿听力受损的灵敏度和特异度分别为92.20%和100.00%。结论高胆红素可对患儿听力造成损害,血清NSE具有较好的临床预测听力损害的价值。
Objective To investigate the relationship between the level of serum indirect bilirubin (UCB) and the brainstem auditory evoked potential (BAEP) in preterm infants with hyperbilirubinaemia. Methods One hundred and ten children with hyperbilirubinaemia in preterm infants admitted from February 2013 to December 2014 in our hospital were divided into group A (UCB≤342μmol / L), B (342μmol / L 427μmol / L). The levels of serum neuron specific enolase (NSE) and BAEP in each group were detected. Results The serum NSE levels in the three groups were significantly different (P <0.05). The Krukal-Wallis test showed that there was significant difference in V wave response threshold among the three groups (P <0.05) There were significant differences in the duration of Ⅰ-Ⅲ wave interval and Ⅲ-Ⅴ wave interval between the two groups (P <0.05). The serum level of UCB receptor The area under the receiver operating characteristic curve (ROC curve) was 0.817 and the cut-off point was 309.12 μmol / L. The sensitivity and specificity of prediction of hearing loss in children were 88.00% and 75.50% respectively, while the area under the serum NSE ROC curve was 0.965 , With a cut-off point of 14.93 ng / ml. The sensitivity and specificity of predicting hearing loss in children were 92.20% and 100.00% respectively. Conclusion High bilirubin can cause hearing impairment in children, and serum NSE has a better clinical value in predicting hearing loss.