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目的:探讨高胆红素血症患儿总胆红素/血清蛋白(B/A)比值与脑干听觉诱发电位(BAEP)的关系及其对患儿听觉及脑干功能损害的预测价值。方法:选取209例高胆红素血症患儿为研究对象,根据BAEP结果分为A组(BAEP正常组)72例,B组(仅脑干功能损伤组)58例,C组(仅听觉神经损伤)42例,D组(脑干及听觉神经均损伤)37例,对比各组总胆红素(TBIL)及B/A值,并探讨B/A值与BAEP的关系。结果:与A组、B组比较,C组、D组TBIL水平显著升高(P<0.05)。与A组比较,B组、C组、D组B/A值显著升高(P<0.05)。与B组比较,C组、D组TBIL水平、B/A值显著升高(P<0.05)。与C组相比,D组TBIL水平、B/A值无统计学差异(P>0.05)。与A组BAEP相比,B组、C组、D组潜伏期V波及峰间期Ⅰ-Ⅴ、Ⅲ-Ⅴ波具有统计学差异(P<0.05)。结论:B/A值与BAEP关系密切,可作为高胆红素血症患儿神经毒性的预测指标。
Objective: To investigate the relationship between total bilirubin / serum protein (B / A) ratio and brainstem auditory evoked potential (BAEP) in children with hyperbilirubinemia and their predictive value of auditory and brainstem dysfunction in children. Methods: A total of 209 children with hyperbilirubinemia were selected as study subjects. According to the results of BAEP, they were divided into group A (BAEP normal group), group B (58 cases), group B (group B) 42 cases of nerve injury, 37 cases of group D (brain stem and auditory nerve injury). The total bilirubin (TBIL) and B / A value of each group were compared. The relationship between B / A value and BAEP was also discussed. Results: Compared with group A and group B, the levels of TBIL in group C and group D were significantly increased (P <0.05). Compared with group A, the B / A values of group B, group C and group D were significantly increased (P <0.05). Compared with group B, the level of TBIL and the value of B / A in group C and group D were significantly increased (P <0.05). Compared with group C, there was no significant difference in TBIL level and B / A between group D and group C (P> 0.05). Compared with BAEP in group A, the latency of V wave and peak I-V, III-V wave in group B, group C and group D were significantly different (P <0.05). Conclusion: The B / A value is closely related to BAEP and can be used as a predictor of neurotoxicity in children with hyperbilirubinemia.