【摘要】 目的探讨总胆红素/白蛋白比值与脑干听觉诱发电位(BAEP)的相关性及其预测高胆红素血症新生儿听力损害的临床价值。方法检测113例新生儿的总胆红素(TSB)、白蛋白水平,计算总胆红素/白蛋白比值(B/A),将B/A值≥3.0×10-3的83例新生儿作为观察组,并根据B/A值分4个亚组;另30例B/A﹤3.0×10-3的新生儿作为对照组。检测所有新生儿的BAEP,分析TSB水平、B/A值与BAEP异常的相关性。结果观察组各亚组间新生儿的BAEP异常率差异有统计学意义(P<0.01),随B/A值增大,BAEP异常率增高;观察组各亚组间新生儿BAEP的Ⅴ波潜伏期及Ⅰ-Ⅴ、Ⅲ-Ⅴ波间期的差异有统计学意义(P均<0.05);TSB水平、B/A值的工作特征曲线(ROC)下面积(AUC)差异也有统计学意义(P<0.05);BAEP异常与B/A值密切相关(χ2=13.489,P<0.05)。结论 B/A值与BAEP异常相关性高,具有预测高胆红素血症新生儿听力损害的临床价值。更多还原

【Abstract】 Objective To assess the clinical value of bilirubin /albumin(B/A)ratio in predicting bilirubin-induced auditory impairment,and its correlation with brainstem auditory evoked potential(BAEP)in full-term neonates with jaundice.Methods One hundred and thirteen infants’peripheral blood specimens were obtained to determine B/A ratio,indrect serum bilirubin and total serum bilirubin(TSB).Hereinto 83 jaundice infants were enrolled as case group and stratified into 4 subgroups based on their levels of B/A ratio(subgroup A:3.0 × 10-3-4.0 × 10-3,subgroup B:4.0 × 10-3-5.0 × 10-3,subgroup C:5.0 × 10-3-6.0 × 10-3,subgroup D:≥ 6.0 × 10-3).Besides,30 infants with B/A ﹤3.0 × 10-3 were as control group.All enrolled infants were examined with BAEP.Results There was significant difference of BAEP between control group and case group(χ2 = 17.265,P = 0.001).A positive correlation was observed between B/A ratio and peak latency(PL)Ⅴ,inter-peak latency(IPL)Ⅰ-Ⅴ and Ⅲ-Ⅴ(P < 0.05).The area under curve(AUC)of B/A receiver operating characteristic curves(ROCC)was 0.767,significantly larger than that of TSB(0.691).Abnormal BAEP outcome was closely associated with the B/A ratio(P < 0.05).Conclusions Rising B/A ratio would be associated with BAEP abnormality.B/A ratio can be used as a predictor in estimating auditory impairment in neonates with jaundice.更多还原