【摘要】 目的了解不同周龄早产儿及同龄足月儿听性脑干反应(ABR)的发展变化,探讨早产儿听力损失的早期诊断时机和诊断标准。方法按照周龄的不同将听功能正常的早产儿分成3组(34~37周龄儿为A组,37+1~44周龄儿为B组,50~54周龄儿为C组),3月龄健康足月儿为D组,分别进行ABR测试,比较各组ABR的各波潜伏期和波间期的变化,并进行统计学分析。结果与足月儿相比,早产儿ABR波形较为简单,波间期较长;随着周龄的增加,波Ⅰ引出率逐渐增加,波Ⅰ、Ⅲ、Ⅴ潜伏期和Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期逐渐缩短。70dB nHL短声刺激下,A组与C、D两组比较,B组与C组比较各波潜伏期及波间期的差异有统计学意义;A组与B组的波Ⅲ潜伏期的差异有统计学意义。50~54周龄(相当于足月儿3月龄)的早产儿,与同龄健康足月儿相比,ABR各波潜伏期和波间期均无统计学差异。30dB nHL短声刺激下各组ABR波Ⅴ潜伏期随周龄增加而缩短,其差异有统计学意义。结论①早产儿听力损失的早期诊断,可以在推算周龄为50~54周时进行,诊断标准可参考同龄健康足月儿;②ABR阈值正常,但潜伏期和波间期异常的早产儿要定期随访。更多还原

【Abstract】 Objective To investigate the developmental characteristics and rules of auditory pathway in preterm neonates and infants.To provide diagnosis parameters of auditory brainstem response (ABR) and timing for preterm infants for hearing loss.Methods ABR was performed to 3 groups preterm infants of different weeks of conception with normal hearing.It was analysed that peak latencies of Ⅰ、Ⅲ、Ⅴand interpeak latencies of Ⅰ-Ⅲ、Ⅲ-Ⅴ and Ⅰ-Ⅴ in different groups. The characteristics and different testing parameters of ABR were summarized.Results Comparing with full-term born infants, the wave morphology in preterm infants were simpler,the peak latencies of Ⅰ、Ⅲ、Ⅴand interpeak latencies of Ⅰ-Ⅲ、Ⅲ-Ⅴ and Ⅰ-Ⅴ were longer. The four groups showed significant difference in peak and interpeak latencies of ABR in 70 dB nHL and peak latencies of wave Ⅴ in 30 dB nHL. The latency was getting shorter as conceptional weeks increaseing. No significant difference was noted between group B and C in the interpeak latency of Ⅰ-Ⅲ.No significant differences were showed between preterm infants in 50～54 weeks of conception and full-term infants at the same conceptional age (P>0.05).Conclusion For preterm infants, the early diagnosis of hearing loss should be performed at 50～54 weeks of conception. And the criteria is the same as that for full-term infants of 3-month. Preterm infants with normal hearing threshold but abnormal latencies should be followed-up continuously.更多还原