[1]李丽娟,罗家胜,杨引通,等.瞬态耳声发射联合自动听性脑干反应对高胆红素血症足月新生儿听力损伤的筛查价值[J].陕西医学杂志,2025,54(3):358-363.[doi:DOI:10.3969/j.issn.1000-7377.2025.03.014]
　LI Lijuan,LUO Jiasheng,YANG Yintong,et al.Value of TEOAE combined with AABR in screening of hearing impairment in full-term neonates with hyperbilirubinemia[J].,2025,54(3):358-363.[doi:DOI:10.3969/j.issn.1000-7377.2025.03.014]
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瞬态耳声发射联合自动听性脑干反应对高胆红素血症足月新生儿听力损伤的筛查价值
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
54
期数:
2025年3期
页码:
358-363
栏目:
临床研究
出版日期:
2025-03-05

文章信息/Info

Title:
Value of TEOAE combined with AABR in screening of hearing impairment in full-term neonates with hyperbilirubinemia
作者:
李丽娟1; 罗家胜1; 杨引通1; 秦 燕1; 常换换2
(1.西安市人民医院 西安市第四医院耳鼻咽喉头颈外科,陕西 西安 710004; 2.西安市儿童医院耳鼻咽喉头颈外科,陕西 西安 710003)
Author(s):
LI Lijuan1; LUO Jiasheng1; YANG Yintong1; QIN Yan1; CHANG Huanhuan2
(1.Department of Otolaryngology Head and Neck Surgery,Xi'an People's Hospital,Xi'an 710004,China; 2.Department of Otorhinolaryngology Head and Neck Surgery,Xi'an Children's Hospital,Xi'an 710003,China)
关键词:
高胆红素血症;  听力损伤;  听力筛查;  瞬态耳声发射;  自动听性脑干反应;  足月新生儿
Keywords:
Hyperbilirubinemia;  Hearing impairment;  Hearing screening;  Transient otoacoustic emission;  Automatic auditory brainstem response;  Full-term neonates
分类号:
R 722.1
DOI:
DOI:10.3969/j.issn.1000-7377.2025.03.014
文献标志码:
A
摘要:
目的:探讨瞬态耳声发射(TEOAE)联合自动听性脑干反应(AABR)对高胆红素血症足月新生儿听力损伤的筛查价值。方法:选取高胆红素血症足月新生儿296例(592耳)为研究对象,根据血清总胆红素(TSB)水平分为重度组(TSB≥342 μmol/L,199例,398耳)、极重度组(TSB≥427 μmol/L,88例,176耳)和危险组(TSB≥510 μmol/L,9例,18耳),均于出生后7 d内行TEOAE和AABR听力初筛,42 d后行听力复筛,3个月后行诊断型ABR检测确诊听力,并对听力结果进行统计学分析。结果:三组TEOAE、AABR及两项联合测试听力初筛、复筛未通过率及诊断型ABR异常率比较差异有统计学意义(均P<0.05)。经组间两两比较后发现危险组上述指标明显高于重度组和极重度组(均P<0.05)。经诊断型ABR检测,听力受损147耳(24.83%)。对于听力受损疾病,复筛听力时两项联合测试的敏感度、准确率和Kappa值高于单独TEOAE或AABR,同时漏诊率较低。结论:危险高胆红素血症是足月新生儿听力损伤的高危因素。TEOAE联合AABR对高胆红素血症足月新生儿听力损伤具有良好的筛查价值。
Abstract:
Objective:To explore the value of combined transient otoacoustic emission(TEOAE)combined with automatic auditory brainstem response(AABR)in the screening of hearing impairment in full-term neonates with hyperbilirubinemia.Methods:A total of 296 full-term neonates(592 ears)with hyperbilirubinemia were enrolled as subjects.According to the serum total bilirubin(TSB)level,they were divided into severe group(TSB ≥342 μmol/L,199 cases,398 ears),extremely severe group(TSB ≥427 μmol/L,88 cases,176 ears)and fatal group(TSB ≥510 μmol/L,9 cases,18 ears).All of them underwent TEOAE and AABR hearing screening within 7 days after birth,followed by hearing re-screening after 42 days,and diagnostic ABR test after 3 months to confirm hearing.The hearing results were statistically analyzed.Results:In all three groups,the failure pass rates of TEOAE,AABR,and the combination of both tests showed statistically significant differences in initial screening,re-screening,and diagnostic ABR abnormality rates(all P<0.05).After pairwise comparison between groups,it was found that above differences in the fatal group were significantly higher than those in the severe group and the extremely severe group(all P<0.017).A total of 147 ears(24.83%)with hearing impairment were identified by diagnostic ABR.For hearing impairment diseases,the sensitivity,accuracy,and Kappa value of the combined test during re-screening were higher than those of TEOAE or AABR alone,with a lower rate of missed diagnoses.Conclusion:The fatal hyperbilirubinemia is a higher risk factor for neonatal hearing impairment.TEOAE combined with AABR has a good screening value for hearing impairment in full-term neonates with hyperbilirubinemia.

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备注/Memo

备注/Memo:
[基金项目]西安市卫生和计划生育委员会卫生科研人才项目(J201802030)
更新日期/Last Update: 2025-03-05