目的 研究脑干听觉诱发电位(BAEP或ABR)对婴幼儿神经心理发育的预测作用,为出生6月内持续BAEP异常对2岁神经心理发育的影响提供科学依据。方法 选取湖北省妇幼保健院2014年6月—2015年10月出生的早产儿95例,平均孕周(34.3±1.7)周,体重(2.457±0.268)kg。足月儿100例,平均孕周(38.3±1.9)周,体重(3.457±0.328)kg。Bayley婴幼儿发展量表随访至2岁,同时在1、3、6月龄监测BAEP。观察其6月龄BAEP正常、异常与2岁神经心理发育的内在关系。结果 28~32、32~34、35~36周早产儿及足月儿6月龄BAEP异常的婴幼儿2岁的智力发展指数(MDI)分别为80.63±5.216、83.43±3.563、86.36±7.658、90.12±5.658,BAEP正常的婴幼儿2岁的MDI分别为89.75±5.249、94.30±7.740、94.44±7.570、93.89±9.752,每组差异均有统计学意义(P<0.05)。结论 6月龄进行BAEP监测是2岁神经心理发育水平预测的敏感指标。
Abstract
Objective To analyze the predictive validity of brainstem auditory evoked potential(BAEP) or auditory brainstem response(ABR) on neuropsychological development in infants and young children,in order to provide scientific evidence for the effect of persistent BAEP abnormality on neuropsychological development in infants aged 2 years. Methods Totally 95 premature babies born in Hubei Maternal and Child Health Hospital from June 2014 to October 2015 were selected as participants. The average gestational age was (34.3±1.7) weeks and the weight was (2.457±0.268) kg. There were 100 full-term infants with an average gestational age of (38.3±1.9) weeks with a weight of (3.457±0.328) kg. Bayley Infant Development Scale was followed up to 2 years old,and BAEP was monitored at the age of 1,3 and 6 months. The relationship between normal and abnormal BAEP results at the age of 6 months old and neuropsychological development at 2 years old was observed. Results The mental development indexes (MDI) at the age of 2 years old in preterm infants with abnormal BAEP aged 28-32 weeks,32-34 weeks,35-36 weeks and full-term infants were 80.63±5.216,83.43±3.563,86.36±7.658 and 90.12±5.658,respectively. While the MDIs at the age of 2 years old in infants with normal BEAP results in those children were 89.75±5.249,94.30±7.740,94.44±7.570 and 93.89±9.752,respectively. The differences were significant among the groups (P<0.05). Conclusion BAEP monitoring at the age of 6 months old is a sensitive index for predicting the level of neuropsychological development at 2 years old.
关键词
脑干听觉诱发电位 /
神经心理发育 /
预测 /
婴幼儿
Key words
brainstem auditory evoked potential /
neuropsychological development /
prediction /
infants
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参考文献
[1] 李蓓,冯菁菁,徐秀. 早产儿早期神经运动发育纵向随访[J].中国儿童保健杂志,2013,21(5):470-476.
[2] 张梅,钱红艳,匡晓妮. 早产儿矫正年龄1 岁时神经发育特征分析[J] 中国当代儿科杂志,2017,19(2):147-151.
[3] 邵肖梅,桂永浩. 胎儿和新生儿脑损伤[M]. 上海:上海科学技术出版社,2008:1-54,334-340,397-400.
[4] 胡燕丽,吕兰秋. 早产儿团体干预模式的研究概述[J]. 中国儿童保健杂志,2015,23(11):1157-1159.
[5] Lind A,Parkkola R,Lehtonen L,et al.Associations between regional brain volumes at term-equivalent age and developmentat 2 years of age in preterm children[J]. Pediatr Radiol,2011,41(8):953-961.
[6] 中华医学会儿科学分会新生儿学组,《中华儿科杂志》编辑委员会. 新生儿高胆红素血症的诊断和治疗专家共识[J]. 中华儿科杂志,2014,52(10):745-749.
[7] 张梅,匡晓妮,钱红艳,等. 早产高危因素及早产儿并发症的病例对照研究[J]. 中国儿童保健杂志,2015,23(11):1181-1184.
[8] van Imhoff DE,Dijk PH,Hulzebos CV,et al. Uniform treatment thres-holds for hyperbilirubinemia in preterm infants:Background and synopsisof a national guideline[J]. Early Humdev,2011,33(3):676-682.
[9] 张伦,丁伟.76例中枢协调功能发育障碍患儿脑干听觉诱发电位的观察分析[J].新疆医学,2011,41(1):108-110.
[10] Sanjiv B, Dawn VE.Auditory neural myelination is associated with early childhood language development in premature infants[J].Early Hum Dev,2014,90(10):673-678.
[11] 马晶,万浪,丁海峰,等.孤独症患儿听力障碍的早期发现与干预[ J ] .中国耳鼻咽喉头颈外科, 2016,23(6):325-327.
[12] Neta G,Grewal J,Mikolajczyk R,et al.Does the individualized reference outperform a simple ultrasound-based reference applied to birth weight inpredicting child neurodevelopment[J]. Ultrasound Obstet Gynecol,2011,38(1):62-66.
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