Auditory neuropathy spectrum disorder in late preterm and term infants with severe jaundice.
Auditory neuropathy spectrum disorder in late preterm and term infants with severe jaundice.
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DOI：
10.1016/j.ijporl.2010.08.007
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发表时间：
2010-11
影响因子：
1.5
通讯作者：
Amin, Sanjiv
中科院分区：
文献类型：
--
作者：
Saluja, Satish;Agarwal, Asha;Kler, Neelam;Amin, Sanjiv
关键词：
评估重度黄疸是否与其他健康的晚期早产儿和足月新生儿的急性听神经病谱系障碍相关。在一项前瞻性观察性研究中，根据美国儿科学会指南，所有因重度黄疸入院的新生儿在出院回家前进行了全面的听力评估，在重度黄疸时可能需要进行换血。有感染、围产期窒息、染色体异常、颅面畸形或儿童期听力损失家族史的新生儿被排除在外。由不知道黄疸严重程度的听力学家进行全面的听力评估（鼓室导抗、耳声发射测试和听觉脑干诱发反应）。在机构化学实验室分别使用重氮和溴甲酚紫法测量血清总胆红素和血清白蛋白。根据美国儿科学会，共有13名总血清胆红素浓度达到需要进行换血的新生儿在3个月内入住新生儿重症监护室。13例新生儿中有6例（46%）有急性听神经病谱系障碍的听力学表现。6例发生急性听神经病的新生儿和7例听力正常的新生儿在胎龄、出生体重、溶血、血清白蛋白浓度、血清总胆红素浓度峰值和胆红素：白蛋白摩尔比峰值方面无显著差异。只有2/6的听神经病谱系障碍婴儿有急性胆红素脑病的临床体征和症状。我们的研究结果强烈表明，听神经病谱系障碍是一种常见的表现急性胆红素诱导的神经毒性在晚期早产儿和足月婴儿严重黄疸。我们的研究结果还表明，全面的听觉评估应定期进行新生儿严重黄疸，无论存在的临床表现急性胆红素脑病。
To evaluate if severe jaundice is associated with acute auditory neuropathy spectrum disorder in otherwise healthy late preterm and term neonates. In a prospective observational study, all neonates who were admitted with severe jaundice at which exchange transfusion may be indicated as per American Academy of Pediatrics guidelines had comprehensive auditory evaluation performed before discharge to home. Neonates with infection, perinatal asphyxia, chromosomal disorders, craniofacial malformations, or family history of childhood hearing loss were excluded. Comprehensive auditory evaluations (tympanometry, oto-acoustic emission tests, and auditory brainstem evoked responses) were performed by an audiologist unaware of the severity of jaundice. Total serum bilirubin and serum albumin were measured at the institutional chemistry laboratory using the Diazo and Bromocresol purple method, respectively. A total of 13 neonates with total serum bilirubin concentration at which exchange transfusion is indicated as per American Academy of Pediatrics were admitted to the Neonatal Intensive Care Unit over 3 month period. Six out of 13 neonates (46%) had audiological findings of acute auditory neuropathy spectrum disorder. There was no significant difference in gestational age, birth weight, hemolysis, serum albumin concentration, peak total serum bilirubin concentrations, and peak bilirubin:albumin molar ratio between six neonates who developed acute auditory neuropathy and seven neonates who had normal audiological findings. Only two out of six infants with auditory neuropathy spectrum disorder had clinical signs and symptoms of acute bilirubin encephalopathy. Our findings strongly suggest that auditory neuropathy spectrum disorder is a common manifestation of acute bilirubin-induced neurotoxicity in late preterm and term infants with severe jaundice. Our findings also suggest that comprehensive auditory evaluations should be routinely performed in neonates with severe jaundice irrespective of the presence of clinical findings of acute bilirubin encephalopathy.
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影响因子：
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