探讨肌酸激酶脑型同工酶(CK-BB)与脑干诱发电位(BAEP)对新生儿胆红素脑损伤早期诊断的临床价值。

实验组病例选自2004年1月至2005年3月入住本院新生儿室的新生儿高胆红素血症病例71例。其中，男性病例37例，女性34例。实验组病例均符合新生儿高胆红素血症诊断标准。选同期上述单位产科母婴同室30例正常新生儿作为对照组，其中男性16例，女性14例。所有病例均于入院当日抽取外周静脉血液送检，测定肝功能(含胆红素)及CK-BB，并行BAEP检查，再于治疗后复查肝功能、CK-BB及BAEP。用SPSS统计软件进行数据处理，以P<0.05为差异有显著意义。

本研究表明，胆红素的神经细胞毒性，可引起患儿神经系统损伤。实验组与对照组血清CK-BB各组之间总体均数不全相等，重度高胆红素血症组与对照组比较，CK-BB明显高于正常对照组。高胆红素血症组血清CK-BB与BAEP异常率及BAEP各波的波潜伏期(PL)，波间潜伏期(IPL)与对照组相比，差异有显著意义。高胆红素血症组治疗后与对照组BAEP各波PL，IPL比较，轻度高胆红素血症组各波的PL，IPL延长不明显。重度高胆红素血症组BAEP的I〜Ⅲ，I〜V IPL与对照组相比延长，显示高胆红素血症引起的中枢性听觉传导通路有损伤，提示脑损伤特异性酶的释放增加及听觉传导通路的损害。

CK-BB与BAEP可用于胆红素脑损伤的早期诊断。对CK-BB与BAEP异常者应及早干预，以预防胆红素脑病的发生。

To study the value of creatine kinase bb (CK-BB) for early diagnosing of bilirubin encephalopathy and the relationship between creatine kinase bb and brain-stem auditory evoked response (BAEP). Then to find bilirubin induced-brain damage earlier and prevent its sequela.

71 cases full term neonates within 1〜7 days old are divided into 4 groups according to their total serum bilirubin (TSB) concentration. There are 28 newborns in the first test group, whose TSB are 220. 6 〜256. 5μmol/L; The second test group includes 22 neonates, whose TSB are 256. 5〜342. 0 μmol/L;The third group includes 21 neonates, whose TSB are more than 342. 0 μmol/L. There are 30 newborns in the control group, whose TSB are less than 220. 6 μmol/L. None of the infants showed any other symptoms of kernicterus except for jaundice. BAEP and CK-BB detected in neonates. All measure datum were presented as Mean ± SD, the difference between the group were calculated by the t-test or F-test and q-test. We used the frequencies to present the PStyleified datum, and used the χ²-test to calculated the difference between different groups. P <0. 05 was considered significant.

The result of the jaundice neonates are compared with the those of the controls: CK-BB in the moderate and severe hyperbilirubinemia are more than those of the control group and there are significant differences (P<0. 05). Both of the BAEP mean latencies of waves and inter-peaks of two test groups are prolonged (P<0. 05) ,The abnormal rates of BAEP of the two groups are higher than that of the control group (P<0. 01). For the abnormal BAEP of the hyperbilirubinemia, its serum CK-BB concentration is higher than those of the normals (P<0. 01). After treatment, the BAEP mean latencies of waves and inter-peaks are decreased, there are no significant differences compared with the control group except for the IPL of I 〜Ⅲ, and I ~V in the severe hyperbilirubinemia.

CK-BB and BAEP are changed before some of full term jaundice neonates show the symptoms of kernicterus. So they can be used for early diagnoses bilirubin induced-brain damage.