探讨振幅整合脑电图(aEEG)及脑干听觉诱发电位(BAEP)在中、高危新生儿高胆红素血症患儿中的早期诊断价值。

选取2014年1至2015年12月广西壮族自治区妇幼保健院新生儿科收治的152例中、高危新生儿高胆红素血症患儿为研究对象。按照血清间接胆红素(UCB)水平，将其分为A组(血清UCB水平≤342 μmol /L，n＝32) ，B组(342 μmol/L<血清UCB水平≤427 μmol/L，n＝37)和C组(血清UCB水平>427 μmol /L，n＝83)。对3组患儿进行aEEG和BAEP测定。统计学比较和分析3组患儿aEEG及BAEP测定结果。本研究遵循的程序符合广西壮族自治区妇幼保健院人体试验委员会制定的伦理学标准，征得受试对象监护人的知情同意，并与之签署临床研究知情同意书。

① 3组高胆红素血症患儿性别构成比、胎龄、出生体重等基本临床资料比较，差异均无统计学意义( P>0.05)。②152例高胆红素血症患儿均接受床旁aEEG监测，aEEG正常者为75例(49.3%)，异常为77例(50.7%)。3组高胆红素血症患儿aEEG检测结果比较，差异有统计学意义(χ²＝40.874，P<0.05)。③152例患儿中，120例患儿完成BAEP检查，结果显示Ⅴ波正常者为90例(75.0%)，异常为30例(25.0%)。3组患儿BAEP Ⅴ波反应阈结果比较，差异有统计学意义(χ²＝17.073，P<0.05)。④ aEEG与BAEP Ⅴ波反应阈异常程度比较呈正相关关系(r＝0.357，P<0.01)。⑤152例患儿中，33例为急性胆红素脑病，3例(9.09%)患儿血清胆红素水平<25 mg/dL，另30例(90.9%)患儿血清胆红素水平≥25 mg/dL。急性胆红素脑病的发生与BAEP异常程度呈正相关关系(r＝0.549，P<0.01)。

中、高危新生儿高胆红素血症患儿早期进行aEEG和BAEP检测，可早期识别新生儿急性胆红素脑病，采取积极有效的干预措施，降低其神经系统后遗症的发生风险。

To analyze the changes of amplitude integrated electroencephalogram (aEEG) and brainstem auditory evoked potential (BAEP) in brain function evaluation of middle to high risk neonatal hyperbilirubinemia infants.

From January 2014 to December 2015, a total of 152 infants who diagnosed as high risk neonatal hyperbilirubinemia at Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region were included into this study. They were divided into three groups according to different levels of indirect bilirubin (UCB): group A (serum UCB level≤342 μmol/L, n=32), group B (342 μmol/L<serum UCB level≤427 μmol/L, n=37) and group C (serum UCB level>427 μmol /L, n=83). Both aEEG and BAEP were tested and compared among three groups. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. Informed consent was obtained from the parents of each participating patient.

① There was no significant differences among three groups in the aspects of constitution ratio of gender, gestational age and birth weight (P>0.05). ②A total of 152 aEEG records were taken from 152 infants, aEEG was normal in 75 cases (49.3%), abnormal in 77 cases (50.7%). There was significant difference among three groups in aEEG records (χ²=40.874, P<0.05). ③ Among 152 infants, 120 infants finished BAEP test, and BAEP wave Ⅴ showed 90 cases (75.0%) were normal, 30 cases (25.0%) were abnormal. There was significant difference among three groups in BAEP wave Ⅴ (χ²=17.073, P<0.05). ④The aEEG was found to be significantly correlated with abnormal degrees of BAEP wave Ⅴ (r=0.357, P<0.01). ⑤ Among all infants, 33 had acute bilirubin encephalopathy. The occurrence of acute bilirubin encephalopathy was positively correlated with abnormal degrees of BAEP (r=0.549, P<0.01).

The neonates with high risk hyperbilirubinemia should take aEEG and BAEP tests as early as possible, in order to decrease the incidence of neurological sequelae.