Clinical Analyse Of 103 Cases Brainstem Auditory Evoked Potential In Bilirubin Encephalopathy Newborns

Objective:To analysis characteristics of the hearing loss of bilirubin toxicity in full-term neonatal hyperbilirubinemia and the correlation between BAEP and bilirubin encephalopathy by detecting audiometry brainstem auditory evoked potential(BAEP),and to provide reference for clinical diagnosis and treatment.Methods:Clinical datum and BAEP result of two group cases was collected for summary and analysis,which include 33 cases neonatal bilirubin encephalopathy,70 cases neonatal hyperbilirubinemia,diagnosed in the neonatal ward of Pediatrics of First Affiliated Hospital of Guangxi Medical University from September 2015 to February 2017,and retrospective analysis the relationship of bilirubin toxicity between bilirubin encephalopathy and BAEP.Results:1.There was no significant difference for gender,gestational age and birth weight between bilirubin encephalopathy group and hyperbilirubinemia group(P > 0.05);2.For jaundice appears time respectively(1.42,2.08d),the duration of jaundice(5.80,3.45 d),the peak time for jaundice(4.8,6.3 d)of bilirubin encephalopathy group and hyperbilirubinemia group duration,there was significant difference between two groups(P<0.05);3.The TSB,UCB and B/A values of bilirubin encephalopathy group were higher than those of bilirubin group,and the difference between the two groups was statistically significant(P<0.05);4.The abnormal rate of BAEP in bilirubin encephalopathy group 72.7% was higher than hyperbilirubinemia group 44.3%(P<0.05),and the average threshold value(55.88±28.55dBnHL)was higher than that of the control group(38.08±7.7dBnHL);5.The abnormal rate of BAEP and the abnormal rate of threshold in different bilirubin levels increased with the increase of bilirubin level,the difference was statistically significant(P < 0.05);6.Multivariate Logistic regression analysis show that TSB(OR: 1.017),duration of jaundice(OR: 1.244),and average threshold score(OR: 2.301)were the risk factors of neonatal bilirubin encephalopathy,and appear time of jaundice(OR: 0.061)was the protective factor.7.ROC curve of BAEP and bilirubin encephalopathy showed that the sensitivity was 72.7%,the specificity was 55.7%,and the area under the ROC curve was 0.642.8.In the discriminant equation of UCB/ Icterus peak time and the average threshold level of bilirubin encephalopathy,judgement right rate was84.5%(hyperbilirubinemia: Y1=-3.383+0.530 * average thresholdlevel+0.082* UCB/ icterus peak time;bilirubin encephalopathy:Y2=-11.739+1.891* average threshold level+0.149 * UCB/ icterus peak time),provide a reference method for the prediction equation of bilirubin encephalopathy.Conclusion:1.The abnormal rate of BAEP was higher than that of hyperbilirubinemia in bilirubin encephalopathy,and increased with the increase of bilirubin level;2.BAEP is an important method of screening for bilirubin encephalopathy,and it is suggested to early examines and followed-up for high-risk infants;3.Discriminant equation of bilirubin encephalopathy is: hyperbilirubinemia: Y1=-3.383+0.530 * average threshold level+0.082* UCB/ jaundice peak time;bilirubin encephalopathy: Y2=-11.739+1.891* average threshold lev-el+0.149 *UCB/ jaundice peak time,provide a reference method for the prediction equation of bilirubin encephalopathy.