诱发电位,听觉,脑干

摘要： 目的 探讨改良振幅整合脑电图(aEEG)评分联合血清神经元特异性烯醇化酶(NSE)水平,对新生儿胆红素脑损伤的早期预测价值.方法 选择2017年3月至2018年2月,于苏北人民医院新生儿病房住院治疗的80例高胆红素血症新生儿为研究对象.根据头颅MRI检查结果是否有苍白球高信号改变,将其分为脑损伤组(n=37)及无脑损伤组(n=43);并选择本院产科同期出生的40例健康足月新生儿为对照组.对3组受试儿进行aEEG监测,并进行改良aEEG评分,检测血清总胆红素(TBiL)浓度及NSE水平,以及脑干听觉诱发电位(BAEP).对3组受试儿一般临床资料、改良aEEG评分、血清TBiL浓度及NSE水平,采用单因素方差分析及最小显著性差异法(LSD)-t检验,进行总体比较及两两比较;对改良aEEG评分、血清NSE水平及aEEG分度分别与BAEP分度的相关性,采用Spearman秩相关分析法;绘制受试者工作特征曲线(ROC),比较改良aEEG评分、血清NSE水平及二者联合,对高胆红素血症新生儿发生胆红素脑损伤的预测价值.本研究遵循本院伦理委员会所制定的伦理学标准,并得到批准(审批文号:2016KY-064),所有纳入对象监护人知情同意.结果 ①3组新生儿性别构成,入院时日龄及胎龄,出生时体重、身长、头围及胸围,以及其母亲孕次、产次比较,差异均无统计学意义(P>0.05).②脑损伤组新生儿的改良aEEG评分为(7.7±1.6)分,分别低于无脑损伤组及对照组的(10.4±1.5)分和(10.9±1.3)分;而血清TBiL浓度及NSE水平分别为(349.7±74.0)μmol/L、(47.6±13.2)μg/L,均分别高于无脑损伤组的(295.7±31.4)μmol/L、(32.3±7.7)μg/L及对照组的(185.1±35.9)μmol/L、(28.6±7.3)μg/L,并且差异均有统计学意义(均为P<0.001).③本研究受试儿的改良aEEG评分与BAEP分度呈负相关关系(rs=-0.718,P<0.001),血清NSE水平及aEEG分度,均与BAEP分度呈正相关关系(rs=0.685,P<0.001;rs=0.647,P<0.001).④改良aEEG评分、血清NSE水平及二者联合,预测高胆红素血症新生儿发生胆红素脑损伤的ROC曲线下面积(ROC-AUC)分别为0.875(95％CI:0.795～0.954,P<0.001),0.853(95％CI:0.769～0.937,P<0.001)及0.938(95％CI:0.861～0.980,P<0.001);3种方法预测脑损伤的敏感度分别为86.5％、62.2％、83.8％,特异度分别为74.4％、93.0％、90.7％.结论 改良aEEG评分联合血清NSE水平,对新生儿胆红素脑损伤的早期预测价值,较单一采用改良aEEG评分或血清NSE水平更高.

摘要： 目的 评估振幅整合脑电图(amplitude-integrated electroencephalography,aEEG)在严重高胆红素血症新生儿脑损伤的监测意义. 方法 回顾性纳入201 8年1 0月至2020年6月在广州市妇女儿童医疗中心新生儿科完成aEEG监测的严重高胆红素血症足月儿223例.比较aEEG正常组(n=180)和aEEG异常组(n=43)之间的血清胆红素水平、急性胆红素脑病(acute bilirubin encephalopathy,ABE)发生率,分析aEEG对ABE的早期诊断作用以及与脑干听觉诱发电位(brain stem auditory evoked potential,BAEP)和头颅MRI的相关性.采用两独立样本t检验、Mann-Whitney U检验、x2检验进行组间比较,采用Goodman-Kruskal Gamma进行关联性分析.结果 aEEG异常组血清总胆红素水平[(536.2±154.6)与(422.1±103.0)μmol/L,t=-5.109,P＜ 0.001]和ABE发生率明显高于aEEG正常组[62.8％(27/43)与9.4％(17/180),x2=62.366,P＜ 0.001].aEEG对ABE诊断的灵敏度为61.3％,特异度为91.1％.随着ABE由警告期向痉挛期进展,aEEG电压抑制越严重(Gamma=0.847,P=0.003),睡眠觉醒周期越紊乱(Gamma=0.941,P＜ 0.001),痫性放电越频繁(Gamma=0.976,P＜0.001).223例中148例完成BAEP检查,BAEP异常组aEEG异常率明显高于BAEP正常组[32.7％ (33/101)与6.4％(3/47),x2=12.040,P=0.001],且BAEP重度异常组电压异常率高于BAEP轻度异常组[20.6％(7/34)与2.6％(1/38),x2=5.858,P=0.016],BAEP重度异常组痫性放电率明显高于BAEP轻度异常组[32.4％(11/34)与2.6％(1/38),x2=11.413,P=0.001]和BAEP中度异常组[32.4％(11/34)与3.5％(1/29),x2=8.480,P=0.004].223例中1 08例完成MRI检查,胆红素脑损伤特征性影像学改变组aEEG监测痫性放电率明显高于MRI正常组[28.6％(10/35)与2.6％(1/39),x2=9.864,P=0.002]和其他影像学改变组[28.6％(10/35)与2.9％(1/34),x2=8.451,P=0.004]. 结论 aEEG监测对于ABE的诊断有一定帮助,并且能反映病情的严重程度.高胆红素血症所致的脑损伤在aEEG监测上主要表现为痫性放电增加且多为频繁放电.aEEG监测与BAEP及MRI检查结果具有一定相关性.

摘要： 目的采用Meta分析方法综合评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对听功能的影响。方法计算机检索中英文数据库中公开发表OSAHS听功能各指标的病例对照研究,检索时限从建库开始至2019-07-25。制定严格纳入与排除标准进行文献筛选和数据提取,随后行Meta分析。结果共计纳入16篇文献,905例研究对象,OSAHS组562例,对照组343例。12篇听性脑干反应(ABR)检查文章显示,OSAHS组较对照组Ⅰ波、Ⅴ波潜伏期,Ⅰ-Ⅴ、Ⅲ-Ⅴ间期均明显延长。11篇纯音测听检查文章显示,与对照组相较,OSAHS组各频率气导听阈均有所升高,以高频为主。8篇畸变产物耳声发射检查文章提示,OSAHS组在0.5、2、4、6和8 kHz频率的反应幅值较对照组均有所降低。结论较对照组而言,OSAHS组存在一定程度听力下降,以高频听力下降为主,临床医师应注重OSAHS患者早期听力评估。

摘要： 目的 探讨超低出生体重儿(ELBWI)的住院、转归及其随访情况.方法 选择2010年1月1日至2016年5月31日,于广西壮族自治区妇幼保健院、玉林市妇幼保健院、钦州市妇幼保健院等10家医疗机构的新生儿重症监护病房接受住院治疗的276例ELBWI为研究对象.对其临床病例资料及随访资料,进行回顾性分析,内容包括孕母及ELBWI一般临床资料,ELBWI新生儿期常见临床症状、并发症、转归及出院后随访情况等.采用x2检验及Mann-Whitney U检验,对ELBWI出生胎龄＜28周与出生胎龄≥28～32周,并存活出院者的呼吸支持治疗情况进行统计学比较.本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求.结果 ①本研究分娩ELBWI的209例孕妇中,双胎妊娠孕妇占31.6％(66/209).这209例分娩ELBWI孕妇的前3位妊娠期并发症依次为:胎膜早破(27.3％,57/209),妊娠期高血压疾病(19.6％,41/209)及妊娠期糖尿病(17.7％,37/209).②本研究276例ELBWI中,新生儿期前4位常见临床症状依次为:呼吸困难(91.7％,253/276),反应差(75.7％,209/276),口唇或全身青紫(67.8％,187/276)及腹胀(40.6％,112/276).③本研究276例ELBWI中,新生儿期前6位并发症依次为:高胆红素血症(81.2％,224/276),呼吸窘迫综合征(RDS) (75.7％,209/276),早产儿贫血(64.1％,177/276),宫内感染性肺炎(50.0％,138/276),支气管肺发育不良(BPD)(48.6％,134/276)及败血症(45.7％,126/276).④存活出院的128例ELBWI中,出生胎龄＜28周ELBWI的呼吸机辅助通气治疗率及治疗时间分别为92.6％和8.0 d(3.0～16.0 d)、连续气道正压通气(CPAP)治疗率及治疗时间,分别为96.3％和16.0 d(11.0～25.0 d),均显著高于或长于出生胎龄≥28～32周者的67.2％、2.0 d(0～7.5 d)、73.4％、7.5 d(0～20.0 d),并且差异均有统计学意义(x2=11.321、P=0.001,Z=-3.994、P＜0.001,x2=11.329、P=0.001,Z=-3.301、P=0.001).⑤本研究276例ELBWI救治存活率为46.4％(128/276),其中88例为治愈出院,40例为好转出院,137例(49.6％)死亡(36例因抢救无效死亡,101例因家属放弃治疗后很快死亡),其余11例由家属签字出院后结局不详.⑥对128例存活出院ELBWI进行随访的结果显示,25例失访,失访率为19.5％(25/128).103例完成随访ELBWI中,4例于生后6个月内死亡;48.1％ (39/81)听性脑干反应测听未通过,69.4％(59/85)合并早产儿视网膜病(ROP).完成随访并且存活的99例ELBWI中,运动、语言发育落后者分别占27.3％(27/99)、17.2％(17/99),仅37.4％(37/99)按时接受《盖塞尔发育量表》评估,或于新生儿科/康复科接受随访.结论 ELBWI发生的常见原因为双胎、孕妇胎膜早破及妊娠期高血压疾病.ELBWI新生儿期并发症多,死亡率高,出院后应对其密切随访.%Objective To investigate the hospitalization,outcomes and follow-up results of extremely low birth weight infant (ELBWI).Methods From 1 January 2010 to 31 May 2016,a total of 276 cases of ELBWI who were hospitalized in neonatal intensive care unit of 10 medical institutions,including Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region,Maternal & Child Health Hospital of Yulin,Maternal & Child Health Hospital of Qinzhou,etc.,were chosen as research subjects.Clinical case data and follow-up results of the ELBWI were analyzed retrospectively,including general clinical data of ELBWI and their mothers,common clinical symptoms,complications,sequelaes and follow-up conditions of ELBWI.Among survival and discharged ELBWI,the respiratory therapy between gestational age ＜28 weeks and ≥28-32 weeks ELBWI were comparedstatistically by chi-square test and Mann-Whitney U test.This study was in line with World Medical Association Declaration of Helsinki revised in 2013.Results ① General informations of 209 mothers of ELBWI in this study:the twin pregnancy rate was 31.6％ (66/209).Top three pregnancy complications in turn of 209 mothers were premature rupture of membrane (27.3％,57/209),gestational hypertension diseases (19.6％,41/209) and gestational diabetes mellitus (17.7％,37/209).②Top four clinical symptoms in turn of 276 cases of ELBWI in neonatal period were dyspnea (91.7％,253/276),poor response (75.7％,209/276),cyanosis of lips or whole body (67.8％,187/276) and abdominal distention (40.6％,112/276).③Top six complications in turn of 276 cases of ELBWI in neonatal period were hyperbilirubinemia (81.2％,224/276),respiratory distress syndrome (RDS) (75.7％,209/276),anemia of prematurity (64.1％,177/276),intrauterine infectious pneumonia (50.0％,138/276),bronchopulmonary dysplasia (BPD) (48.6％,134/276) and sepsis (45.7％,126/276).④Among 128 cases of ELBWI who were alive and discharged from hospitals,the rate of treatment and duration of respirator assisted ventilation of ELBWI with gestational age ＜28 weeks were 92.6％ and 8.0 d (3.0 16.0 d),respectively,the rate of treatment and duration of continuous positive airway pressure (CPAP) of ELBWI with gestational age ＜28 weeks were 96.3％ and 16.0 d (11.0-25.0 d),respectively,which were all much higher or longer than those of 67.2％,2.0 d (0-7.5 d),73.4％,7.5 d (0-20.0 d) in ELBWI with gestational age ≥28-32 weeks,and all differences were statistically significant (x2 =11.321,P =0.001;Z =-3.994,P ＜ 0.001;x2 =11.329,P=0.001;Z=-3.301,P=0.001).⑤ The survival rate of 276 cases of ELBWI in this study was 46.4％(128/276).Among 276 cases of ELBWI,a total of 88 cases were cured and 40 cases were improved when discharged from hospitals,and 137 cases (49.6％) died in hospitals as ineffective treatments (36 cases) or their guardians gave up treatment to their ELBWI (101 cases),and outcomes of another 11 cases was unknown after they discharged from hospitals by their guardians' signature.⑥ Follow-up results of 128 alive and discharged cases showed that 25 cases followed up uncompleted,and the missing rate in this study was 19.5％ (25/128).Among 103 cases of ELBWI who followed up successfully,4 of them died within 6 months after birth.Among infants who have completed follow-up,48.1％ (39/81) of them failed to pass the auditory brainstem response audiometry test,69.4％ (59/85) of them had been diagnosed of retinopathy of prematurity (ROP).Among 99 survival cases who were followed up successfully,ratio of motor and language development retardation were 27.3％ (27/99) and 17.2％ (17/99),respectively,and only 37.4％ (37/99) of them assessed by Gesell Developmental Scale or followed up regularly in neonatology/rehabilitation department.Conclusions The twin birth,premature rupture of membrane and gestational hypertension diseases of mother are the common causes of ELBWI.There are many complications and high mortality rate during the neonatal period of ELBWI.We should take close follow-up after ELBWI discharging from hospitals.

摘要： Objective To explore the imaging characteristics of large vestibular aqueduct syndrome(LVAS) patients and their relationship with the acoustically evoked short latency negative response (ANSR),so as to provide reference for the diagnosis of LVAS.Methods Clinical data of 174 patients(334 ears) with LVAS diagnosed and treated by the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Guangxi Medical University,from October 2009 to December 2017 were retrospectively analyzed,including 117 males and 57 females,aged from 5 months to 47 years old,with the median age of 4 years and 4 months.ABR and imaging data of patients were collected.Midpoint diameter and the outlet diameter of the vestibular aqueduct were measured on CT images,the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac(EES) were measured on MRI images.The correlation between the above measurements was analyzed by Pearson test using SPSS 17.0.According to whether ASNR was detected in ABR,the above data were divided into two groups,and the differences of the above imaging measurements were compared by the Independent-Sample Test.Results The average midpoint diameter of the vestibular aqueduct was (1.87±0.58) mm (~ ± s,the following was the same),and the outlet diameter was (3.07±0.99) mm on CT;the average midpoint diameter of the intraosseous parts in enlarged endolymphatic sac(EES) was (2.39± 1.37) mm,and the extraosseous parts was (2.50±2.18) mm on MRI.There was a correlation between the four measurements (P＜0.05),among which the midpoint diameter of vestibular aqueduct was strongly positively correlated with the outlet diameter (r=0.760),and the remaining pairs were weakly correlated.ASNR was detected in 241 ears (72.16％,241/334) and undetected in 93 ears (27.84％,93/334) of the 334 ears with LVAS.Midpoint diameter and the outlet diameter of the vestibular aqueduct in no ASNR group were smaller than the ASNR group,and the difference was statistically significant (t value was 2.814 and 2.754,P＜0.05).There was no significant difference in the midpoint diameter of the intraosseous parts and the extraosseous parts of enlarged endolymphatic sac between the two groups,and the difference was no statistically significant(t value was 0.101 and 0.683,P＞0.05).Conclusions There is a strong positive correlation between the midpoint diameter of vestibular aqueduct and the outlet diameter in LVAS patients.There is a certain correlation between the size of vestibular aqueduct and the size of endolymphatic sac.The smaller the diameter of vestibular aqueduct,the lower the occurrence rate of ASNR.%目的 探讨大前庭水管综合征(large vestibular aqueduct syndrome,LVAS)患者的影像学特征及其与声诱发短潜伏期负反应(acoustically evoked short latency negative response,ASNR)之间的关系,为LVAS的诊断提供参考依据.方法 回顾性分析2009年10月至2017年12月期间广西医科大学第一附属医院耳鼻咽喉头颈外科诊治的174例(334耳)LVAS患者的临床资料,其中男117例、女57例,年龄5个月～47岁,中位年龄4岁4个月.收集患者听性脑干反应(ABR)以及影像学检查资料.在CT图像上测量前庭水管中点直径和前庭水管外口直径,在MRI图像上测量内淋巴囊骨内部分最大中点直径和骨外部分最大中点直径,采用SPSS 17.0软件Pearson检验分析上述测量值之间的相关性.按照ABR检查是否引出ASNR分成两组,采用独立样本t检验比较上述影像学测量值的组间差异.结果 CT前庭水管中点直径为(1.87±0.58) mm((x)±s,下同),外口直径为(3.07±0.99) mm;MRI内淋巴囊骨内部分最大中点直径为(2.39±1.37) mm,骨外部分最大中点直径为(2.50±2.18) mm;4个测量值之间均存在相关性(P值均＜0.05),其中前庭水管中点直径与外口直径呈强正相关(r=0.760),其余两两之间呈弱相关.334耳LVAS患耳中241耳(72.16％,241/334)可检测到ASNR,93耳(27.84％,93/334)未引出ASNR;未引出ASNR组患耳的前庭水管中点和外口直径均小于ASNR组,差异有统计学意义(t值分别为2.814和2.754,P值均＜0.05);两组患耳内淋巴囊骨内和骨外部分最大中点直径无明显区别,差异均无统计学意义(t值分别为0.101和0.683,P值均＞0.05).结论 LVAS患者前庭水管中点直径与外口直径呈强正相关,前庭水管大小与内淋巴囊大小之间存在一定的相关性.前庭水管直径越小,引出ASNR的概率越低.

摘要： 目的 探讨重症监护病房未通过听力筛查的新生儿听性脑干反应的特点.方法 选择2014年3月至2015年5 月单耳或双耳未通过自动判别听性脑干反应(AABR)或畸变产物耳声发射(DPOAE)筛查的NICU新生儿(NICU组,425例)及门诊无围生期疾病健康新生儿(健康组,833例)进行听性脑干反应检测.结果 Ⅴ波反应阈大于或等于30 dB者健康组301例(36.1%),NICU组211例(49.6%),NICU新生儿ABR听力异常率明显高于健康新生儿(P<0.05).健康组ABR平均阈值为(19.76±6.59)dB,NICU组ABR平均阈值为(41.52±20.35)dB,比较差异有统计学意义(P<0.05). NICU组双耳Ⅰ、Ⅲ、Ⅴ波潜伏期及Ⅰ~Ⅴ波间期明显较健康组延长(P<0.05).结论 NICU 新生儿听力损失程度高于健康新生儿,ABR的异常反映了听觉传导通路异常.%Objective To investigate the auditory brainstem response (ABR) of newborns in the neonatal intensive care unit (NICU) after hear screening failure.Methods To test ABR of 833 healthy newborns with no perinatal diseases at the clinic,and 425 newborns born in NICU who failed the hearing screening of monaural or both-ear from March 2014 to May 2015.Results 49.6% of children′s wave V response thresholds were ≥30 dB in the NICU group and 36.1% children′s wave V response thresholds were ≥30 dB in healthy group.The hearing abnormality rate of the NICU group was significantly higher than that of the healthy group(P<0.05);The average auditory thresholds healthy of the group[(19.76±6.59)dB] was significantly lower than those of the NICU group[(41.52±20.35)dB](P<0.05);both ear latency for waves Ⅰ,Ⅲ and Ⅴ and interpeak latency for waves Ⅰ-Ⅴ in healthy group were significantly shorter than those in NICU group (P<0.05).Conclusion The hearing loss extent of the NICU group is greater than that of the healthy group.The ABR abnormality reflects auditory pathway is abnormal.

摘要： Objective 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.Methods 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/L427 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.Results 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,P427 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. 结果 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).结论 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.

摘要： 目的 探讨振幅整合脑电图(amplitude integrated electroencephalogram,aEEG)、脑干听觉诱发电位(brainstem auditory evoked potential,BAEP)、头颅磁共振成像(magnetic resonance imaging,MRI)与急性胆红素脑病临床诊断的相关性及敏感度.方法 回顾性选取2014年1月至2015年12月我院新生儿科收治、胎龄≥35周的中、高危高胆红素血症新生儿为研究对象,根据急性胆红素脑病诊断标准,分为急性胆红素脑病组和非急性胆红素脑病组,收集相关临床资料,分析aEEG、BAEP、头颅MRI结果与急性胆红素脑病临床诊断的相关性,并应用受试者工作特征曲线评价血清胆红素峰值、aEEG、BAEP、头颅MRI在急性胆红素脑病早期诊断中的价值.结果 纳入研究的高胆红素血症患儿共152例,其中急性胆红素脑病组33例,非急性胆红素脑病组119例.(1) aEEG、头颅MRI异常与急性胆红素脑病临床诊断成正相关,但关系不密切(aEEG:r=0.487,P＜0.001;MRI:r =0.220,P=0.018),BAEP异常与急性胆红素脑病临床诊断成正相关且关系密切(r=0.593,P＜0.001).(2)aEEG异常与BAEP异常、头颅MRI异常在急性胆红素脑病的诊断中成正相关,但关系不密切(BAEP:r=0.424,P＜0.001;MRI:r =0.307,P＜0.001).(3)血清总胆红素峰值、BAEP、aEEG、头颅MRI异常预测高胆红素血症患儿发生急性胆红素脑病的受试者工作特征曲线下面积分别为0.899、0.767、0.738、0.590.结论 aEEG、BAEP、头颅MRI在急性胆红素脑病诊断中具一定相关性和互补性,aEEG对急性胆红素脑病的预测具有较高敏感度,有助于急性胆红素脑病的早期诊断.%Objective To investigate the diagnostic correlation and sensitivity of amplitude integrated electroencephalogram (aEEG),brainstem auditory evoked potential (BAEP) and cranial magnetic resonance imaging (MRI) for acute bilirubin encephalopathy (ABE) in the newborn.Method Term and near-term neonates (gestational age ≥ 35 weeks) with hyperbilirubinemia (the level of bilirubin over than 95th percentile) of high and intermediate risk group admitted in the neonatal ward of Guangxi Maternal and Child Health Care Hospital from Jan 2014 to Dec 2015 were recruited retrospectively.The infants were assigned to ABE group and non-ABE group according to the diagnostic criteria of ABE.The clinical data of the newborns were collected and the diagnostic correlation between clinical diagnosis and aEEG,BAEP and cranial MRI were analyzed.The receiver operating characteristic (ROC) curve was adopted to assess the diagnostic efficiency of the peak level of serum bilirubin,aEEG,BAEP and cranial MRI on the early diagnosis of ABE.Result A total of 152 newborns with hyperbilirubinemia were recruited,including 33 cases in the ABE group and 119 cases in non-ABE group.(1) The results of aEEG and MRI were marginally positively correlated with clinical diagnosis of ABE (aEEG:r =0.487,P ＜ 0.001;MRI:r =0.220,P=0.018),while the results of BAEP were closely related to the clinical diagnosis of ABE (r =0.593,P ＜ 0.001);(2) The results of BAEP and MRI on the diagnosis of ABE were positively correlated with those of aEEG (BAEP:r =0.424,P ＜ 0.001;MRI:r =0.307,P ＜ 0.001).(3) The area under the ROC curves for predicting the onset of ABE were 0.899 for the peak level of serum bilirubin,0.767 for BAEP,0.738 for aEEG and 0.590 for MRI.Conclusion There was the correlation on the diagnosis of ABE among the methods of aEEG,BAEP and MRI.The combined diagnosis of the three methods could play a complementary role.The aEEG contributed to the early diagnosis of ABE with high sensitivity.

摘要： 目的 探讨儿童与青年脑干言语编码能力的性别差异.方法 对纯音听阈、声导抗、耳声发射和短声诱发听性脑干反应(click-ABR)测试结果均正常的56名青年人(男29名,女27名,年龄20～34岁)和经过年龄匹配的24名学龄期儿童(男、女各12名,年龄6～12岁)进行言语诱发听性脑干反应(speech-ABR)测试.speech-ABR测试采用插入式耳机,右耳给声,刺激声为/da/音.结果 ①女青年speech-ABR瞬态成分(V波、A波和O波)及周期成分(D波、E波和F波)的潜伏期均显著短于男青年(P值均＜0.05);除0波反应幅值(绝对值,下同)差异无统计学意义外(P＞0.05),女青年其余各波(V波、A波、D波、E波及F波)反应幅值均高于男青年(P值均＜0.05);女青年V/A复合波的斜率(绝对值,下同)也大于男青年[(-0.43 ±0.13)μV/ms vs(-0.25±0.08)μV/ms,P＜0.01].②男、女童speech-ABR的瞬态成分(V波、A波及O波)及周期成分(D波、E波及F波)的潜伏期及幅值差异均无统计学意义(P值均＞0.05);女童V/A复合波的斜率大于男童,差异具有统计学意义[(-0.46 ±0.12)μV/ms vs(-0.35±0.15)μV/ms,P＜0.05].③男青年与男童相比,除E波外(P＞0.05),男青年speech-ABR的瞬态成分(V波、A波及O波)及周期成分(D波及F波)的潜伏期均较男童有明显延迟,差异具有统计学意义(P值均＜0.05);男青年的A波、D波及F波与男童相比,幅值降低(P值均＜0.05),而V波、O波和E波的幅值并无明显降低(P值均＞0.05);此外,男童的V/A复合波的斜度明显大于男青年(P＜0.05).④女童与女青年speech-ABR的潜伏期及波幅接近,差异无统计学意义(P值均＞0.05);二者V/A复合波的斜率差异也无统计学意义(P＞0.05).结论 女青年听觉脑干对言语编码的同步性及锁相能力优于男青年,而在学龄期儿童中却未显示出这种性别差异.女青年与女童的脑干言语编码能力无明显差异,而男青年的脑干言语编码能力弱于男童,提示经历青春期后,雄激素浓度的升高可能会弱化男性脑干对言语信号的编码能力.

摘要： 本发明实施例公开了一种听觉脑干诱发电位检测方法及装置。所述方法包括：合成能够补偿耳蜗基底膜行波延迟的时域扫频声音信号；采用所述时域扫频声音信号对听觉系统进行刺激，得到听性脑干反应ABR波形。本发明实施例通过合成能够补偿耳蜗基底膜行波延迟的时域扫频声音信号，并采用合成的时域扫频声音信号对听觉系统进行刺激，可以得到较为准确的ABR波形。

摘要： 本发明涉及一种基于脑干听觉诱发电位的音高感知能力客观评估方法，其特征在于包括以下内容：1)采集记录待测被试的频率跟随响应，对频率跟随响应信号进行数据预处理；2)对经过预处理的频率跟随响应信号进行特征参数提取，得到客观评估待测被试音高感知能力的特征参数s，s越大，被试的音高感知能力越好。本发明实现了基于神经电生理信号的音高感知能力客观评估，过程中无需被测试者的主观参与，扩大了该方法的适用范围。本发明可以广泛应用于音高感知能力的评估中。

摘要： 一种双耳交替刺激的脑干听觉诱发电位描记装置，由计算机、触发脉冲发生器及两路单耳测试处理单元按一定方式联结和扩展，计算机控制触发脉冲发生器产生间隔为40ms的触发脉冲，分两路施加给脉冲刺激发生器，再通过声刺激发生器发出一定形式的声刺激。交叉放置在本侧乳突及对侧太阳穴的两对电极对将激励后的脑干响应信号引出，经放大器放大及A/D转换后送给算术平均计算机进行处理。两路测量通道以相同原理同时工作，但其中一路在触发脉冲发生器与脉冲刺激发生器之间连接了一个脉冲延迟器，使触发脉冲被延迟20ms。本发明通过两路信号交替刺激，可同时测量双耳的脑干诱发电位，解决了检测时间与检测精度之间的矛盾，成本低廉，结构简单。

摘要： 本发明公开了一种基于中潜伏期听觉诱发电位的听觉注意特征提取、识别系统及方法，包括设备控制模块、数据存储器、刺激声发生装置、数据采集装置和数据处理分析模块，所述刺激声发生装置、数据采集装置和数据处理分析模块分别与设备控制模块相连接，所述数据存储装置与设备控制模块、数据采集装置以及数据处理分析模块连接。本发明可以诱发出有效的事件相关电位，再计算其能量、方差、面积、AR模型系数及波形峰值作为特征值。最后，通过模式识别算法进行分类。实验结果：8位受试者以人工神经网络(ANN)为分类器的平均正确率可达到77.2％。本设计的实验方案，方便简洁有效。

摘要： 一种在GSI Audera听觉诱发电位仪增加40Hz听觉诱发电位记录的方法，完善了GSIAudera听觉诱发电位仪的功能。本方案编写了一系列刺激声，其刺激时长100ms，包含4个间隔均匀的刺激短音，在系统刺激速率为10Hz时，可以同时得到40Hz的短音刺激速率和100ms的记录窗宽，从而实现在GSI Audera记录40Hz听觉诱发电位。

摘要： 本发明涉及一种基于脑干听觉诱发电位的音高感知能力客观评估方法，其特征在于包括以下内容：1)采集记录待测被试的频率跟随响应，对频率跟随响应信号进行数据预处理；2)对经过预处理的频率跟随响应信号进行特征参数提取，得到客观评估待测被试音高感知能力的特征参数s，s越大，被试的音高感知能力越好。本发明实现了基于神经电生理信号的音高感知能力客观评估，过程中无需被测试者的主观参与，扩大了该方法的适用范围。本发明可以广泛应用于音高感知能力的评估中。

摘要： 本发明实施例公开了一种听觉脑干诱发电位检测方法及装置。所述方法包括：合成能够补偿耳蜗基底膜行波延迟的时域扫频声音信号；采用所述时域扫频声音信号对听觉系统进行刺激，得到听性脑干反应ABR波形。本发明实施例通过合成能够补偿耳蜗基底膜行波延迟的时域扫频声音信号，并采用合成的时域扫频声音信号对听觉系统进行刺激，可以得到较为准确的ABR波形。

摘要： 一种双耳交替刺激的脑干听觉诱发电位描记装置，由计算机、触发脉冲发生器及两路单耳测试处理单元按一定方式联结和扩展，计算机控制触发脉冲发生器产生间隔为40ms的触发脉冲，分两路施加给脉冲刺激发生器，再通过声刺激发生器发出一定形式的声刺激。交叉放置在本侧乳突及对侧太阳穴的两对电极对将激励后的脑干响应信号引出，经放大器放大及A/D转换后送给算术平均计算机进行处理。两路测量通道以相同原理同时工作，但其中一路在触发脉冲发生器与脉冲刺激发生器之间连接了一个脉冲延迟器，使触发脉冲被延迟20ms。本发明通过两路信号交替刺激，可同时测量双耳的脑干诱发电位，解决了检测时间与检测精度之间的矛盾，成本低廉，结构简单。

摘要： 本发明涉及基于听觉诱发电位采集的鱼类听觉特性测量系统及其应用，包含以下单元：声刺激信号合成单元，用于合成多种频率和多种声压级的声刺激信号；声刺激信号发射单元，用于向待测的鱼体发射所述多种频率和多种声压级的声刺激信号；听觉诱发电位信号采集单元，连接至待测的鱼体，用于获取所述待测的鱼体对所述多种频率和多种声压级的声刺激信号的反应；计算单元，用于根据所述待测的鱼体对所述多种频率和多种声压级的声刺激信号的反应得到所述待测的鱼体的听觉敏感特性曲线。

摘要： 本实用新型公开了一种脑干听觉诱发电位检查用辅助装置，针对在设备和被检查者之间所形成的多根线缆包围区域内线缆容易杂乱且不便于收取的问题，设置一个由若干个支撑节依次嵌合形成的竖直立柱结构，竖直立柱结构安装在卡接座上，卡接座卡合并由上顶螺栓上顶紧固在桌板上，且相邻的两个支撑节上的侧开口卡线套交错分布在竖直立柱结构的两侧，使得在进行脑干听觉诱发电位检查时，多根线缆能够容易地收取，有利于提高检查人员的工作效率。