关键词: 高胆红素血症, 神经行为, 脑干听觉诱发电位, 新生儿

Abstract: Objective To investigate the influence of neonatal pathological jaundice on the neurobehavioral development of 3-month-old infants,in order to provide evidence for early clinical treatment and early evaluation of prognosis. Methods Totally 114 neonates with pathological jaundice treated in the Affiliated Hospital of Guilin Medical College from August 2014 to April 2016 were enrolled in this study, and were divided into three groups according to different levels of serum bilirubin concentration, including low level group(46 case, Sb<257 μmol/L),moderate level group(31 cases, Sb 257-342 μmol/L)and high level group(37 cases, Sb> 342 μmol/L).Infants received brainstem auditory evoked potentials (BAEP) test on admission and the abnormal cases would be retested BAEP at the age of 3 months old. Intelligent tests were conducted in all infants at their age of 3 months old. Results The abnormality rates of first BAEP test at admission in low level group, moderate level group and high level group were 34.8%(16/46), 51.6%(16/31) and 64.9%(24/37),respectively. And the difference was significant among three groups(P＜0.05).The scores of (mental development index,MDI) and (psychomotor development mdex,PDI) increased with the decrease of Sb level, and were negatively correlated with Sb level(r＝-0.583,-0.574,P＜0.001). And there was significant delay in the cases with abnormal BAEP results for the primary screening compared with normal ones. However, only three cases were abnormal in BAEP test at the age of 3 months old. Conclusions BAEP is a sensitive index of cerebral injury in children with neonatal pathological jaundice, but not an indicator for the recovery of patients′ nervous system independently. So it is suggested that together with regular neurobehavioral development test, BAEP warrants timely abnormal condition of nervous system for pediatricians in order to give early intervention and improve the prognosis.

Key words: hyperbilirubinemia, neurobehavioral development, brainstem auditory evoked potentials, neonates