首页 > 过刊浏览 > 文章详情

OAE和AABR在新生儿听力筛查中听力损失检出效能的Meta分析

Meta-analysis of the Detection Efficiency of OAE and AABR in Universal Newborn Hearing Screening

文铖;黄丽辉;王现蕾;赵雪雷;邓奎;李小洪;袁雪莲;程晓华;

1:首都医科大学附属北京同仁医院耳鼻咽喉头颈外科北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室

2:四川大学华西第二医院中国出生缺陷监测中心

在线阅读

摘要

目的评价耳声发射(OAE))、自动听性脑干反应(AABR)及OAE+AABR用于新生儿听力筛查时听力损失的检出效能。方法通过Cochrane Library、Pubmed、Embase等数据库检索2000～2018年间国内外发表的应用OAE、AABR及OAE+AABR进行新生儿听力筛查的文献,设定文献筛选标准,使用STATA15.0软件对相关数据进行统计分析,对各筛查技术对听力损失检出的灵敏度及特异度进行Meta分析。结果共纳入符合要求的文献13篇,三种筛查方法的灵敏度合并效应值OAE为93%(87%～96%),AABR为70%(62%～77%),OAE+AABR为97%(87%～99%);特异度合并效应值OAE为94%(84%～98%),AABR为98%(95%～100%),OAE+AABR为97%(92%～99%);SROC曲线下面积OAE为96%,AABR为76%,OAE+AABR为99%;OAE+AABR联合筛查的灵敏度合并效应值最高,SROC曲线下面积最大;AABR筛查的特异度合并效应值最高。结论 OAE+AABR联合筛查对听力损失的检出效能可能优于仅使用OAE或AABR,建议新生儿听力复筛中采用OAE+AABR联合筛查。

关键词

新生儿听力筛查;Meta分析;灵敏度;特异度;SROC曲线下面积

基金项目(Foundation):

国家重点研发计划项目（2018YFC1002200）;; 国家自然科学基金面上项目（81870730）;; 北京市自然科学基金面上项目（7172052）

作者

文铖;黄丽辉;王现蕾;赵雪雷;邓奎;李小洪;袁雪莲;程晓华;

参考文献

1 Huang LH,Zhang L,Tobe RY,et al.Cost-effectiveness analysis of neonatal hearing screening program in china:should universal screening be prioritized[J]?Bmc Health Services Research,2012,12:97.

2 中华人民共和国卫生部.新生儿听力筛查技术规范[卫妇社发[2010]96号][J].中国儿童保健杂志,2011,19:574.

3 American Academy of Pediatrics,Joint Committee on Infant Hearing.Year 2007 position statement:principles and guidelines for early hearing detection and intervention programs[J].Pediatrics,2007,120:898.

4 唐军,胡敏,苏艳,等.518例新生儿听力及耳聋基因联合筛查结果分析[J].听力学及言语疾病杂志,2017,25:197.

5 陈欣,王智楠,夏忠芳,等.546例新生儿耳聋基因与听力联合筛查结果分析[J].听力学及言语疾病杂志,2016,24:182.

6 张天嵩,钟文昭,李博,等.实用循证医学方法学[M].湖南:中南大学出版社,2014.187～188.

7 吴皓,黄治物,孙喜斌,等.新生儿听力筛查[M].北京:人民卫生出版社,2014.267～268.

8 张天嵩,钟文昭,李博,等.实用循证医学方法学[M].湖南:中南大学出版社,2014.417～427.

9 Berninger E,Westling B.Outcome of a universal newborn hearing-screening programme based on multiple transient-evoked otoacoustic emissions and clinical brainstem response audiometry[J].Acta Oto-Laryngologica,2011,131:728.

10 Cubillanaherrero JD,Pelegrínhernández JP,Solervalcarcel A,et al.The assessment of the newborn hearing screening program in the region of murcia from 2004 to 2012[J].International Journal of Pediatric Otorhinolaryngology,2016,88:228.

11 Grill E,Uus K,Hessel F,et al.Neonatal hearing screening:modelling cost and effectiveness of hospital- and community-based screening[J].Bmc Health Services Research,2006,6:14.

12 Hall JW,Smith SD,Popelka GR.Newborn hearing screening with combined otoacoustic emissions and auditory brainstem responses[J].Journal of the American Academy of Audiology,2004,15:414.

13 Abdullah A,Long CW,Saim L,et al.Sensitivity and specificity of portable transient otoacoustic emission (TEOAE) in newborn hearing screening[J].Med J Malaysia,2005,60:21.

14 黄远,杨森,张静,等.耳声发射和自动听性脑电反应联合对新生儿听力筛查的临床价值[J].中国妇幼保健,2018,33:3023.

15 陈磊,严菊花.耳声发射和自动听性脑电反应联合进行新生儿听力筛查结果分析[J].中国儿童保健杂志,2015,23:1224.

16 李晓璐,卜行宽,陆玲,等.自动听性脑干反应在新生儿听力筛查中的应用[J].中国儿童保健杂志,2008,16:47.

17 Kennedy C,Mccann D,Campbell MJ,et al.Universal newborn screening for permanent childhood hearing impairment:an 8-year follow-up of a controlled trial[J].Lancet (North American Edition),2005,366:1.

18 Dort JC,Tobolski C,Brown D.Screening strategies for neonatal hearing loss:which test is best[J]?Journal of Otolaryngology ,2000,29:206.

19 Benitoorejas JI,Ramírez B,Morais D,et al.Comparison of two-step transient evoked otoacoustic emissions (TEOAE) and automated auditory brainstem response (AABR) for universal newborn hearing screening programs[J].Int J Pediatr Otorhinolaryngol,2008,72:1193.

20 Shang Y,Hao W,Gao Z,et al.An effective compromise between cost and referral rate:a sequential hearing screening protocol using TEOAEs and AABRs for healthy newborns [J].Int J Pediatr Otorhinolaryngol,2016,91:141.

21 蒋黎艳,雷朝霞,娄志武,等.TEOAE和AABR联合运用在新生儿听力复筛中的临床价值[J].吉林医学,2013,34:3111.

22 韩冰,历建强,兰兰,等.中国内地新生儿听力筛查情况的回顾性分析[J].听力学及言语疾病杂志,2012,20:6.

23 王莹,袁玲,关兵,等.听力初筛未通过婴幼儿DPOAE和AABR联合复筛的意义[J].听力学及言语疾病杂志,2018,26:468.

本文信息

PDF(1836K)

本文关键词相关文章

新生儿听力筛查 Meta分析灵敏度特异度 SROC曲线下面积

本文作者相关文章

文铖黄丽辉王现蕾赵雪雷邓奎李小洪袁雪莲程晓华