摘要目的：探讨振幅整合脑电图联合行为测定在足月新生儿高胆红素血症脑损伤早期评估中的应用价值。方法选取2015年8月至2016年2月扬州大学临床医学院新生儿科收治的高胆红素血症患儿42例为研究对象，根据头颅磁共振成像（MRI）结果将其分为亚临床胆红素脑病组22例、高胆红素血症正常对照组20例；选择同期该院产科20名健康足月新生儿为健康对照组。比较3组血清胆红素（TB）水平及脑干听觉诱发电位（BAEP）、行为神经测定评分（NBNA）、振幅整合脑电图（aEEG）异常率，分析之间的相关性。结果（1）亚临床胆红素脑病组、高胆红素血症正常对照组及健康对照组新生儿血清TB水平、NBNA评分及BAEP、aEEG异常率比较差异均有统计学意义（F=20.16、7.12，χ2=15.18、12.23，P<0.01）。亚临床胆红素脑病组血清TB值、BAEP及aEEG异常率均高于高胆红素血症正常对照组及健康对照组，差异均有统计学意义（P<0.01，0.05）；NBNA评分均低于高胆红素血症正常对照组及健康对照组，差异均有统计学意义（P<0.01）。高胆红素血症正常对照组血清TB水平虽显著高于健康对照组（P<0.01），但NBNA评分及BAEP、aEEG异常率与健康对照组比较，差异无统计学意义（P>0.05）。（2）亚临床胆红素脑病组aEEG轻度异常7例中，BAEP轻度异常6例，中度异常1例；aEEG重度异常9例中，BAEP中度异常1例，重、极重度异常8例。aEEG与BAEP异常程度存在正相关（γ=0.806，P=0.032）。（3）亚临床胆红素脑病组22例，其中aEEG异常病例16例，占72.73%；aEEG+NBNA异常病例21例，占95.45%。aEEG与aEEG+NBNA异常率的比较，差异有统计学意义（χ2=4.08，P<0.05）。结论aEEG联合NBNA评分可作为评估足月新生儿高胆红素血症早期脑损伤的参考指标，具有十分重要的临床指导价值，值得临床推广。

abstractsObjective To investigate the application value of amplitude integrated electroencephalogram (aEEG) and neonatal behavioral neurological assessment(NBNA) in the early evaluation on brain damage for full-term neonates with hyperbilirubinemia. Methods From August 2015 to February 2016, 42 full-term neonates with hyperbilirubinemia were divided into two groups:subclinical bilirubin encephalopathy group and hyperbilirubinemia control group according to the results of magnetic resonance imaging(MRI), while 20 normal healthy full-term infants born in our hospital at the same time were chosen as normal control group. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Clinic Medical College of Yangzhou University. Informed consent was obtained from each parents.The serum level of total bilirubin(TB), the score of NBNA, the abnormality rate for brainstem auditory evoked potential (BAEP) and aEEG were compared among three groups,meanwhile the correlation for these parameters were assayed. Results (1)There were significant differences in the level of UCB ,the score of NBNA, the abnormality rate of BAEP and aEEG among different groups (F=20.16, 7.12,χ2=15.18,12.23,&nbsp;P<0.01). The level of TB , abnormality rate of BAEP and aEEG in subclinical bilirubin encephalopathy group were higher than those of the other 2 groups (P<0.01,0.05), while the score of NBNA in this group were significantly lower than those of hyperbilirubinemia control group and normal control group (P<0.01). The level of serum TB were higher in hyperbilirubinemia control group than that in the normal control group, but there were no statistically significant differences for the the score of NBNA ,abnormality rate of BAEP and aEEG (P>0.05). (2)Of the 7 mildly abnormal aEEG cases in the subclinical bilirubin encephalopathy group, 6 mildly abnormal and 1 moderately abnormal were found in BAEP test. All of the 9 severely abnormal aEEG cases in the subclinical bilirubin encephalopathy group were found 1 moderately abnormal and 8 severely/very severely abnormal of BAEP. By linear correlation analysis,the abnormality degree of aEEG was positively correlation with BAEP (γ=0.806, P=0.032). (3)22 cases of subclinical bilirubin encephalopathy group inclued 16 abnormal aEEG cases (72.73%) and 21abnormal aEEG with NBNA cases (95.45%) respectively,there were statistically significant differences (χ2=4.08,P<0.05). Conclusion aEEG combining with NBNA may be an reference indicator for early evaluation on brain damage in full-term neonates with hyperbilirubinemia. It has great clinical important value and can be worth popularizing.