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预防医学  2018, Vol. 30 Issue (6): 590-594    DOI: 10.19485/j.cnki.issn2096-5087.2018.06.012
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新生儿听力和耳聋基因联合筛查临床应用研究
忻蓉,顾春健 ,沈学萍,蒋琦
湖州市妇幼保健院,浙江 湖州 313000
Clinical value of hearing screening combined with gene screening on newborns
XIN Rong,GU Chun-jian,SHEN Xue-ping,JIANG Qi
Huzhou Maternal and Child Health Care Hospital,Huzhou ,Zhejiang 313000,China
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摘要 目的 了解湖州市新生儿耳聋突变基因携带情况,探讨听力和耳聋基因联合筛查的意义。方法 纳入在湖州市妇幼保健院出生的2 258名新生儿进行听力和耳聋基因同步筛查,并随访至3周岁,分析两种筛查的互补性和关联性。听力初筛采用瞬态诱发耳声发射(TEOAE),听力复筛采用TEOAE及自动听性脑干反应(AABR);采集新生儿脐带血检测GJB2、SLC26A4、GJB3和线粒体12SrRNA 4个耳聋基因的20个突变位点。结果 听力初筛未通过550例,未通过率为24.36%;检出耳聋突变基因携带者118例,携带率为5.23%,GJB2、SLC26A4、GJB3和线粒体12SrRNA的基因突变携带率分别为3.10%、1.46%、0.58%和0.09%。母婴同室儿听力初筛未通过率为16.30%(300/1 840),耳聋突变基因携带率为5.65%(104/1 840);NICU儿听力初筛未通过率为59.81%(250/418),耳聋突变基因携带率为3.35%(14/418);NICU儿听力初筛未通过率高于母婴同室儿(P<0.01),两组耳聋突变基因携带率差异无统计学意义(P>0.05),是否通过听力初筛与是否携带耳聋突变基因无统计学关联(P>0.05)。失访52例,最终确诊听力障碍12例,听力障碍率为0.54%,其中9例耳聋基因筛查正常,3例耳聋基因筛查异常。结论 新生儿是否通过听力筛查与是否携带耳聋突变基因无关,采用听力和耳聋基因联合筛查可以减少迟发性耳聋的漏诊,预防药物性耳聋。
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忻蓉
顾春健
沈学萍
蒋琦
关键词 新生儿听力耳聋基因筛查    
AbstractObjective To understand the carrying condition of the mutation gene of neonatal deafness in Huzhou City and explore the significance of the combination screening of hearing and deafness genes. Methods 2 258 newborns who were born in Huzhou maternal and child health care hospital were screened for hearing and deafness and were followed up to the age of 3. Two kinds of complementarity and relativity of screening were analyzed. Early hearing screening was used by transient evoked otoacoustic emission(TEOAE)screening,hearing rescreening was used by TEOAE and autoauditory brainstem response(AABR). Collected the neonatal umbilical cord blood and detected GJB2,SLC26A4,GJB3,mitochondrial 12SrRNA 4 genes 20 deafness mutations. Results Early hearing screening failed in 550 cases,with a failure rate of 24.36%. Detected in 118 cases of deafness gene carriers,total carrying rate was 5.23%. GJB2,SLC26A4,GJB3 and mitochondrial 12SrRNA gene mutation rate were 3.10%,1.46%,0.58% and 0.09% respectively. Initial failure rate of mother and child hearing screening was 16.30 %(300/1 840). The rate of gene transfer for deafness mutation was 5.65 %(104/1 840). Initial failure rate of NICU hearing screening was 59.81 %(250/418). The rate of gene transfer for deafness mutation was 3.35%(14/418). The failure rate of initial hearing screening of NICU newborns was higher than that of mother and child(P<0.01). There was no statistically significant difference in carrying rate between the two groups(P>0.05). There was no statistical correlation between initial hearing screening and whether or not to carry deaf mutation gene(P>0.05). 52 infants were missed in this study. 12 patients were diagnosed with hearing impairment,and the hearing impairment rate was 0.54%. Among them,9 cases were normal and 3 cases were abnormal. Conclusion Newborns hearing screening by whether or not had nothing to do with deafness gene.Hearing screening with deafness gene screening at the same time can reduce the delay in diagnosis of deafness and drug deafness can also be prevented early.
Key wordsNewborns    Hearing    Deafness gene    United screening
          出版日期: 2018-06-04
中图分类号:  R764.43  
基金资助:湖州市科技局公益性技术应用研究一般项目(2014GYB16)
通信作者: 顾春健,E-mail:guchunj@163.com   
作者简介: 忻蓉,硕士,副主任医师,主要从事儿童听力障碍诊断和治疗工作
引用本文:   
忻蓉,顾春健 ,沈学萍,蒋琦. 新生儿听力和耳聋基因联合筛查临床应用研究[J]. 预防医学, 2018, 30(6): 590-594.
XIN Rong,GU Chun-jian,SHEN Xue-ping,JIANG Qi. Clinical value of hearing screening combined with gene screening on newborns. Preventive Medicine, 2018, 30(6): 590-594.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2018.06.012      或      http://www.zjyfyxzz.com/CN/Y2018/V30/I6/590
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