成人3种频率特异性听觉诱发电位的比较

发布时间：2018-01-21 03:47

本文关键词： 法医学诱发电位听觉测听法纯音听阈　出处：《苏州大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的通过比较3种不同类型频率特异性听觉诱发电位（Auditory evokedpotential，AEP）的反应阈值与行为听阈之间的关系，为不同类型频率特异性AEP在客观评估听阈中的准确运用提供基础数据。方法分别对听力正常组34例（68耳）及听力障碍组89例进行0.5～4kHz频率范围内的40Hz听觉相关电位（40Hz auditory event related potential，40Hz AERP）、短纯音听觉脑干反应（tone burst auditory brainstem response，Tb-ABR）、听性稳态反应（auditory steady-state response，ASSR）这3种频率特异性AEP及纯音测听（pure tone audiometry，PTA）测试，分析不同频率之间、不同方法之间、不同组间这3种频率特异性AEP反应阈值与PTA阈值的相关性，并对不同频率3种AEP反应阈值之间以及与PTA阈值间的差异进行统计分析。结果在听力正常组和听力障碍组，40Hz AERP、Tb-ABR、ASSR在0.5～4kHz频率范围的反应阈值与PTA阈值之间均具有较好的相关性，两组比较，听力障碍组的相关性优于听力正常组。在听力正常组和听力障碍组两组相同的是，在0.5kHz及1kHz频率，40Hz AERP反应阈值与PTA阈值相关性优于Tb-ABR及ASSR，而在2kHz、4kHz频率，Tb-ABR及ASSR反应阈值与PTA阈值相关性优于40Hz AERP。无论听力正常组还是及听力障碍组，40Hz AERP、Tb-ABR、ASSR反应阈值与PTA阈值之间均存在差值，反应阈值高于PTA阈值。不同频率之间，40Hz AERP、Tb-ABR、ASSR反应阈值与PTA阈值之间差值有不同的统计学意义；不同组间，3种方法的反应阈值与PTA阈值的差异亦不同。听力正常组：在0.5kHz频率，40Hz AERP反应阈值与PTA阈值之间的差值最小，且差异与其他2种方法均具有统计学意义；在1kHz频率，ASSR反应阈值、40Hz AERP反应阈值与PTA阈值之间的差值相近，，差异无统计学意义；而在2kHz、4kHz频率，ASSR反应阈值与PTA阈值之间差值最小，且差异与其他2种方法均具有统计学意义。听力障碍组：在0.5、1kHz频率，40Hz AERP反应阈值与PTA阈值之间的差值最小，且与其他2种方法的差异有统计学意义；而在2、4kHz频率，虽Tb-ABR反应阈值与PTA阈值的差值最小，但与其他2种方法的差异无统计学意义。结论40Hz AERP、Tb-ABR、ASSR这3种频率特异性AEP检测技术所测得的反应阈值经过校正，均可以用于言语频率的客观听阈评估。从3种AEP反应阈值与PTA阈值之间的相关性及差值间的差异综合考虑，在0.5kHz、1kHz频率，建议选择40HzAERP检测方法，而在2kHz、4kHz频率，建议选择Tb-ABR或ASSR检测方法，以提高客观评估听阈的准确性。
[Abstract]:Objective to compare the relationship between behavioral threshold and response threshold of three different types of frequency specific auditory evoked potentials (AEPs). To provide basic data for the accurate application of different types of frequency specific AEP in objective assessment of hearing threshold. Methods the 40 Hz auditory related potentials (40 Hz) in the frequency range of 0.5 kHz in the normal hearing group (34 cases, 68 ears) and the hearing impairment group (89 cases, respectively) were studied. 40Hz auditory event related potential. 40Hz AERP, short tone auditory brainstem response (burst auditory brainstem response Tb-ABR). Auditory steady-state response to auditory steady-state response. Three kinds of frequency specific AEP and pure tone audiometry were tested and analyzed between different frequencies and methods. The correlation between the three frequency specific AEP reaction thresholds and the PTA thresholds among different groups was analyzed. The differences between the three AEP response thresholds and the PTA thresholds at different frequencies were analyzed statistically. Results 40 Hz AERP Tb-ABR was found in normal hearing group and hearing impairment group. There was a good correlation between the response threshold and PTA threshold of ASSR in the frequency range of 0.5kHz. The two groups were compared. The correlation of hearing impairment group was better than that of normal hearing group. The frequencies of 0.5kHz and 1kHz were the same in the normal hearing group and the hearing impairment group. The correlation between 40 Hz AERP response threshold and PTA threshold was better than that of Tb-ABR and ASSRs, but at 2 kHz ~ 4 kHz. The correlation between the threshold of Tb-ABR and ASSR reaction and the threshold of PTA was better than that of 40 Hz AERP. There was a difference between PTA threshold and 40 Hz AERP Tb-ABRN ASSR response threshold in both normal hearing group and hearing impairment group. The response threshold was higher than the PTA threshold, and the difference between the PTA threshold and the 40 Hz AERPU Tb-ABRN threshold was statistically significant. The difference of response threshold and PTA threshold was also different among different groups. In normal hearing group, the difference between 40 Hz AERP response threshold and PTA threshold was the smallest at 0.5 kHz frequency. The difference was statistically significant with the other two methods. The difference between the 40Hz AERP threshold and the PTA threshold was similar at 1kHz frequency. The difference was not statistically significant. The difference between ASSR response threshold and PTA threshold was the smallest at 2kHz and 4kHz, and the difference was statistically significant compared with the other two methods. 1kHz frequency 40Hz AERP reaction threshold and PTA threshold were the smallest, and the difference was statistically significant compared with the other two methods. However, at 2kHz, the difference between the threshold of Tb-ABR reaction and that of PTA was the smallest, but there was no significant difference between the two methods. Conclusion the response threshold measured by 40 Hz AERP Tb-ABRN ASSR and three frequency specific AEP techniques has been corrected. All of them can be used to evaluate the objective hearing threshold of speech frequency. Considering the correlation and difference between the three AEP response thresholds and PTA thresholds, the frequency of 0.5 kHz is 1 kHz. In order to improve the accuracy of objective assessment of hearing threshold, it is suggested to choose 40 Hz AERP detection method and 4 kHz frequency at 2kHz. It is suggested that Tb-ABR or ASSR detection method should be selected to improve the accuracy of objective assessment of hearing threshold.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R764

【参考文献】