短纯音耳蜗微音电位评估耳蜗功能的临床应用价值

发布时间：2018-02-02 23:16

本文关键词： 耳蜗微音电位畸变产物耳声发射短纯音耳蜗蜗性聋　出处：《中华耳科学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的通过分别比较听力正常成年人及听力下降(蜗性聋)成年人相应频率的短纯音耳蜗微音电位(CM)及畸变产物耳声发射(DPOAE)的引出情况,探讨短纯音诱发的耳蜗微音电位在成人听力检测中的意义及临床应用价值。方法对听力正常成年人(34例68耳)、轻度听力下降成年人(23例27耳)及中度听力下降成年人(19例22耳)分别进行500 Hz、1000 Hz、2000 Hz短纯音CM及DPOAE检测,通过受试者自身对比,分析比较二者相应频率的检出率。结果听力正常组500 Hz、1000 Hz、2000 Hz短纯音CM的检出率分别为100%(68/68)、100%(68/68)、86.76%(59/68),DPOAE的检出率分别为76.47%(52/68)、100%(68/68)、100%(68/68);听力正常组500 Hz的短纯音CM检出率显著高于DPOAE检出率(P0.05)。轻度听力下降组(27耳)500 Hz、1000 Hz、2000 Hz短纯音CM的检出率分别为85.19%(23/27)、81.48%(22/27)、37.03%(10/27),相应频率DPOAE的检出率分别为29.63%(8/27)、51.85%(14/27)、44.44%(12/27),此组500 Hz、1000 Hz短纯音CM的检出率均显著高于DPOAE的检出率(P0.05)。中度听力下降组(22耳)500 Hz、1000 Hz、2000 Hz短纯音CM的检出率分别为77.27%(17/22)、77.27%(17/22)、27.27%(6/22),相应频率DPOAE检出率分别为13.64%(3/22)、40.91%(9/22)、40.91%(9/22),此组500 Hz、1000 Hz短纯音CM的检出率均显著高于DPOAE的检出率(P0.05)。。结论对于轻度、中度蜗性听力损失患者,CM在500 Hz、1000 Hz的敏感性优于DPOAE,能弥补DPOAE在中低频段敏感性不足、假阳性率高的问题;在临床工作中推荐联合应用CM和DPOAE评估耳蜗功能。
[Abstract]:Objective to compare the frequencies of CMV and DPOAE in normal hearing adults and adults with hearing loss (cochlear deafness). To explore the significance and clinical value of cochlear microphonetic potentials induced by short pure tone in adult hearing. Methods 34 cases (68 ears) with normal hearing were treated. Patients with mild hearing loss (n = 23, n = 27) and adults with moderate hearing loss (n = 19, n = 22) were treated with 500 Hz, 1 000 Hz, respectively. The detection rate of 200Hz short tone CM and DPOAE was analyzed and compared by self comparison. Results in the normal hearing group, the frequency of 500Hz was 1000Hz. The detection rate of 2000 Hz short tone CM was 100 / 68 / 100 / 86.76 / 86 / 68 respectively (59 / 68). The detectable rate of DPOAE was 76.47 / 68 / 100 / 68 / 68 / 100 respectively. The detection rate of short tone CM at 500Hz in normal hearing group was significantly higher than that in DPOAE group (P 0.05). The detection rate of 2000 Hz short tone CM was 85.19 / 23 / 81.48 / 22 / 27 / 37.03 / 27). The detectable rate of DPOAE at corresponding frequencies was 29.63 and 51.85 / 51.85, respectively. The detection rate of DPOAE was 14 / 27 / 44.4444.44 / 27, respectively, in this group 500Hz. The detection rate of 1000Hz short tone CM was significantly higher than that of DPOAE. The detectable rate of 2000 Hz short tone CM was 77.27 / 77.27 / 77.27 and 17 / 22 / 27.27 / 27, respectively. The detection rate of DPOAE at the corresponding frequency was 13.64 / 40.91and 40.91and 40.91respectively, and the corresponding frequency was 40.91 / 22Hz, which was 500Hz in this group. The detection rate of 1000Hz short tone CM was significantly higher than that of DPOAE (P 0.05). Conclusion in mild and moderate cochlear hearing loss patients, CM is at 500Hz. The sensitivity of 1000Hz is better than that of DPOAE, which can make up for the lack of sensitivity and high false positive rate of DPOAE in low and middle frequency. To evaluate cochlear function with CM and DPOAE in clinical work is recommended.
【作者单位】：暨南大学第二临床医学院(深圳市人民医院)耳鼻咽喉科;
【分类号】：R764
【正文快照】： 耳蜗微音电位(Cochlear microphonics,CM)和耳声发射(Otoacoustic emission,OAE)都是反映耳蜗外毛细胞功能的客观指标[1]。耳声发射已在临床广泛应用于新生儿听力筛查、小儿及成人耳蜗功能的诊断评估,但其检测明显受到中耳、外耳功能的影响,也易受测试环境本底噪声的干扰,存在

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