极重度感音神经性听力损失婴幼儿TB-ABR与CE-Chirp ASSR结果分析

发布时间：2018-05-08 21:35

本文选题：极重度 + 短纯音　；参考：《广州医科大学》2017年硕士论文

【摘要】：【背景】目前,短声ABR在临床上得到了广泛应用,为评估受试者听力水平和蜗后病变的诊断提供了客观依据。随着听力学的发展.新生儿听力筛查的普遍开展,发现全聋和/或极重度听力损失患儿越来越多,患儿年龄也越来越小,助听器验配技术的提高,为有残余听力的患儿提供了一线希望。但是由于短声ABR反映的是2000Hz~4000Hz的听力水平[1],它完全满足不了现如今临床听力学的发展要求。在临床中,获得可观有效的残余听力是非常重要和急迫的,所以具有频率特异性的短纯音ABR(tone burst ABR,tb-ABR)和CE-Chirp声诱发的听觉稳态诱发电位(CE-Chirp ASSR)的研究受到极大的重视。因为它们具有客观性、频率特异性、准确性高的特点,可用于婴幼儿早期听力损失的诊断与评估,它们能为我们提供500Hz~4000Hz具有频率特异性的波V阈值。故目前在国内外都得到了广泛的应用[2-6]。本文将对100例极重度感音性听力损失婴幼儿短纯音ABR与CE-Chirp ASSR的结果进行分析,观察它们的异同点,以期了解短声ABR最大输出无反应的情况下,是否代表全聋,它们的短纯音ABR与CE-Chirp ASSR各频率的反应阈值是否存在,两者的反应阈是否存在一定关系。【目的】对100例极重度感音神经性听力损失婴幼儿进行短纯音听性脑干反应(tone burst auditory brainstem response,tb-ABR)和CE-Chirp声诱发的听性稳态反应(auditory steady-state response,CE-Chirp ASSR)测试,对各频率反应阈的结果进行总结分析,比较两种测试方法的异同点。【方法】对100例极重度感音神经性听力损失婴幼儿进行短纯音ABR与CE-Chirp ASSR各频率反应阈值的测试,分别记录0.5k、1.0 k、2.0 k和4.0kHz的反应阈值,所得数据采用SPSS 11.0统计软件进行相关性检验和X2检验。【结果】短纯音ABR与CE-Chirp ASSR各频率能引出不同程度的阈值,V波引出阈值百分比主要集中在91-100dBHL,500~4000Hz波V阈值引出率之间的相关系数分别为:0.852、0.911、0.870、0.910,所有P值0.001。CE-Chirp ASSR与短纯音ABR各频率反应阈的卡方检验P值0.05。【结论】短声ABR提示极重度感音性听力损失婴幼儿,其短纯音ABR与CE-Chirp ASSR各频率均有不同程度的残余听力,短纯音ABR与CE-Chirp ASSR各频率反应阈引出率有很好的相关性,耳别间也无显著性差异。
[Abstract]:Background: at present, short-tone ABR has been widely used in clinical practice, which provides an objective basis for the evaluation of hearing level and diagnosis of retrocochlear lesions. With the development of audiology. With the widespread development of neonatal hearing screening, it is found that more and more children with total deafness and / or extremely severe hearing loss are getting younger and younger. The improvement of hearing aid matching technology provides a glimmer of hope for children with residual hearing. But because short tone ABR reflects the level of 2000Hz~4000Hz, it can not meet the requirements of clinical audiology. In clinical practice, it is very important and urgent to obtain significant and effective residual hearing. Therefore, the study of frequency specific short tone ABR(tone burst ABRtb-ABR and CE-Chirp acoustic-evoked auditory steady-state evoked potentials (CE-Chirp ASSRs) has received great attention. Because they have the characteristics of objectivity, frequency specificity and high accuracy, they can be used in the diagnosis and evaluation of early hearing loss in infants and children. They can provide us with frequency specific wave V threshold of 500Hz~4000Hz. So it has been widely used at home and abroad [2-6]. In this paper, the results of short-tone ABR and CE-Chirp ASSR in 100 infants with extremely severe sensorineural hearing loss were analyzed, and their similarities and differences were observed in order to find out if the maximum output of ABR represented total deafness. Whether there is a threshold of reaction between their short-tone ABR and CE-Chirp ASSR at each frequency, [objective] to measure the short tone auditory brainstem response (burst auditory brainstem responsetb-ABR) and the auditory steady-state response induced by CE-Chirp (auditory steady-state responseCE-Chirp ASSRs) in 100 infants with extremely severe sensorineural hearing loss. The results of each frequency response threshold were summarized and analyzed, and the similarities and differences between the two methods were compared. [methods] 100 infants with extremely severe sensorineural hearing loss were tested with short-tone ABR and CE-Chirp ASSR frequency response thresholds. The reaction thresholds of 0.5 kW 1.0 kg 2.0 k and 4.0kHz were recorded, respectively. The data were tested by SPSS 11.0 statistical software for correlation test and X2 test. [results] the percentage of threshold of short tone ABR and CE-Chirp ASSR can lead to different degrees of threshold / V wave extraction mainly in 91-100dBHL5004000Hz threshold rate. The correlation coefficients between them were 0. 852U 0. 9110. 8700. 910. the chi-square test P value of all P values of 0.001.CE-Chirp ASSR and short tone ABR was 0. 05. [conclusion] short tone ABR suggests very severe hearing loss in infants and young children with sensorineural hearing loss, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, respectively. The frequencies of short tone ABR and CE-Chirp ASSR had different degrees of residual hearing. There was a good correlation between short tone ABR and CE-Chirp ASSR. There was no significant difference among different ears.
【学位授予单位】：广州医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R764.43

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