小儿听神经病患者ASSR检测结果分析

发布时间：2018-03-24 06:02

本文选题：听性稳态反应　切入点：听神经病　出处：《听力学及言语疾病杂志》2014年02期

【摘要】：目的探讨小儿听神经病患者的听性稳态反应(auditory steady-state response,ASSR)特征及临床应用价值。方法研究对象为30例(60耳)诊断为双侧听神经病的患儿(观察组),其ABR双侧100dB nHL未引出反应,DPOAE和耳蜗微音电位(CM)均可引出,中耳功能正常。另选择30例(60耳)诊断为双侧极重度感音神经性聋的患儿为对照组,其ABR双侧100dB nHL未引出反应,DPOAE和CM均未引出,中耳功能正常。应用美国智听IHS ASSR系统对两组患儿进行ASSR测试,刺激声为调幅调制声,载波频率分别为500、1 000、2 000和4000Hz,调制频率分别为77~103Hz,耳机型号为ER-3A插入式气导耳机。比较两组患儿各频率ASSR反应阈。结果观察组500、1 000、2 000和4 000Hz ASSR反应阈分别为81.1±12.5、84.6±13.0、74.7±13.2和62.7±8.3dB nHL,对照组各频率ASSR反应阈分别为90.8±5.9、104.3±6.4、106.9±4.9和108.2±10.3dB nHL,观察组各频率ASSR反应阈均低于对照组,差异有显著统计学意义(P0.01)。结论虽然小儿听神经病患者ABR测试不能引出反应,但ASSR仍可引出反应,且其反应阈低于极重度感音神经性聋患儿;ASSR可引出反应的听神经病患儿可能可以排除听神经缺失的病变。
[Abstract]:Objective to investigate the auditory neuropathy patients with auditory steady-state response (auditory steady-state, response, ASSR) and clinical application. Methods 30 patients (60 ears) diagnosed as bilateral auditory neuropathy in children (observation group), the ABR 100dB nHL did not elicit bilateral responses, DPOAE and cochlear microphonics (CM) can lead, normal middle ear function. The other 30 cases (60 ears) diagnosed with bilateral sensorineural deafness patients as the control group, the ABR of bilateral 100dB nHL did not elicit reaction, DPOAE and CM were not drawn, normal middle ear function. Application of America's wisdom to listen to IHS ASSR system ASSR test on two groups of children, for the sound stimulus amplitude modulation, carrier frequency were 500,1 000,2 and 000 4000Hz, the modulation frequency was 77~103Hz, headset type ER-3A plug-in air conduction headset. Comparison of two groups of children with various frequency thresholds of ASSR. Results the observation group 500,1 000,2 000 4 000Hz and ASSR thresholds were 81.1 + 12.5,84.6 + 13.0,74.7 + 13.2 and 62.7 + 8.3dB nHL, control group ASSR frequency response threshold were 90.8 + 5.9104.3 + 6.4106.9 + 4.9 and 108.2 + 10.3dB nHL, observation group ASSR frequency response threshold was lower than the control group, the difference was statistically significant (P0.01). Conclusion although children with auditory neuropathy ABR test can not lead to reaction, but ASSR still leads to reaction, and the reaction is lower than the threshold of sensorineural deafness in children; ASSR can lead to the reaction of auditory neuropathy in children may lack of auditory nerve lesions can be excluded.

【作者单位】：首都医科大学生物医学工程学院;解放军总医院耳鼻咽喉头颈外科耳内科解放军耳鼻咽喉研究所;
【基金】：国家自然科学基金重大国际合作项目(81120108009);国家自然科学基金青年科学基金项目(81100719)联合资助
【分类号】：R764

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