重度阻塞性睡眠呼吸暂停低通气综合征对患者听觉功能的影响
发布时间：2019-05-05 12:32
【摘要】：目的探讨重度OSAHS对患者听觉系统造成的影响大小,提出相应的治疗措施,预防听力进一步的损害。 方法我们随机选取临床资料完整的24例诊断为OSAHS的患者,根据OSAHS严重程度将其分为轻、中、重度OSAHS组,8例无打鼾的健康人作为对照组,在隔音屏蔽室中(噪音20dB SPL),分别检测各组的常频(125-6000Hz)纯音气导电测听和扩展高频(8000-16000Hz)气导电测听、声导抗、畸变产物耳声发射(DPOAE)、瞬态诱发性耳声发射(TEOAE)、听性脑干反应(ABR)、40Hz听觉事件相关电位(40Hz AERP)、听觉稳态反应(ASSR),并记录检测结果。用SPSS 13.0统计软件进行相关数据处理分析。 结果①轻中度OSAHS组常频250Hz、1000Hz气导听阈较对照组差异显著(P0.05),500 Hz气导听阈较对照组差异非常显著(P0.01),重度OSAHS组常频500 Hz气导听阈较对照组差异非常显著(P0.01);轻中度OSAHS组扩展高频16000 Hz气导听阈较对照组差异显著(P0.05);重度OSAHS组扩展高频10000 Hz气导听阈较对照组差异显著(P0.05)。 ②对照组与轻中度OSAHS组间TEOAE检出率差异无显著性(P0.05),对照组与重度OSAHS组间TEOAE检出率有显著性差异(P0.05)。 ③轻中度OSAHS组DPOAE反应幅值与对照组比较差异无显著性(P0.05),重度OSAHS组DPOAE反应幅值在750、3000、4000 Hz频率点与对照组比较有非常显著性差异(P0.01)。 ④750 Hz频率点上,DPOAE检出率OSAHS组明显低于对照组,两组之间有非常显著性差异(P0.01);1000 Hz频率点,DPOAE检出率OSAHS组低于对照组,两组之间有显著性差异(P0.05)。 ⑤重度OSAHS组与对照组ABR I、II、III波潜伏期相比有非常显著性差异(P0.01),重度OSAHS组与对照组ABR IV波潜伏期相比有显著性差异(P0.05);波I-III间期、III-V间期、I-V间期及ABR阈值两组之间比较无显著性差异(P0.05)。 ⑥重度OSAHS、轻中度OSAHS与对照组40Hz AERP听阈之间比较无显著性差异(P0.05)。 ⑦轻中度OSAHS组在500 Hz、1000 Hz处ASSR听阈较对照组有非常显著性差异(P0.01),在2000 Hz处听阈较对照组有显著性差异(P0.05);重度OSAHS组在500 Hz、1000 Hz、4000 Hz处听阈较对照组有非常显著性差异(P0.01)。 结论重度OSAHS可以导致常频和扩展高频听阈提高;可以使OAE检出率下降,DPOAE反应幅值下降;可以使ABR各波潜伏期延长;可导致ASSR听阈提高。OSAHS可以导致耳蜗功能受损。
[Abstract]:Objective to investigate the effect of severe OSAHS on the auditory system of the patients, and to propose the corresponding treatment measures to prevent further hearing damage. Methods We randomly selected 24 patients diagnosed as OSAHS with complete clinical data and divided them into mild, moderate, severe OSAHS group according to the severity of OSAHS, and 8 healthy persons without snoring as the control group, in the sound insulation room (noise 20dB SPL),). Normal frequency (125-6000Hz) pure tone audiometry and extended high frequency (8000-16000Hz) audiometry, acoustic impedance, distortion product otoacoustic emission (DPOAE),) transient evoked otoacoustic emission (TEOAE),) auditory brainstem response (ABR),) were measured in each group. 40Hz auditory event-related potential (40Hz AERP),) auditory steady-state response (ASSR),) was recorded. SPSS 13.0 statistical software was used for data processing and analysis. Results (1) in mild and moderate OSAHS group, the air conduction threshold at 1000Hz was significantly higher than that in the control group (P0.05), and the difference was very significant at 500Hz compared with the control group (P0.01). In the severe OSAHS group, the air conduction threshold of 500 Hz was significantly different from that of the control group (P0.01). The hearing threshold of extended high frequency (16000 Hz) in mild to moderate OSAHS group was significantly higher than that in control group (P0.05), and that of 10000 Hz in severe OSAHS group was significantly higher than that in control group (P0.05). 2There was no significant difference in the detection rate of TEOAE between the control group and the mild to moderate OSAHS group (P0.05), but there was a significant difference between the control group and the severe OSAHS group in the detection rate of TEOAE (P0.05). 3There was no significant difference in the amplitude of DPOAE reaction between the mild and moderate OSAHS group and the control group (P0.05). The amplitude of DPOAE reaction in the severe OSAHS group was 750,3000,4 000 Hz higher than that in the control group (P0.01). At the frequency of 4750 Hz, the detection rate of DPOAE in OSAHS group was significantly lower than that in control group (P0.01), and the detection rate of DPOAE in OSAHS group was lower than that in control group at 1000 Hz frequency point (P0.05). 5There were significant differences in latency of ABR I, II and III between severe OSAHS group and control group (P0.01), and there was significant difference between severe OSAHS group and control group in ABR IV wave latency (P0.05). There was no significant difference in wave I-III interval, III-V interval, I / V interval and ABR threshold between the two groups (P0.05). (6) there was no significant difference in hearing threshold between severe OSAHS, mild and moderate OSAHS and control group 40Hz AERP (P0.05). (7) there was a significant difference in ASSR hearing threshold at 500 Hz,1000 Hz between mild and moderate OSAHS group compared with the control group (P0.01), and there was a significant difference in the hearing threshold at 2000 Hz compared with the control group (P0.05). There was a significant difference in hearing threshold at 500 Hz,1000 Hz,4000 Hz between the severe OSAHS group and the control group (P0.01). Conclusion severe OSAHS can increase the hearing threshold of constant frequency and extended high frequency, decrease the detection rate of OAE and decrease the amplitude of DPOAE response, prolong the latency of each wave of ABR, and increase the hearing threshold of ASSR. OSAHS can cause cochlear dysfunction.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R766
本文编号：2469566
[Abstract]:Objective to investigate the effect of severe OSAHS on the auditory system of the patients, and to propose the corresponding treatment measures to prevent further hearing damage. Methods We randomly selected 24 patients diagnosed as OSAHS with complete clinical data and divided them into mild, moderate, severe OSAHS group according to the severity of OSAHS, and 8 healthy persons without snoring as the control group, in the sound insulation room (noise 20dB SPL),). Normal frequency (125-6000Hz) pure tone audiometry and extended high frequency (8000-16000Hz) audiometry, acoustic impedance, distortion product otoacoustic emission (DPOAE),) transient evoked otoacoustic emission (TEOAE),) auditory brainstem response (ABR),) were measured in each group. 40Hz auditory event-related potential (40Hz AERP),) auditory steady-state response (ASSR),) was recorded. SPSS 13.0 statistical software was used for data processing and analysis. Results (1) in mild and moderate OSAHS group, the air conduction threshold at 1000Hz was significantly higher than that in the control group (P0.05), and the difference was very significant at 500Hz compared with the control group (P0.01). In the severe OSAHS group, the air conduction threshold of 500 Hz was significantly different from that of the control group (P0.01). The hearing threshold of extended high frequency (16000 Hz) in mild to moderate OSAHS group was significantly higher than that in control group (P0.05), and that of 10000 Hz in severe OSAHS group was significantly higher than that in control group (P0.05). 2There was no significant difference in the detection rate of TEOAE between the control group and the mild to moderate OSAHS group (P0.05), but there was a significant difference between the control group and the severe OSAHS group in the detection rate of TEOAE (P0.05). 3There was no significant difference in the amplitude of DPOAE reaction between the mild and moderate OSAHS group and the control group (P0.05). The amplitude of DPOAE reaction in the severe OSAHS group was 750,3000,4 000 Hz higher than that in the control group (P0.01). At the frequency of 4750 Hz, the detection rate of DPOAE in OSAHS group was significantly lower than that in control group (P0.01), and the detection rate of DPOAE in OSAHS group was lower than that in control group at 1000 Hz frequency point (P0.05). 5There were significant differences in latency of ABR I, II and III between severe OSAHS group and control group (P0.01), and there was significant difference between severe OSAHS group and control group in ABR IV wave latency (P0.05). There was no significant difference in wave I-III interval, III-V interval, I / V interval and ABR threshold between the two groups (P0.05). (6) there was no significant difference in hearing threshold between severe OSAHS, mild and moderate OSAHS and control group 40Hz AERP (P0.05). (7) there was a significant difference in ASSR hearing threshold at 500 Hz,1000 Hz between mild and moderate OSAHS group compared with the control group (P0.01), and there was a significant difference in the hearing threshold at 2000 Hz compared with the control group (P0.05). There was a significant difference in hearing threshold at 500 Hz,1000 Hz,4000 Hz between the severe OSAHS group and the control group (P0.01). Conclusion severe OSAHS can increase the hearing threshold of constant frequency and extended high frequency, decrease the detection rate of OAE and decrease the amplitude of DPOAE response, prolong the latency of each wave of ABR, and increase the hearing threshold of ASSR. OSAHS can cause cochlear dysfunction.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R766
【参考文献】
相关期刊论文 前10条
1 詹晓东;蒋成义;张明洁;王伟;;血清一氧化氮变化对豚鼠庆大霉素耳毒性作用影响的实验研究[J];蚌埠医学院学报;2007年02期
2 王鸿南,王希军,宋江顺;急性缺氧对豚鼠听性脑干反应的影响[J];第一军医大学学报;2000年03期
3 马颖钰;曲雁;;糖尿病听力损伤的研究进展[J];国外医学(老年医学分册);2009年05期
4 熊巍,邱建华;耳蜗的缺血/再灌注损伤研究进展[J];国外医学.耳鼻咽喉科学分册;2005年04期
5 马乙心 ,陈乾美 ,林尚泽;中老年高脂血症患者的40 Hz听觉相关电位和中潜伏期反应[J];贵州医药;2002年03期
6 马乙心 ,陈乾美;高脂血症对听觉功能潜在性损害的研究[J];贵州医药;2003年05期
7 董明敏,史晓瑞,董民声;内皮依赖性舒张因子对豚鼠内耳微循环障碍所致听力损伤的保护作用[J];河南医科大学学报;2000年06期
8 王超,张欣然,刘颖,肖辉,肖玉丽,金德均;扩展高频测听对耳鸣及噪音性聋患者早期听力损害的诊断作用[J];哈尔滨医科大学学报;2005年02期
9 王超,张欣然,肖辉,刘颖,肖玉丽,金德均;扩展高频测听对老年性听力损失早期诊断的意义[J];哈尔滨医科大学学报;2005年05期
10 周本忠,王胜国,姬长友,周定蓉,兰兰;脂代谢紊乱与阻塞性睡眠呼吸暂停低通气综合征的发病关系[J];解放军医学杂志;2005年06期
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