颞叶癫痫患者的中枢听功能初探  

Primary investigation of central auditory function in patients with temporal lobe epilepsy

作　　者：李丽[1] 王宁宇[1] 张华[2] 葛晓辉[3] 李金兰[1] 谢迁[1] 徐先发[1] 刘博[2] 刘莎[2] 胡文立[1] 李燕[1] 

机构地区：[1]首都医科大学附属北京朝阳医院耳鼻咽喉头颈外科,100020 [2]北京市耳鼻咽喉科研究所 [3]中国聋儿康复研究中心

出　　处：《中华耳鼻咽喉头颈外科杂志》2007年第9期664-668,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的采用汉语最低听觉功能测试(minimal auditory capabilities in china,MACC)中背景噪声下言语测听法(speech-perception-in-noise test,SPIN),评价颞叶癫痫患者的中枢听觉功能。方法对9例经脑电图和 MRI、CT 检查后神经内科确诊的颞叶癫痫患者,进行 SPIN、听性脑干反应(auditory brainstem response,ABR)测试。选择19例年龄、性别相匹配的健康人做对照组,进行 SPIN测试。所有受试者均经询问病史、耳科检查及纯音测听、声导抗测定除外传导、感音神经性及混合性聋,且纯音听阈均在25 dB 以内。SPIN 测试材料中测试言语和噪声材料,采用独立声道录制,通过预实验选择测试信噪比(S/N)为-25 dB。测试时,每受试句均朗读2次,并对2次的结果分别进行记录和比较。结果在 ABR 测试中,癫痫患者仅Ⅴ波潜伏期左耳较右耳延长,且差异有统计学意义(P<0.05),余各波潜伏期及波问期差异均无统计学意义(P>0.05);在 SPIN 测试中,健康对照组第1次聆听左右耳间得分比较,差异无统计学意义(P>0.05),第2次聆听时,差异有统计学意义(P<0.05);颞叶癫痫患者左右耳间得分比较,第1次和第2次聆听的差异均无统计学意义(P>0.05),而颞叶癫痫患者无论在单耳、双耳聆听以及第1次和第2次聆听的 SPIN 得分,与健康对照组相比,差异均有统计学意义(P<0.01)。由于9例癫痫患者中有3例为右侧颞叶病变,余为双侧颞叶病变,故未对左、右侧颞叶病变与左、右利手的关系可能对实验造成的影响进行统计分析。结论本组颞叶癫痫患者在纯音测听、ABR 检查无明显异常,而 SPIN 测试言语识别率明显低于对照组,差异有统计学意义,证明颞叶癫痫患者具有中枢听功能障碍,同时提示 SPIN 是一项敏感、无创的中枢听觉功能检查方法,建议临床上将其作为听处理套查方法之一。Objective To investigate the function of central auditory, Speech - perception - in - noise test （SPIN test） was used to assess that whether temporal lobe epilepsy patients have central auditory processing disorders. Methods Four audiological test were performed in 9 patients with temporal lobe epilepsy and 19 age- matched normal heating persons as controls, which include pure tone audiometry, acoustic immittanee measurement, ABR（ auditory brainstem response） and SPIN test. All the temporal lobe epilepsy patients were performed by CT or MRI and diagnosed by the neurologists prior to the test. The testing metiarals of speech and noise in SPIN test was recorded in independent tracks and the S/N was identified by - 25 dB by pre - experiment. In the test, every words were read twice and both the results were recorded. Results In the ABR test, only wave V latency showed longer values in the left ear, other waves likeⅠ , Ⅲ and inter - peak intervals hadnt shown significant statistical differences in both ears of temporal lobe epilepsy patients. However, In the SPIN test,there＇s no significant statistical differences in both left and right ears of the controls by the first- time heating（ P =0. 107 ） ,and the differences showed by the second- time hearing （P = 0. 048 ） ; but in the comparition of both ears in temporal lobe epilepsy patients, both time of heating showed no significant statistical differences with P = 0. 174 and P = 0. 163. In additional, the SPIN recognition score of the temporal lobe epilepsy patients ,whether in the fist or second time heating ,whether in the monaural or binaural modals, presented significant statistical differences compared to the controls （ P =0. 000）. Conclusions There was no statistically significant difference in pure tone audiometry and ABR test for all the groups. But the speech recognition score obtained from SPIN test of temprol lobe epilepsy patients is lower than the normal persons,which has statistically significant difference. （P 〈0. 001 ） Th

关 键 词：颞叶 癫痫 听觉 中枢神经系统 噪声 

分 类 号：R742.1[医药卫生—神经病学与精神病学]