婴儿听性稳态反应和听性脑干反应听力评估对比分析  

The Comparison of cABR and Auditory Steady-State Responses in Assessing the Hearing of Infants who Failed Screening

作　　者：王智楠[1] 陈平[1] 徐忠强[1] 魏翠芬[1] 刘艳[1] 韩芳[1] 姚薇[1] 吴展元[2] 

机构地区：[1]武汉市儿童医院耳鼻咽喉科,武汉430012 [2]武汉大学人民医院耳鼻咽喉科

出　　处：《听力学及言语疾病杂志》2008年第5期391-394,共4页Journal of Audiology and Speech Pathology

摘　　要：目的对新生儿听力筛查复筛未通过的婴儿的cABR及ASSR检测资料进行对比分析，了解它们各自的应用限度和相互关系。方法听力筛查复筛未通过，DPOAE、cABR及ASSR检测资料完整的婴儿546耳，男326耳，女220耳，年龄1～12月。分为3组：①听力正常组：DPOAE正常、cABR波V反应阈≤30dBnHL，146耳；②可疑听力损失组：DPOAE未能引出或部分频率不能引出、即使cABR波V反应阈≤30dBnHL也列入该组，126耳；③听力损失组：DPOAE正常或不正常、cABR波V反应阈〉30dBnHL，听力损失组中又按cABR反应阈分为3组：cABR反应阈≤60dBnHL 153耳、61～97dBnHL 75耳、无反应46耳。分别计算各组cABR波V反应阈与ASSR的0．5、1、2、4kHz反应阈的均值和标准差、变异系数，并进行相关性分析。结果婴儿cABR波V反应阈正常平均值为24．7±5．0dBnHL05、1、2、4kHzASSR正常反应阈平均值分别为43．3±11．2、36．9±9．5、28．6±11．8、31．7±14．0dBnHL。cABR反应阈正常平均值的标准差明显比ASSR小．cABR变异系数小于AS—SR，差异有统计学意义（P〈0．05）。cABR最大输出无反应的46耳中ASSR各频率也未引出的有6耳，ASSR各频率都可以引出的有27耳，部分引出的有13耳。结论ASSR与cABR在婴儿听力评估中起重要的相互补充的作用，运用ASSR加cABR进行综合评估值得推荐。Objective To investigate the correlation between the response thresholds of cABR and auditory steady stale responses（ASSR） for a group of infants who failed a newborn hearing screening. Methods The study was based on the DPOAE, cABR and ASSR diagnostic evaluation data of 546 ears of infants in aging from 1 to 12 months. The data were divided into 3 groups ：① normal hearing group consisting of 146 ears with normal DPOAE and the threshold of cABR 430 dB nHL ;②the group with unconfirmed, made up of 126 ears with abnormal DPOAE but the thresholds of cABR 430 dB nHL;③the hearing loss group consisting of three subgroups： subgroups Ⅰ had 153 ears witheABR threshold 460 dB nHL. subgroupⅡ had 75 ears with cABR threshold 61-97dBnHL, subgroup Ⅲ had 46 erars with absent cABR response. The means, standard deviant and coefficient of variation（CV） of the thresholds of ASSR were calculated and then compared with that of cABR. Results For the normal hearing group, the threshold of cABR was 24.7±5.0 dB nHL,the ASSR threshold at 0.5,1,2 and 4 kHz was 43.3±11.2, 36.9±9.5,28.6±11.8,30.1±11.3 dBnHL,respectively. The coefficient of variation of cABR was less than that of ASSR, the difference had statistical significance. For 46 ears without cABR response, 6 ears had no response of ASSR, but 40 ears had actually ASSR response. Conclusion cABR and ASSR are their own advantages and limitations,and a comprehensive assessment of cABR and ASSR testing results would be recommended for estimation hearing thresholds in infants.

关 键 词：婴儿 听性稳态反应 听性脑干反应 

分 类 号：R764.04[医药卫生—耳鼻咽喉科] R764.5[医药卫生—临床医学]