听力测试组合在高压氧治疗感音神经性耳聋中的应用  

Application of bearing test combination in sensorineural deafness with hyperbaric oxygen treatment

作　　者：王秋莎[1] 田树昌[4] 孙爱华[4] 高春锦[5] 王培嵩[6] 俞海安[2] 钱文华[3] 孙学军[7] 

机构地区：[1]南京医科大学附属常州第二人民医院高压氧科,江苏省常州213003 [2]南京医科大学附属常州第二人民医院五官科,江苏省常州213003 [3]南京医科大学附属常州第二人民医院预保科,江苏省常州213003 [4]第二军医大学附属长征医院耳鼻喉科 [5]北京朝阳医院高压氧科 [6]青岛大学医学院附属医院高压氧科 [7]第二军医大学潜水医学教研室

出　　处：《中华航海医学与高气压医学杂志》2008年第4期222-224,共3页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：国家自然科学基金（30472124）;山东省卫生计划发展基金（2001CAICKB7）

摘　　要：目的寻找感音神经性耳聋的发病与耳蜗毛细胞损伤的联系，探讨早期发现、早期干预本病的听力测试方法。方法从进行高压氧（HBO）治疗的感音神经性耳聋患者中随机选出253人，对HBO治疗前、治疗1、2个疗程后的治疗效果进行比较；行听性脑干反应（ABR）、畸变产物耳声发射（DPOAE）听力测试，并对结果进行比较。结果HBO治疗2个疗程后轻度耳聋治愈率与总有效率显著高于中度耳聋；HBO治疗1、2个疗程后与治疗前、治疗1个疗程后与2个疗程后ABR异常的发生率相比，差异有统计学意义（P〈0．05）。HBO治疗前与治疗2个疗程后比较，治疗1个疗程后与治疗2个疗程后比较，DPOAE幅值中、高频率段下移明显；治疗1个疗程后较治疗前在1．4～6．0kHz频率段略有上移。结论HBO可能是通过恢复耳蜗凋亡过程中毛细胞的活性而达到对感音神经性聋的治疗效果；DPOAE较ABR在对感音性耳聋检测中有敏感性和前瞻性；可以通过ABR、DPOAE组合检测来判断感音神经性耳聋的听力损伤和恢复的程度。Objective To study the relationship between the cochlear hair cell and sensorineural deafness, so as to explore hearing test method for early intervention and discovery. Methods Two hundred and fifty-three patients suffered from sensorineural deafness with hyperbaric oxygen （HBO） treatment were randomly seteceted, curative effect before and after HBO treantment were recorded and compared, respectively. Examinations of acoustic brainstem evoked respone （ABR） and distortion product otoacoustic emission （DPOAE） were conducted for the evaluation of hearing test result. Results It was revealed that total effective rate of mild hearing loss after two courses of HBO treatment was significantly higher than that of moderate deafness. There was significant difference in the incidence of abnormal ratio of ABR between pretherapy and aftertherapy of HBO （ P 〈 0.05 ）. DPOAE amplitude obviously decreased after one and two courses of HBO treatment. At 1.4-6.0 kHz frequency before and one course of HBO treatment, there was a slight upward. Conclusions HBO may have therapeutic efficacy on sensorineural deafness by revive the activity of cochlear hair apoptosis cell. DPOAE is more sensitive and prospective than ABR. The combination of ABR and DPOAE can be used to judge the degree of hearing impairment and recovery.

关 键 词：耳蜗毛细胞 感音神经性耳聋 高压氧 听性脑干反应 畸变产物耳声发射 

分 类 号：R686[医药卫生—骨科学]