应用多频稳态诱发电位鉴别诊断职业性噪声聋的临床研究  

Clinical Study on Differential Diagnosis of Occupational Noise-induced Deafness with Multiple Auditory Steady-state Evoked Responses

作　　者：郑倩玲[1] 朱光华[1] 夏丽华[1] 黄伟欣[1] 林瑞祯[2] 刘移民[3] 

机构地区：[1]广东省职业病防治院,广东广州510300 [2]广东省人民医院 [3]广州市职业病防治院

出　　处：《实用预防医学》2008年第6期1700-1702,共3页Practical Preventive Medicine

基　　金：广东省医学科研基金项目(项目编号:B2006010)

摘　　要：目的探讨应用多频稳态诱发电位（multiple auditory steady-state evoked responses，ASSR）鉴别诊断职业性噪声聋的方法与意义。方法33例客观聋组、47例夸大聋组和30例正常听力组人员均行0．5、1、2、4kHz频率处的ASSR和纯音测试（pure tone threshold audiometry，PTA），对结果进行统计学分析。结果①客观聋组、正常听力组的ASSR反应阈与PTA听阈相关系数为0．67～0．89，夸大聋组为0．28～0．47。②在Bayes准则下分别应用ASSR反应阈、PTA听阈进行判断分析的总体符合率分别为78．18％、82．73％，判别夸大聋的准确率为65．96％、74．47％。③客观聋组的ASSR反应阈与VIA听阈存在线性依存关系，可建立回归方程。结论在职业性噪声聋诊断中，可利用ASSR为鉴别夸大聋和评估真实听阈提供证据。Objective To study the methods and value of differential diagnosis for occupational noise- induced deafness differential diagnosis with multiple auditory steady- state evoked responses （ASSR）. Methods ASSR and pure tone threshold audiometry（PTA）at 0.5, 1, 2 and 4 kHz were measured in 33 cases of objective deafness group, 47 cases of exag- gerated deafness group, and 30 cases of normal hearing group. The data investigated was analyzed with SPSS 13.0. Results （1） The correlation coefficients of the two methods in the objective deafness group and the normal hearing group were 0.67-- 0.89, and 0.28-- 0.47 in the exaggerated deafness group. （2） Adopting the rule of Bayes to discriminant analysis by the thresholds of ASSR and PTA, the total fitting ratios were 78.18 % and 82.73 % , and the accuracy ratios of the exaggerated deafness were 65.96 % and 74.47 % respectively. （3） In the objective deafness group, there was a linear relation between the ASSR and PTA, and the linear regression equation could be established. Conclusions ASSR can be used to evaluate hearing condition and discriminate exaggerated deafness in the differential diagnosis for occupational noise - induced deafness.

关 键 词：多频稳态诱发电位 纯音测听 职业性噪声聋 

分 类 号：R135.2[医药卫生—劳动卫生]