多频稳态诱发电位在职业性噪声聋诊断的应用  

Application of multiple auditory steady-state evoked responses in differential diagnosis of occupational noiseinduced deafness

作　　者：郑倩玲[1] 杨爱初[1] 林瑞祯[2] 梁晓阳[1] 梁伟辉[1] 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,广东广州510080 [3]广州市职业病防治院,广东广州510620

出　　处：《中国热带医学》2009年第1期55-57,共3页China Tropical 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可行性及临床应用价值。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0.5kHz、1kHz、2kHz、4kHz共四个频率处的ASSR和纯音测试(pure tone threshold audiometry,PTA),进行相关性分析和一元回归分析。结果各频率的ASSR-PTA差值在正常听力组依次为(7.63±5.62)dBHL、(11.58±2.80)dBHL、(10.54±3.24)dBHL、(9.20±3.32)dBHL,在客观聋组依次为(-0.63±8.22)dBHL、(8.99±8.75)dBHL、(12.50±8.50)dBHL、(10.03±10.13)dBHL,在夸大聋组依次为(-18.02±18.15)dBHL、(-11.05±16.63)dBHL、(-6.06±19.17)dBHL、(-5.81±20.17)dBHL。各频率ASSR反应阈与PTA听阈的相关系数在正常听力组依次为0.668、0.839、0.791、0.716,在客观聋组依次为0.817、0.826、0.892、0.768,而在夸大聋组依次为0.280、0.352、0.396、0.468。以客观聋组的ASSR反应阈为自变量、PTA听阈为因变量,进行一元回归分析。经回顾性考核和前瞻性考核,证实应用ASSR评估真实听力效果较好。结论应用ASSR鉴别诊断职业性噪声聋是可行的,有临床应用价值。Objective To study the feasibility and chnical values of differential diagnosis for occupational noise-induced deafness 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 objective deafness group cases, 47 exaggerated deafness group cases and 30 normal hearing group cases. The differences and correlation coefficients between the thresholds of ASSR and VIA were respectively analyzed. Results①The difference with the thresholds at 0.5, 1, 2 and 4 kHz of ASSR-PTA were （7.63±5.62）dBHL, （11.58±2.80）dBHL, （10.54±3.24）dBHL, （9.20±3.32）dBHL respectively in the normal hearing group, those in the objective deafness group were （-0.63±8.22）dBHL, （8.99±8.75）dBHL, （12.50±8.50）dBHL, （10.03±10.13）dBHL, and（-18.02±18.15）dBHL, （-11.05±16.63）dBHL,（-6.06±19.17）dBHL, （-5.81±20.17）dBHL in the exaggerated deafness group. The differences of thresholds of ASSR-PTA between the exaggerated deafness group and the normal hearing group or the objective deafness group are statistically signifieant （P〈0.001）;②The correlation coefficients of the two methods at 0.5, 1, 2 and 4 kHz in the normal hearing group were 0.668, 0.839, 0.791, 0.716, in the objective deafness group were 0.817, 0.826, 0.892, 0.768, and 0.280, 0.352, 0.396, 0.468 in the exaggerated deafness group; Conclusion ASSR can be used to differential diagnosis for occupational noise-induced deafness.

关 键 词：多频稳态诱发电位 职业性噪声聋 纯音测听 

分 类 号：R135.2[医药卫生—劳动卫生]