重度感音神经性聋患者助听时前注意加工的特征  

The Characteristics of the Pre-attentive Process in Severe Sensorineural Hearing Loss Patients with Hearing Aids

作　　者：王晓翠[1] 许贵芳[2] 刘莎[1] 鲜军舫[3] 王振常[2] 莫玲燕[1] 郭连生[1] 杨宜林[1] 

机构地区：[1]首都医科大学附属北京同仁医院,北京市耳鼻咽喉科研究所,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100005 [2]中国科学院心理研究所 [3]首都医科大学附属北京同仁医院放射科

出　　处：《听力学及言语疾病杂志》2010年第3期239-242,共4页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金(30371533)、国家自然科学基金(30872859);北京市自然科学基金(7062019)、北京市自然科学基金(7082026);北京市教育委员会科技发展计划面上项目(KM200710025020);高等学校博士学科点专项科研基金(20060025002);北京市科技新星计划(B类2004-B-31)联合资助

摘　　要：目的以失匹配负波(mismatch negativity,MMN)为指标,初步研究声场下重度感音神经性聋患者助听时前注意加工的特征。方法对14例重度感音神经性聋患者(助听器组)和18例听力正常者(对照组),应用美国64导Neuroscan EEG/ERP记录系统,采用经典的Oddball模式,标准刺激和偏差刺激分别为1000Hz和1100Hz的短纯音,分别测试两组声场下MMN,分析两组MMN的峰潜伏期、开始时间、结束时间、持续时间、峰值波幅和61～240ms时程内每20ms的平均波幅。结果助听器组有12例检出MMN,检出率为85.71%(12/14);对照组检出率为100%。对照组MMN开始时间的平均值为93.06±12.26ms,助听器组为122.17±32.36ms,助听器组明显比对照组晚(P<0.05);对照组结束时间的平均值为233.44±13.20ms,助听器组为192.08±46.10ms,助听器组明显比对照组早(P<0.05);对照组MMN持续时间的平均值为140.38±61.78ms,助听器组为69.92±52.08ms,助听器组明显比对照组短(P<0.05);对照组161～240ms时程内MMN的平均波幅为-1.20μV,助听器组为0.12μV,助听器组明显比对照组降低(P<0.05);两组61～160ms时程内MMN平均波幅、MMN峰潜伏期、峰值波幅的差异无统计学意义(P>0.05)。结论重度感音神经性聋患者助听时可在前注意加工阶段对声音的频率进行加工,与听力正常人相比,助听器组MMN波形的开始时间明显延迟,而结束时间提前,导致MMN波形的持续时间明显缩短,161～240ms时程内的平均波幅明显降低。Objective Mismatch negativity（MMN）, as index, was used to study the characteristics of the pre --attentive process in severe sensorineural hearing loss patients with hearing aids. Methods Two groups were tested：one group of 14 severe sensorineural hearing loss patients as the hearing aids group while the other had 20 control subjects with normal hearing named as control group. Event--related potentials were recorded from 64 electrodes Neuroscan EEG/ERP system using a passive oddball paradigm in free field. The standard-- tone frequency was 1 000 Hz, and the deviant--tone frequency was 1 100 Hz. The onset time,offset time,peak latency,duration and mean amplitudes in 61-240 ms of the two groups were observed. Results MMN could be recorded in 12 amplified patients and 18 control subjects. The mean on set time of control group was 93.06±12.26 ms and the hearing aids group was 122.17±32.36 ms, significantly delayed than control group（P〈0.05）. The mean off set time of control group was 233.44±13. 2 ms and the hearing aids group was 192. 08 ms, significantly earlier than control group （P〈0. 05）; the mean duration of control group was 140.38 ms and the hearing aids group was 69.92 ms, significantly shorter than control group（P〈0. 05）. The mean amplitude of control group in 161-240 ms was -1.20 μV and the hearing aids group was 0.12 μV,significantly decreased in mean amplitude（P〈0.05）. No statistically significant differences were observed in the peck latency,peak amplitude and mean amplitude in 61-160 ms between the two groups （P〉0.05）. Conclusion Severe sensorineural hearing loss patients with hearing aids could process frequency in the pre--attentive stage. The use of hearing aids substantially improved the detectability of MMN. Compared with control group, the hearing aids group had significantly prolonged onset time, shortening offset time, short duration and decreased mean amplitude in 161-240 ms.

关 键 词：感音神经性聋 失匹配负波 前注意加工 助听器 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]