婴幼儿短纯音与短声诱发的听性脑干反应初探  

Tone burst auditory brainstem response and click auditory brainstem response in infants with normal hearing

作　　者：沈安民[1] 陈淑飞[1] 郑周数[1] 许军[1] 徐明[1] 

机构地区：[1]宁波大学医学院附属医院耳鼻咽喉科

出　　处：《中国耳鼻咽喉头颈外科》2010年第5期243-246,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：宁波市科技攻关资助项目(2006041)

摘　　要：目的分析婴幼儿短纯音诱发的听性脑千反应（tone burst click auditory brain stem response, TB-ABR）与短声诱发的听性脑千反应（click auditory brain stem response, C-ABR）阈值的相关性，以探讨TB—ABR在婴幼儿客观听力评估中的临床应用价值。方法对2007年1月-2009年1月，新生儿听力筛查通过且C—ABR阈值正常者27例（54耳），以短纯音为刺激声，进行ABR波V反应阈值及潜伏期测试，并与C-ABR作差异与相关性分析。结果本组27例（54耳）婴幼儿中完成4个频率TB-ABR测试的共27例（54耳），0．5、1、2、4kHz TB—ABR波V反应阈值分别为（40．0±11．6）dBnHL、（36．7±9．0）dBnHL、（27.2±6．7）dBnHL和（25．9±6．3）dB nHL，明显高于C-ABR阈值（17．8±6．4）dBnHL（P〈0．05），TB-ABR波V反应阑值随着刺激声频率的升高而下降，潜伏期随着刺激声频率的升高而缩短。0．5、1、2及4kHz1BABR反应阈与GABR反应阈的线性相关系数分别为0.53、0．60、0.67、0．72，存在直线正相关关系（P〈0．01）。结论婴幼儿TB-ABR和C-ABR反应阈之间存在相关性，且高频相关性优于低频，TB-ABR可作为一种具有频率特异性的婴幼儿客观听力评估方法。OBJECTIVE To evaluate the effectiveness and advantage of tone burst auditory brainstem response （TB-ABR） as a method of auditory diagnosis in infants： METHODS Twenty seven infants （54 ears） who passed the tests including distortion product otoacoustic emission （DPOAE） and click auditory brainstem response （C-ABR） received TB-ABR measurements and correlation analyses between TB-ABR threshold and C-ABR threshold were carried out. RESULTS Wave V threshold of the 27 infants （54 ears） who completed four frequencies TB-ABR was （40.0± 11.6） dB nHL in 0.5 kHz, （36.7±9.0） dB nHL in 1 kHz, （27.2±6.7） dB nHL in 2 kHz and （25.9±6.3） dB nHL in 4 kHz respectively, which were significantly higher than C-ABR threshold （17.8±6.4） dBnHL （P〈0.05） . The higher of the stimulus frequency, the lower of waveVthreshold and the shorter of waveV latency of TB-ABR. Linearity was found between C-ABR threshold and TB-ABR threshold at 0.5, 1, 2 and 4 kHz （γ=0.53, 0.60, 0.67, 0.72, P〈0.01） . CONCLUSION There is a correlation between TB-ABR threshold and C-ABR threshold, the correlation at high frequency is better than that of low frequency in infants with normal hearing. TB-ABR may serve as a preferable objective measurement for assessing the hearing threshold with frequency specificity in infants.

关 键 词：测听法 诱发反应 听觉 婴幼儿 

分 类 号：R764[医药卫生—耳鼻咽喉科]