耳蜗电图和ABR在听神经病诊断中的应用研究  

Application of Electrocochleography and ABR in the Diagnosis of Auditory Neuropathy

作　　者：冀飞[1] 陈艾婷[1] 赵阳[1] 刘兴健[1] 周其有[1] 

机构地区：[1]解放军总医院耳鼻咽喉-头颈外科解放军总医院耳鼻咽喉科研究所,北京100853

出　　处：《临床耳鼻咽喉头颈外科杂志》2010年第10期447-449,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：模式识别国家重点实验室开放课题(No:08-3-1)

摘　　要：目的:分析比较耳蜗电图和ABR测试在听神经病(AN)诊断中的作用。方法:AN组为AN患者16例(32耳),对照组为感音神经性听力损失患者20例(26耳)。对2组受试者行交替极性短声刺激耳蜗电图和ABR测试。分别观测AN组和对照组的波形,并进行以下对比:①比较AN组患者的ABR和耳蜗电图波形引出率;②比较AN组与对照组耳蜗电图的复合动作电位(CAP)潜伏期和绝对幅度,以及总和电位(SP)与CAP的幅度比值。结果:AN组32耳中有25耳引出-SP或CAP,耳蜗电图总体引出率为78.1%。AN组的CAP潜伏期短于对照组(P<0.05),CAP绝对幅度低于对照组(P<0.05),-SP/CAP幅度比值高于对照组(P<0.01)。AN组仅5耳引出不完整的ABR波形,引出率为15.6%,且波形分化较差。ABR引出率明显低于耳蜗电图(P<0.01)。对照组全部引出分化良好的耳蜗电图和ABR波形。结论:耳蜗电图和ABR在AN的诊断中各自发挥重要作用。AN患者听觉信息的时间整合作用受到损害而强度感受机制受影响较小。Objective：To analyze and compare the clinical application of alternating click evoked electrocochleography（ECochG） and auditory brainstem response（ABR） in the diagnosis of auditory neuropathy（AN））subjects.Method：ECochGs and ABRs were recorded in 16 patients（32 ears） with AN /AD as AN group and 20 patients（26 ears） with sensorineural hearing loss（SNHL） as control group.Test stimuli were alternating polarity clicks.①To compare the occurrence rate of ECochGs and ABRs in AN patients.②To compare the peak latency of CAPs,absolute amplitude of CAPs,and amplitude ratios of-SP and CAP between AN group and control group.Result：ECochGs（-SPs or CAPs） presented in 78.1%（25 among 32 ears） of AN patients.CAPs latency of AN group was shorter than control group（P〈0.05）,CAP absolute amplitude of AN group was lower than normal group（P〈0.05）,while-SP/ CAP was higher than control group（P〈0.01）.Deformed ABRs presented in only 5 ears among 32 tested AN ears,while relative good ABR waveforms were evoked in control group.The occurrence rate of ABRs（15.6%） was significantly lower than that of ECochGs in AN patients（P〈0.01）.Conclusion：Both ECochGs and ABRs play important role in the diagnosis of AN.The capacity of temporal processing is significantly impaired while the intensity perception related capability is intact in AN patients.

关 键 词：前庭耳蜗神经疾病 诱发电位 耳蜗电图 听觉 脑干 听力损失 感音神经性 

分 类 号：R764.3[医药卫生—耳鼻咽喉科]