听力筛查转诊婴幼儿不同滤波条件短纯音诱发听性脑干反应的比较  

Comparison of tone burst evoked auditory brainstem responses with different filter settings forreferral infants after hearing screening

作　　者：刁文雯[1] 倪道凤[1] 李奉荣[1] 商莹莹[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科100730

出　　处：《中华耳鼻咽喉头颈外科杂志》2011年第3期201-204,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家科技部“十一五”支撑课题（2007BAll8B12）

摘　　要：目的短纯音诱发听性脑干反应（ABR）是听力筛查转诊婴幼儿听力评估的重要方法，本研究比较滤波分别为30～1500Hz与30～3000Hz时不同频率短纯音ABR阈值之间的差异，总结两种滤波条件下ABR波形特点及对阔值判断的影响，以选择更优化的频率特异性ABR测试参数。方法应用美国IHS公司SmartEP听觉诱发电位仪记录18例（22耳）2～33月龄婴幼儿短声、滤波为30～1500Hz与30～3000Hz短纯音ABR各频率反应阈。结果0．5kHz、1kHz、2kHz、4kHz滤波为30～3000Hz短纯音ABR反应阈比滤波为30—1500Hz短纯音ABR反应阈高。0．5kHz及2．0kHz两种滤波条件下短纯音ABR反应阈之间差异具有统计学意义（t值分别为2．238及2．217，P值均〈0．05），其他频率两种滤波条件下反应阈之间差异无统计学意义（P值均〉0．05）。同等刺激强度下，滤波为30～3000Hz的ABR波形与30～1500Hz相比不平滑，反应波曲线上会出现锯齿状细小的干扰波。结论在用短纯音ABR反应阈评估婴幼儿听力时，30～1500Hz可以作为更优化的滤波设置参数。Objective Auditory brainstem responses （ABR） evoked by tone burst is an important method of hearing assessment in referral infants after hearing screening. The present study was to compare the thresholds of tone burst ABR with filter settings of 30 - 1500 Hz and 30 - 3000 Hz at each frequency, figure out the characteristics of ABR thresholds with the two filter settings and the effect of the waveform judgement, so as to select a more optimal frequency specific ABR test parameter. Methods Thresholds with filter settings of 30 - 1500 Hz and 30 -3000 Hz in children aged 2 -33 months were recorded by click, tone burst ABR. A total of 18 patients （ 8 male / 10 female） , 22 ears were included. Results The thresholds of tone burst ABR with filter settings of 30 - 3000 Hz were higher than that with filter settings of 30 - 1500 Hz. Significant difference was detected for that at O. 5 kHz and 2.0 kHz （t values were 2. 238 and 2. 217, P 〈 0. 05 ）, no significant difference between the two filter settings was detected at the rest frequencies tone evoked ABR thresholds. The waveform of ABR with filter settings of 30 - 1500 Hz was smoother than that with filter settings of 30 - 3000 Hz at the same stimulus intensity. Response curve of the latter appeared jagged small interfering wave. Conclusions The filter setting of 30 - 1500 Hz may be a more optimal parameter of frequency specific ABR to improve the accuracy of frequency specificity ABR for infants＇ hearing assessment.

关 键 词：新生儿筛查 诱发电位 听觉 脑干 婴儿 

分 类 号：R764[医药卫生—耳鼻咽喉科]