电极位置和滤波对婴幼儿短纯音诱发听性脑干反应阈值的影响  

Effects of electrode position and filter setting on tone burst ABR threshold in infants

作　　者：刁文雯[1] 倪道凤[1] 商莹莹[1] 李奉荣[1] 张志勇[1] 朱莹莹[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,北京100730

出　　处：《中华耳科学杂志》2011年第4期408-412,共5页Chinese Journal of Otology

基　　金：国家科技部"十一五"支撑课题(编号:2007BAI18B12)资助

摘　　要：目的比较婴幼儿记录电极置于颅顶、滤波为30-1500Hz(简称第一组测试参数)与记录电极置于前额发际、滤波为30-3000Hz(简称第二组测试参数)各频率短纯音听性脑干反应(Auditory Brain Stem Re-sponse,ABR)阈值之间的差别,总结两种记录参数下短纯音ABR(tone burst ABR,tb-ABR)波形特点对阈值判断的影响,选择更优化的tb-ABR测试条件。方法应用SmartEP听觉诱发电位仪(美国IHS公司)记录0-6月龄婴幼儿短声及上述两种记录参数下tb-ABR各频率反应阈,共12例(10男/2女)20耳。结果 0.5kHz、1kHz、2kHz、4kHz记录电极置于前额发际、滤波为30-3000Hz时tb-ABR反应阈比记录电极置于颅顶、滤波为30-1500Hz时tb-ABR反应阈分别高7.00±5.5、7.25±6.0、7.25±4.7、8.00±5.5dB。各频率两种记录参数下tb-ABR反应阈之间差异均有统计学意义(t值分别为5.715、5.445、6.866、6.532,P值均<0.01)。同等强度时,两种记录参数下tb-ABR各波振幅差别明显,第一组测试参数下tb-ABR各波振幅高于第二组测试参数下tb-ABR各波振幅,前者的反应曲线较后者平滑,波V更容易辨认。结论用短纯音诱发ABR评估婴幼儿听力时,记录电极置于颅顶、滤波为30-1500Hz时各频率测试时反应阈和波形均优于记录电极置于前额发际、滤波为30-3000Hz,可提供更好的阈值测试结果。Objective This study is to compare the difference between thresholds and waveform characteristics of tone burst ABR acquired with different recording parameters, in an attempt to understand effects of testing parameters on waveform interpretation and to optimize testing conditions in frequency specific ABR. Methods Click and tone burst ABRs were tested in 12 children （20 ears） aged 0- 6 months （10 male/2 female）. Two sets of test parameters were used and compared： 1） the recording electrode at the vertex with a filter setting of 30 - 1500 Hz, and 2） the recording electrodeat the hairline-forehead with a filter setting of 30 - 3000 Hz. Results The tone burst ABR thresholds acquired with set- ting #2 were higher than those acquired with setting #1 by 7.00 ± 5.5, 7.25 ± 6.0, 7.25 ± 4.7 and 8.00 ± 5.5 dB at 0.5, 1, 2 and 4 kHz respectively（P 〈 0.01 ）. The ABR amplitudes with the first set of test parameters were also higher than with thesecond set of test parameters with smoother waveforms at the same stimulus intensity and easier-to- interpret wave V. Con- clusions Placing the recording electrode at the vertex and setting fihering between 30- 1500 Hz improve recording of tone burst ABR, as compared with having the recording electrode placed at the hairline-forehead and the filtering between 30-3000 Hz, and can provide increased accuracy in threshold determination.

关 键 词：婴幼儿 短纯音 听性脑干反应 记录参数 

分 类 号：R764.43[医药卫生—耳鼻咽喉科] R339.16[医药卫生—临床医学]