婴幼儿226Hz与1000Hz探测音声导纳测试比较分析  

Comparative analysis of 226 Hz and 1 000 Hz probe tone tympanometry in infants

作　　者：许军[1] 陈淑飞 郑周数 邵小飞 苏仁杰 沈安民[3] 史波宁 

机构地区：[1]宁波大学医学院附属医院耳鼻咽喉科,浙江宁波315020 [2]宁波市儿童听力筛查诊断中心 [3]德国亚琛工业大学院附属医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2013年第7期371-375,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2009年宁波市医学科技计划资助项目(No:2009A16)

摘　　要：目的:比较分析1000Hz、226Hz探测音声导纳在3岁龄内正常婴幼儿与中耳炎患儿中的测试结果和诊断价值。方法:对195例(321耳)正常婴幼儿与122例(171耳)中耳炎婴幼儿,做226Hz探测音鼓室声导纳、1 000Hz探测音鼓室声导纳及共振频率测试,运用SPSS11.0软件对峰导纳、斜率及共振频率等进行统计学分析,按年龄分组计算均值、标准差、中位数、5%分位数、95%分位数及95%置信区间,并检验正常婴幼儿与中耳炎婴幼儿在1 000Hz探测音峰导纳,226 Hz探测音峰导纳、斜率等测量值差别的统计学意义;并分别计算以1 000Hz探测音峰导纳,226Hz探测音峰导纳、斜率等测量值作为诊断标准时,出现的假阳性率和假阴性率,并做χ2检验。结果:1 000Hz峰导纳的正常值判断值定为≥0.2时,0～12个月龄组的假阳性率和假阴性率分别为3.07%、1.84%;正常值判断值定为≥0.3时,13～24个月龄组的假阳性率和假阴性率分别为3.26%、5.26%,25～36个月龄组的假阳性率和假阴性率分别为1.52%、0.00%;正常婴幼儿与中耳炎婴幼儿的226Hz探测音声导纳斜率组间比较,其中0～12个月龄组之间比较,差异无统计学意义(P>0.05)。以226Hz探测音斜率作为诊断标准时,中耳炎婴幼儿在13～24个月龄组的假阳性率和假阴性率分别为44.57%、31.58%,25～36个月龄组的假阳性率和假阴性率分别为16.67%、6.67%。结论:①1 000Hz探测音声导抗测试在诊断0～36个月婴幼儿中耳炎时,准确性优于226Hz探测音鼓室声导纳,建议3岁龄前的婴幼儿应采用1 000Hz探测音鼓室导纳图来评估中耳功能;②0～12个月龄内婴儿将正峰≥0.2mmho作为正常标准较为合理,13～36个月龄内幼儿将正峰≥0.3mmho作为正常标准较为合理。Objective：To analyze the judgement standard and evaluate the diagnostic value of the low frequency and high frequency tympanometry in infants with otitis media.Method：Tympanograms for admittance with 226 Hz and 1 000 Hz probe tones and resonant frequency were obtained from normal infants（195 cases,321 ears） and infants with otitis media（122 cases,171 ears）.The mean,standard deviation,median,5% quantile,95% quantile and 95% confidence interval of peak admittance,gradient and resonant frequency were measured and calculated in different age groups.The significant differences of 1 000 Hz peak admittance,226 Hz peak admittance and gradient between normal infants and infants with otitis median were analyzed using SPSS 11.0.The false positive rate and the false negative rate of different age groups in infants with otitis media were evaluated according to such judgement standards as 1 000 Hz peak admittance,226Hz peak admittance or gradient.Result：The false positive rate and the false negative rate of the 1 000 Hz probe tone tympanometry in infants with otitis media unter one year of age were 3.07% and 1.84% as the normal range of positive peak was more than 0.2 mmho.The false positive rate and the false negative rate of the 1 000 Hz probe tone tympanometry in infants with otitis media aged 1-2 years and aged 2-3 years were 3.26%,5.26% and 1.52%,0.00% respectively,as the normal range of positive peak was more than 0.3 mmho.These was no significant difference in the gradient with 226 Hz probe tone between normal infants and infants with otitis median under one year of age.The false positive rate and the false negative rate of the 226 Hz probe tone tympanometry in infants with otitis media aged 1-2 years and aged 2-3 years were 44.57%,31.58% and 16.67%,6.67% respectively,as the gradient with 226 Hz probe tone was a judgement standrad.Conclusion：①The diagnostic accuracy of tympanometry with 1 000 Hz probe tone for otitis media in infants younger than 3 years of age exceeded 226 Hz probe tone tympenometry,t

关 键 词：婴幼儿 声导纳 中耳功能 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]