唇腭裂患者听觉失匹配负波检查的初步研究  

Primary study of auditory mismatch negativity test in patients with cleft lip and plate

作　　者：王鸿南[1] 吴玮[1] 王佩林[1] 韩浩伦[1] 李保卫[1] 王刚[1] 陈艳芳[1] 孙建芝[1] 屈昌北[1] 

机构地区：[1]解放军三零六医院耳鼻咽喉头颈外科,北京100101

出　　处：《中国耳鼻咽喉头颈外科》2013年第4期204-206,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的对部分唇腭裂患者行听觉失匹配负波(mismatch negativity,MMN)检查,并与健康正常组对照,探讨言语障碍可能的神经功能机制。方法对唇腭裂患者15例,腭裂患者11例,健康志愿者10例分别行MMN检查。所有受试者均行ABR检查,确定ABR阈值,MMN检查采用oddball方式,偏差刺激声为2000 Hz,概率为20%,标准刺激为1000 Hz,概率为80%,观察MMN潜伏期及波幅在各组的表现特点。结果 MMN潜伏期在3组中分别为:唇腭裂组(147.10±29.44)ms;腭裂组(184.29±46.78)ms;对照组(154.86±19.48)ms;腭裂组与唇腭裂组比较有显著差异(F=9.730,P=0.001),腭裂组与对照组比较有显著差异(F=9.730,P=0.000),唇腭裂组与对照组比较无显著差异。MMN波幅在3组间无统计学差异。结论 MMN在不同类型唇腭裂患者的上述表现可能预示着腭裂患者在听觉中枢功能方面存在一定程度障碍。OBJECTIVE As MMN has been proved to be of much value in the assessment of central auditory discrimination and processing, we performed this test in patients with oral clefts, in order to investigate the different characteristics of MMN in different type of oral clefts, and normal volunteers were also tested as control, thus to study the possible neuro-functional mechanisms of the speech dysfunction in these patients. METHODS 26 cases of oral cleft, including 15 cases of cleft lip and palate （CLP） and 11 cases of cleft palate （CP） , and 10 normal volunteers were tested by MMN. In each cases, Auditory brainstem response （ABR） were tested before MMN. The odd-ball model was used in MMN test, the deviation frequency was 2000 Hz with a rate of 20%, the standard frequency was 1000 Hz with a rate of 80%. The latency and amplitude of MMN in each group were analyzed. RESULTS The latency of MMN in CLP, CP and normal were （147.10±29.44） ms; （184.29±46.78） ms and （154.86±19.48） ms respectively, and significant difference existed between CP and CLP; also between CP and normal. No significant difference was found between CLP and normal. There were no significant difference in the amplitude of MMN between each group. CONCLUSION The different latency of MMN in CP may, to some extent, indicate that in patients with CP, there might be some dysfunction in central auditory processing, which is responsible for the speech dysfunction in these patients.

关 键 词：腭裂 唇裂 诱发电位 听觉 脑干 听觉 大脑皮质 失匹配负波 

分 类 号：R764[医药卫生—耳鼻咽喉科]