梅尼埃病听力损失程度和类型对短声诱发的SP/AP比值的影响  

Influence of the hearing loss level and auditory sensation curve type on click evoked SP/AP amplitude ratio in Meniere′s disease

作　　者：王震 邵湘云[2] 只炳元[2] 闫维琴[2] 林晔[2] 

机构地区：[1]解放军第266医院耳鼻咽喉科,河北承德067000 [2]天津医科大学总医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉科杂志》2001年第10期446-449,共4页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :探讨耳蜗电图 (ECoch G)在梅尼埃病诊断中听力损失程度和类型 ,对交替短声诱发的负性总和电位 (SP)与动作电位 (AP)比值 (SP/ AP)的影响。方法 :采用鼓膜电极耳蜗电图描记术 ,对梅尼埃病 90耳 (梅尼埃病组 )和其他原因感音神经性聋 6 0耳 (感音神经性聋组 )及正常听力 5 0耳 (正常对照组 )记录了 AP和 SP各参数 ,对结果进行对照分析。结果 :AP潜伏期 3组差异无显著性 ,AP振幅正常对照组高于梅尼埃病组和感音神经性聋组 (P <0 .0 5 ) ,SP振幅正常对照组高于感音神经性聋组 (P <0 .0 1)而低于梅尼埃病组 (P <0 .0 1)。SP/ AP振幅比值梅尼埃病组 (48.0 9± 14 .38) % ,明显高于感音神经性聋组 (2 0 .0 2± 15 .0 0 ) %和正常对照组 (2 3.85±8.0 5 ) % ,(均 P <0 .0 1)。梅尼埃病组 SP/ AP比值与主观纯音听阈呈正相关 (r =0 .5 6 0 1,P <0 .0 1) ,其异常率为 73%。梅尼埃病不同听力损失组中 ,SP/ AP比值轻度耳聋组低于中度和中重度组 (均 P <0 .0 1) ,后两组差异无显著性意义 (P >0 .0 5 )。低频型低于平坦型 (P <0 .0 5 ) ,高频型和前两型相比差异无显著性意义。结论 :SP/ AP振幅比值异常增大有助于梅尼埃病的临床诊断 ,在一定范围内随听阈提高而增大 ,必须有足够的残余听力才能记录质量好的图形。?Objective:To assess the influence of hearing loss level and auditory sensation curve type on click evoked SP/AP amplitude ratio (negative summating potential /action potential) in the diagnosis of Meniere′s disease.Method:AP and SP was recorded with tympanic ECochG in normal controls (50 ears),patients with sensorineural hearing loss ( SNHL ) and patients with Meniere′s disease (90 ears) which were further divided based upon the degree of hearing loss and audiometric configuration.SP/AP amplitude ratio was calculated and analyzed.Result:AP latency in the three groups had no significant differences. AP amplitude in normal hearing subjects was higher than other two patients groups (P< 0.05 ) .Amplitude of SP of control group was higher than that of SNHL group (P< 0.01 ),but lower than Meniere′s disease group (P< 0.01 ).SP/AP amplitude ratio in Meniere′s disease ears was ( 48.09 ± 14.83 ) %,which was significantly higher than that of SNHL group ( 20.20 ± 15.00 )% (P< 0.01 ) and normal group ( 23.85 ± 8.05 )% (P< 0.01 ).In Meniere′s disease ears,SP/AP amplitude ratio was positively correlated to pure tone thresholds (r= 0.560 1 P< 0.01 ). An elevated SP/AP ratio was found in 73% of the Meniere′s ears and 6% of the SNHL ears. SP/AP ratio among the different levels of hearing loss in Meniere′s disease ears, of the ears with mild hearing loss was lower than those with moderate (P< 0.01 ) and severe hearing loss (P< 0.01 ), but between later groups there was no statistical significant difference (P> 0.05 ). Positive rate of SP/AP ratio was 63% in mild, , 83% in moderate,73% in severe hearing loss ears respectively.SP/AP amplitude ratio in patients with low tone auditory curve type was lower than that with flat type(P< 0.05 ), the latter had no significant difference (P> 0.05 ) compared with high tone type.Positive rate was 67.57 % in low tone type, 75% in high tone type and 78% in flat to

关 键 词：梅尼埃病 听力障碍 听觉诱发电位 耳蜗电图 

分 类 号：R764.33[医药卫生—耳鼻咽喉科]