听神经病谱系障碍患者噪声下言语识别能力研究  

Speech perception in noise in adults with auditory neuropathy spectrum disorders

作　　者：董瑞娟[1] 王硕[1] 刘冬鑫[1] 王媛[1] 陈静[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科中心北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室(首都医科大学)

出　　处：《中华耳科学杂志》2015年第4期604-607,共4页Chinese Journal of Otology

基　　金：国家自然科学基金:81200754;2012北京市科技新星计划:Z121107002512033;北京市自然科学基金面上项目:7122034;北京市自然科学基金青年项目:7154190;首都卫生发展科研专项基金:首发2011-1017-04;首都医科大学基础-临床科研合作基金:12JL46

摘　　要：目的分析听神经病谱系障碍(Auditory neuropathy spectrum disorder,ANSD)患者噪声下言语识别能力。方法利用普通话版噪声下听力测试(Mandarin Hearing In Noise Test,MHINT),分别测试30例ANSD患者,16例感音神经性听力损失(sensorineural hearing loss,SNHL)患者和12例听力正常者在安静情况下和信噪比分别为15,10,5,0 d B的噪声条件下的言语识别能力。结果 ANSD组在噪声条件下的言语识别率显著低于SNHL组和听力正常组(P<0.05);ANSD组在安静条件下与信噪比为15 d B条件下的言语识别率差异无统计学意义(P>0.05),然而与信噪比为10、5和0d B条件下言语识别率差异均具有统计学意义(P<0.05)。安静情况下及噪声条件下,SNHL组和ANSD组言语识别能力与其听力损失程度均呈显著负相关(P<0.01)。结论 ANSD患者的言语识别能力较SNHL患者显著降低,大多数ANSD患者安静条件下言语识别尚可,但噪声情况下言语识别能力显著下降;噪声条件下言语测试对ANSD的诊断具有潜在的重要作用。Objective To characterize speech perception ability in noise for a group of adults with auditory neuropathy spectrum disorders （ANSD）, and investigate the correlation between their hearing thresholds and speech perception performance. Methods Thirty subjects with auditory neuropathy spectrum disorders, sixteen subjects with sensorineural hearing loss （SNHL）, and twelve subjects with normal hearing （NH） participated in this study. Speech identification test was carried out using the Mandarin Hearing in Noise Test （MHINT）. In quiet condition, the speech level was fixed at most comfortable level （MCL）. In noisy conditions, the signal-to-noise ratio was set at ＋15, ＋10, ＋5 or 0 dB, respectively. The order of MHINT test was performed from easy to more difficult. Results The speech perception scores for the subjects with ANSD were significantly poorer than that for the subjects with SNHL and NH （P〈0.05）. In individuals with auditory neu- ropathy spectrum disorder, Post hoc analysis showed that the mean scores in quiet condition were not significantly differ- ent from those obtained in 15 dB conditions （P〉0.05）, but they significantly different from those obtained in 10 dB, 5 dB and 0 dB conditions （P 〈0.05）. Significantly negative correlations were present between speech perception scores and PTA0.5 - 4 kHz for both SNHL （P 〈 0.01） and ANSD （P 〈 0.01） subjects. Conclusions Speech perception abilities in subjects with auditory neuropathy spectrum disorders are poorer than in subjects with sensorineural hearing loss. While sentence recognition in quiet is fairly good （〉 80% correct） for most Mandarin-speaking patients with ANSD, adding a moderate level of noise dramatically decreases their speech recognition capacity. Thus, clinical evaluation of ANSD should also include evaluation of speech recognition under different levels of noise.

关 键 词：听神经病 耳聋 感音神经性 言语感知 

分 类 号：R764.5[医药卫生—耳鼻咽喉科]