脉冲噪声致听力损失前DPOAE异常的转归及意义  

Study on abnormal distortion product otoacoustic emissions without hearing loss following military noise exposure

作　　者：何端军[1] 乔剑[1] 张家超[1] 郭万宏[1] 唐建勇[1] 杨静芬[1] 付艳秋[1] 

机构地区：[1]中国人民解放军第254医院耳鼻咽喉科,天津300142

出　　处：《邵阳学院学报（自然科学版）》2017年第3期93-97,共5页Journal of Shaoyang University：Natural Science Edition

摘　　要：目的观察脉冲军事噪声造成听力损失前畸变产物耳声发射(Distortion Product Otoacoustic Emission简称DPOAE)异常的恢复特点,并对其可能的临床意义进行探讨。方法筛选纯音听阈正常、DPOAE异常者30例(52耳),随机等分为A组(自然恢复组)和B组(给药恢复组)。A组(15例,27耳)给予安慰剂治疗,B组(15例,25耳)静脉给予硫辛酸600mg/日治疗,观察期间,在给药后第2、4、6、8、10天分别进行纯音听阈及DPOAE检查。结果观察期内,两组的纯音听阈无明显变化。DPOAE按3个(或以上)频点恢复到正常值判定为恢复正常,两组在治疗后第6天,B组恢复率显著高于A组(P<0.05),但第8天以后两组恢复率没有显著性差别,第10天两组基本全部恢复正常。结论人耳对脉冲军事噪声致听力损失前DPOAE自然修复期为8-10天,修复周期提示实弹射击训练周期大于8-10天,可减轻急性声损伤的累积作用。硫辛酸对其恢复早期有促进作用,可能对急性声损伤有预防和治疗意义。Objective To investigate the features of recovery from abnormal distortion product otoacousticemission （DPOAE） witli no hearing loss caused by military noise. Methods 30 （52 ears） artillerymen, with normal pure tone hearing thresholds and abnormal DPOAEs amplitude following military noise exposure,were randomly divided into 2 groups. Group A（ control group） witii 15 young adults （27 ears） redrip of placebo. Group B （test group） with 15 young adults （25 ears） received intravenousdrip of lip（600mg day） . Pure tone audiometry and otoacoustic emission were performed on the 2nd, 4 th, 6 th,days after treatment. Pure tone hearing thresholds and amplitudes of DPOAE were compared and analyzed.Results Statistical analysis showed that prior to the treatment both groups with pure tone hearing thresholds andamplitudes of DPOAE at 3, 4,6 and 8 KHz did not differ significantly. DPOAE recovery rate of group B wassignificantly higher than group A on the 6 th day after treatment （ p〈0. 05 ） . After 8 days the recoveryrate of two groups have no significant difference. But in the end ,the total recovery rate was essentially the same. Conclusion Military noise caused by abnormal DPOAE could repair itself. The natural repair periodays. Live firing cycle should be longer than 8 to 10 days. It can reduce the accumulatitrauma. Lipoic acid seems to significantly promote recovery in individuals with subclinical auditory systemimpairment caused by military noise exposure.

关 键 词：军事噪声 急性声损伤 畸变产物耳声发射 纯音测听 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]