Chirp-ASSR对婴幼儿听神经病谱系障碍诊断的应用研究  

Clinical Application of Chirp-ASSR in Children With Auditory Neuropathy Spectrum Disorder

作　　者：李楚凌[1] 谭淑娟 王远明[1] 罗香林[1] 徐亚雄[1] 尹宝珠[1] 罗仁忠 王小亚 Li Chuling;Tan Shujuan;Wang Yuanming;Luo Xianglin;Xu Yaxiong;Yin Baozhu;Luo Renzhong;Wang Xiaoya(Department of Otolaryngology Head and Neck Surgery,Dongguan City Maternal and Child Health Hospital,Dongguan Hospital for Women and Children, Dongguan,523003, Chin)

机构地区：[1]东莞市妇幼保健院东莞市妇女儿童医院耳鼻咽喉-头颈外科,东莞523003 [2]广州市妇女儿童医疗中心耳鼻咽喉-头颈外科

出　　处：《听力学及言语疾病杂志》2018年第3期243-246,共4页Journal of Audiology and Speech Pathology

基　　金：东莞市社会科技发展重大项目(2015108101034)

摘　　要：目的比较婴幼儿Chirp声和调频调制音诱发的听性稳态反应(auditory steady-state responses,ASSR)的特征表现,探讨婴幼儿听神经病谱系障碍(auditory neuropathy spectrum disorder,ANSD)的临床听力学特点。方法观察组为19例(38耳)确诊为双侧ANSD的患儿,年龄3个月~3.6岁,平均年龄1.4±1.2岁,Chirp声行Chirp-ASSR检查;对照组为16例(32耳)确诊的双侧ANSD患儿,年龄3个月~4岁,平均年龄1.7±1.4岁,行调频调制音ASSR检测;比较两组平均检测时间,并将两组患儿ABR反应阈与两组ASSR反应阈间两两比较。结果 Chirp-ASSR检测时间(双耳平均21分17秒)较调频调制音ASSR(双耳平均26分9秒)短,节省时间22.87%;两组ASSR引出率[对照组为57.89%(22/38),观察组为65.63%(21/32)]高于ABR引出率[分别为21.05%(8/38)和25.00%(8/32)](均为P<0.05),且观察组高于对照组(P<0.05)。观察组和对照组500、1 000、2 000、4 000Hz ASSR平均反应阈分别为78.62±11.81、78.43±10.72、68.00±12.53、58.74±14.31和76.28±27.04、83.57±14.78、89.83±8.44、78.69±12.04dB nHL,明显低于观察组和对照组的ABR反应阈(分别为106.84±10.15和106.72±9.72dB nHL);于500Hz处,Chirp-ASSR反应阈均值较调频调幅ASSR略大,但差异无统计学意义(P>0.05),而1 000、2 000和4 000 Hz处,Chirp-ASSR反应阈均值较调频调幅ASSR反应阈均值均有下降,差异有统计学意义(P<0.05)。结论 Chirp-ASSR用于ANSD婴幼儿的听力检测用时短,且有频率特性,有良好的临床应用价值。Objective To compare the characteristics of ASSR（auditory steady-state responses）induced by chirp-sound and FM modulation sound in infants and children,and to study the audiology clinical characteristics of ANSD（auditory neuropathy spectrum disorder）.Methods A total of 19 cases（38 ears）with ANSD as the observation group received the Chirp-ASSR test.The instruments Eclipe and Smart EP were used to conduct ChirpASSR test with Chirp sound.The control group was 16 cases（32 ears）ANSD who received ASSR by FM modulation sound.The ABR response threshold and the ASSR threshold of two groups were compared.Results The testing time of Chirp-ASSR was 22.8%shorter than FM modulation.The response threshold of ASSR was markedly lower than ABR.At 0.5 kHz,the mean value of Chirp-ASSR was slightly longer than ASSR,but without statistic difference.At 1,2 and 4 kHz,the mean value of Chirp-ASSR was lower than ASSR,with statistic difference（P〈0.05）.Conclusion As a new objective listening test tool,Chirp-ASSR has a great clinical value in differential diagnosis of ANSD in infants and children.

关 键 词：听神经病谱系障碍 婴幼儿 Chirp声 听性稳态反应 

分 类 号：R764.431[医药卫生—耳鼻咽喉科]