听阈正常耳鸣患者听性脑干反应检测的特点及临床意义  

Characteristics and Clinical Significance of Auditory Brainstem Response in Tinnitus with Normal Auditory Thresholds

作　　者：冯帅[1] 李晓瑜[2] 罗扬拓[1] 李伟光[1] 王智翔 姜学钧[1] FENG Shuai;LI Xiaoyu;LUO Yangtuo;LI Weiguang;WANG Zhixiang;JIANG Xuejun(The First Hospital of China Medical University,Shenyang,China,110000;The Affiliated Hospital of Jining Medical University,Jining,China,272029)

机构地区：[1]中国医科大学附属第一医院,沈阳110000 [2]济宁医学院附属医院,济宁272029

出　　处：《中华耳科学杂志》2019年第2期209-213,共5页Chinese Journal of Otology

摘　　要：目的研究听阈正常耳鸣患者听性脑干反应(auditory brainstem response,ABR)、畸变产物耳声发射(dis-tortion product evoked otoacoustic emissions, DPOAE)客观测试结果的特点,探讨ABR检测在耳鸣中的意义。方法对24例听力正常单侧耳鸣为主诉的患者进行纯音听阈、DPOAE和ABR检测,对比耳鸣侧和健侧的听阈、DPOAE各频率检出率及幅值和ABR各波波幅及潜伏期结果,进行统计分析。结果 24例患者双侧纯音听阈全部≤25dBHL,双侧无显著差异;DPOAE各频率检出率及幅值双侧无显著性差异;ABR结果中Ⅰ波波幅在耳鸣侧较健侧降低(t=-2.681,P<0.05),而Ⅲ、Ⅴ波波幅双侧无显著性差异,各波幅比双侧无显著性差异;Ⅰ、Ⅲ、Ⅴ各波潜伏期及波间期双侧无显著性差异。结论 ABR中Ⅰ波波幅下降代表听阈正常的耳鸣患者可能已经存在耳蜗早期变化,对耳鸣早期临床诊断有重要意义。Objective To report characteristics of auditory brainstem responses (ABR) and other objective tests in tinnitus patients with normal auditory thresholds and possible significance of ABRs in evaluation of early tinnitus. Methods Patients with unilateral tinnitus and normal hearing (n=24) received pure tone audiometry, distortion product otoacoustic emissions (DPOAE) and ABR testing, and the results of the tinnitus and healthy sides were compared. Results Pure tone thresholds were at 25 dB HL or lower in both ears in all 24 patients, with no significant difference between the two sides. There was no significant difference in DPOAE detection rate or amplitude between the tinnitus and healthy ears. ABR wave I amplitudes were lower on the tinnitus side than on the healthy side (t=-2.681, P<0.05), while there was no significant difference in waves III and V amplitudes, nor in V/I and III/I amplitude ratios, latency and interwave intervals of waves I, III and V between the two sides. Conclusion The decrease of ABR wave I amplitudes may represent early cochlear changes in patients with tinnitus and normal auditory thresholds, which is of great significance for the early diagnosis of tinnitus.

关 键 词：耳鸣 听性脑干反应 听阈正常 

分 类 号：R764[医药卫生—耳鼻咽喉科]