OAE和AABR在新生儿听力筛查中听力损失检出效能的Meta分析  

Meta-analysis of the Detection Efficiency of OAE and AABR in Universal Newborn Hearing Screening

作　　者：文铖 黄丽辉[1] 王现蕾 赵雪雷[1] 邓奎 李小洪 袁雪莲 程晓华[1] Wen Cheng;Huang Lihui;Wang Xianlei;Zhao Xuelei;Deng Kui;Li Xiaohong;Yuan Xuelian;Cheng Xiaohua(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Otolaryngology,Key Laboratory of Otolaryngology Head and Neck Surgery,Ministry of Education,Beijing,100730,China)

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,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,北京100730 [2]四川大学华西第二医院中国出生缺陷监测中心

出　　处：《听力学及言语疾病杂志》2020年第2期201-206,共6页Journal of Audiology and Speech Pathology

基　　金：国家重点研发计划项目(2018YFC1002200);国家自然科学基金面上项目(81870730);北京市自然科学基金面上项目(7172052)。

摘　　要：目的评价耳声发射(OAE)、自动听性脑干反应(AABR)及OAE+AABR用于新生儿听力筛查时听力损失的检出效能。方法通过Cochrane Library、Pubmed、Embase等数据库检索2000~2018年间国内外发表的应用OAE、AABR及OAE+AABR进行新生儿听力筛查的文献,设定文献筛选标准,使用STATA15.0软件对相关数据进行统计分析,对各筛查技术对听力损失检出的灵敏度及特异度进行Meta分析。结果共纳入符合要求的文献13篇,三种筛查方法的灵敏度合并效应值OAE为93%(87%~96%),AABR为70%(62%~77%),OAE+AABR为97%(87%~99%);特异度合并效应值OAE为94%(84%~98%),AABR为98%(95%~100%),OAE+AABR为97%(92%~99%);SROC曲线下面积OAE为96%,AABR为76%,OAE+AABR为99%;OAE+AABR联合筛查的灵敏度合并效应值最高,SROC曲线下面积最大;AABR筛查的特异度合并效应值最高。结论OAE+AABR联合筛查对听力损失的检出效能可能优于仅使用OAE或AABR,建议新生儿听力复筛中采用OAE+AABR联合筛查。Objective To evaluate the detection efficiency of otoacoustic emission(OAE),auditory brainstem response(AABR)and the combination of the two methods in universal newborn hearing screening.Methods The Cochrane Library,PubMed,Embase and other databases published between 2000 and 2018 were used to search literatures related to hearing screening method using OAE,AABR and OAE+AABR.The standard of screening literature was set up and the articles were divided into three groups according to the screening methods.Statistical analysis was performed on the relevant data using STATA 15.0 software,and the sensitivity and specificity were subjected to meta-analysis.Results A total of 13 articles were deemed eligible.For sensitivity pooled value,OAE was 93%(87%~96%),AABR was 70%(62%~77%),and OAE+AABR was 97%(87%~99%).For specificity pooled value,OAE was 94%(84%~98%),AABR was 98%(95%~100%),and OAE+AABR was 97%(92%~99%).For the area under the curve,OAE was 96%,AABR was 76%,and OAE+AABR was 99%.The sensitivity pooled value and the area under the curve of OAE+AABR was the highest.The specificity pooled value of AABR is highest.Conclusion The OAE+AABR combined screening may be more effective in detecting hearing loss than OAE or AABR alone.It is recommended that OAE+AABR combined screening could be used in neonatal hearing rescreening.

关 键 词：新生儿听力筛查 META分析 灵敏度 特异度 SROC曲线下面积 

分 类 号：R764.04[医药卫生—耳鼻咽喉科]