婴幼儿听性脑干反应、听性稳态反应、行为测听的相关性分析  

Correlation Analysis of Auditory Brain Stem Response, Auditory Steady State Response and Behavioral Audiometry in Infants

作　　者：李果 林垦 王翔 高映勤[1] 陈泉东[1] 赵丽萍[1] 马静[1] LI Guo;LIN Ken;WANG Xiang;GAO Ying-qin;CHEN Quan-dong;ZHAO Li-ping;MA Jing

机构地区：[1]昆明市儿童医院(云南省儿童医学中心,昆明医科大学附属儿童医院)耳鼻咽喉头颈外科,昆明650000

出　　处：《中国听力语言康复科学杂志》2020年第4期295-298,共4页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：云南省儿童听力障碍及语言疾病综合防治省创新团队项目(2019HC026);云南省中青年学术和技术带头人后备人才培养项目(2019HB102);昆明市儿童先天出生缺陷防控研究重点实验室项目。

摘　　要：目的分析不同程度听力损失婴幼儿听性脑干反应(ABR)、听性稳态反应(ASSR)、行为测听三者的相关性。方法对75例(142耳)7个月~3岁的婴幼儿进行ABR、ASSR、行为测听和声导抗检查,按ABR的V波反应阈分为4组,组1(小于等于40dB n HL)、组2(41~60 dB nHL)、组3(61~80 dB nHL)、组4(80 dB nHL以上)。分析ABR、ASSR反应阈与行为测听听阈以及ABR与ASSR反应阈的相关性及三者间的差值。结果组4的57耳中ABR的V波有37耳未引出,ASSR反应阈在0.5、1、2和4kHz未引出率分别为29.73%、64.86%、67.57%、78.38%,行为测听听阈在0.5、1、2和4kHz未引出率分别为16.22%、27.03%、43.24%、37.84%。ABR反应阈与行为测听听阈差最大为8.79dB,ASSR反应阈与行为测听听阈差最大为9.43dB,ABR反应阈与ASSR反应阈差最大为6.22dB。ABR反应阈与其各频率行为测听听阈以组4中4kHz的相关系数最大,为0.895;ASSR反应阈与其各频率行为测听对应频率听阈以组4中1kHz的相关系数最大,为0.868;ABR反应阈与其各频率ASSR反应阈以组4中4kHz的相关系数最大,为0.926;ABR反应阈、ASSR反应阈、行为测听听阈三者间各频率相关系数组1~组4均逐渐增大;以上相关系数具有统计学意义(P<0.05)。结论 ABR和ASSR可以作为临床听力评估良好而可靠的手段,对行为测听不配合的婴幼儿,是非常有临床应用价值的测试方法。对于最大声输出ABR的V波不能引出反应的婴幼儿,应结合ASSR和行为测听检查作慎重判定。Objective To analyze the correlation among auditory brain stem response(ABR), auditory steady-state response(ASSR) and behavioral audiometry. Methods 75 infants(142 ears) aged 7 months to 3 years old were examined for ABR, ASSR, behavioral audiometry and acoustic impedance test. According to the response threshold of ABR, they were divided into four groups: group 1(less than or equal to 40 dB nHL), group 2(41~60 dB nHL), group 3(61~80 dB nHL), and group 4(more than 80 dB nHL). The correlation and difference between ABR, ASSR response threshold and behavioral audiometry threshold and the correlation between ABR and ASSR response threshold were analyzed. Results Among the 57 ears of group 4, 37 ears of ABR were not elicited. In these 37 ears, the rate of non elicitation of ASSR response threshold at 0.5, 1, 2 and 4 kHz was 29.73%, 64.86%, 67.57% and 78.38% respectively. The rate of non elicitation of behavioral audiometry threshold at 0.5, 1, 2 and 4 kHz was 16.22%, 27.03%, 43.24% and 37.84%, respectively. The maximum difference between ABR response threshold and behavioral audiometry threshold 8.79 dB, and the correlation coefficient 0.895 in 4 kHz in group 4;the maximum difference between ASSR response threshold and behavioral audiometry threshold 9.43 dB and the correlation coefficient 0.868 in 1 kHz in group 4;and the maximum difference between ABR response threshold and ASSR response threshold 6.22 dB and the correlation coefficient 0.926 in 4 kHz in group 4.The correlation coefficient rate increased from group 1 to group 4, and the above correlation coefficients were statistically significant(P<0.05). Conclusion The threshold of ABR and ASSR was significantly correlated with the subjective threshold of each frequency of behavioral audiometry and the threshold of ABR and ASSR. ABR and ASSR can be used as a good and reliable means of clinical hearing assessment. It is a very valuable test method for infants who do not cooperate with behavioral audiometry. Moreover, for infants whose V wave of ABR can’t elicit

关 键 词：听性脑干反应 听觉稳态诱发反应 阈值 相关性 

分 类 号：R764[医药卫生—耳鼻咽喉科]