226 Hz和1000 Hz探测音声导纳测试对婴幼儿分泌性中耳炎诊断价值分析  

Analysis of the diagnostic values of 226 Hz and 1000 Hz tympanometry for secretory otitis media in infants and young children

作　　者：李佳宸 Li Jiachen(Department of Otorhinolaryngology,First Hospital Affiliated to Suzhou University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院耳鼻咽喉科,江苏苏州215006

出　　处：《海军医学杂志》2021年第1期68-74,共7页Journal of Navy Medicine

摘　　要：目的研究226 Hz和1000 Hz探测音声导纳测试对婴幼儿(0~36个月)分泌性中耳炎诊断价值。方法选取苏州大学附属第一医院耳鼻咽喉科2018年8月至2019年10月诊断为内分泌中耳炎的198例(343耳)0~36个月龄婴幼儿作为研究对象,选取同期入院的172例(344耳)0~36个月龄耳道正常者作为对照组。每组根据月龄分为0~6、7~12、13~24、25~36个月4个亚组。采用受试者特征曲线(ROC)比较226 Hz和1000 Hz[基线法(Y1)、Jerger法(Y2)和Baldwin法(Y3)]的诊断价值,并根据约登指数探究相关最佳诊断阈值。结果在各月龄的婴幼儿中,4种测量方法的ROC曲线下面积排序由大到小为Y1>Y3>Y2>226 Hz探测音,同时226 Hz探测音与1000 Hz探测音测量方法的两两比较差异有统计学意义(P<0.05);进行不同测量方法的两两比较后,结果显示只有7~12、13~24、25~36个月的Y1与Y3差异无统计学意义(P>0.05),其余各年龄段的两两比较差异均有统计学意义(P<0.05);各年龄段(0~6、7~12、13~24、25~36个月)约登指数最大的诊断阈值皆为0.1 mmho,约登指数分别为0.70、0.90、0.89和0.93,灵敏度最大时的诊断阈值分别为0.4、0.4、0.3、0.3 mmho。结论1000 Hz探测音声导纳测试为婴幼儿内分泌中耳炎的首选诊断方法,应首选基线法测量1000 Hz探测音声导纳值。以诊断准确度为目的时,应选择0.1 mmho作为诊断阈值;以灵敏度筛查为目的时,1岁前的诊断阈值应选择0.4 mmho,1~3岁之间的诊断阈值应选择0.3 mmho。Objective To study the diagnostic values of 226 Hz and 1000 Hz tympanometry for secretory otitis media in infants and young children(0 to 36 months).Methods One hundred and ninety-eight subjects(343 ears)with an age range of 0-36 months who received treatment in the hospital from August 2018 to October 2019 and were diagnosed to have secretory otitis media were enrolled for study.Within the same time span,172 normal subjects(344 ears)with an age range of 0-36 months were also recruited and were assigned as the control group.Each group was divided into 0-6,7-12,13-24 and 25-36 months,depending on the month age of the child.The receiver operator characteristic curve(ROC)was used to compare the diagnostic value of 226 Hz and 1000 Hz tympanometry[the baseline method(Y1),the Jerger method(Y2)and Baldwin method(Y3)],and relevant optimal diagnostic threshold was investigated by the Youden index.Results In infants and children of all age ranges,the area under the ROC curve by the 4 measurement methods was in the order of Y1>Y3>Y2>226 Hz detection sound.Statistical significance could be noted in the 226 Hz and 1000 Hz detection sound,when comparisons were made between the two(P<0.05).When the 4 detection methods were compared two by two,there was no statistical significance only in Y1 and Y3 in the infants and young children with age ranges of 7-12,13-24 and 25-36 months(P>0.05),pair comparison of the remaining age ranges was statistically significant(P<0.05).The maximum diagnostic threshold for the Jordan index for various age ranges(0-6,7-12,13-24 and 25-36 months)was all 0.1 mmho.The Jordan indexes were respectively 0.70,0.90,0.89,and 0.93,and the diagnostic thresholds with maximum sensitivity were 0.4,0.4,0.3,0.3 mmho respectively.Conclusion The 1000 Hz tympanometry is the first-choice detection method for diagnosing otitis media in infants and young children,and the baseline method should be used first to measure the 1000 Hz detection tone acoustic admittance value.For diagnostic accuracy,0.1 mmho should be selected

关 键 词：鼓室导纳测试 婴幼儿 内分泌中耳炎 受试者特征曲线 

分 类 号：R729[医药卫生—儿科] R444[医药卫生—临床医学]