不同言语识别能力的老年性聋耳蜗电图特征分析  

Characteristics of Electrocochleography in Patients with Presbycusis and Different Levels of Speech Recognition Ability

作　　者：张燕梅[1] 陈喆 宗亚静 钟贞[1] 陈丽[1] 吴园丁[1] 陈婧 刘玉和[1] ZHANG Yanmei;CHEN Zhe;ZONG Yajing;ZHONG Zhen;CHEN Li;WU Yuanding;CHEN Jing;LIU Yuhe(Department of Otorhinolaryngology Head and Neck Surgery,Peking University First Hospital,Beijing,China,100034;School of Electronics Engineering and Computer Science,Peking University,Beijing,China,100871)

机构地区：[1]北京大学第一医院耳鼻咽喉头颈外科,北京100034 [2]北京大学信息科学技术学院,北京100871

出　　处：《中华耳科学杂志》2021年第3期447-451,共5页Chinese Journal of Otology

基　　金：北大医学交叉研究种子基金,编号BMU2018MI004。

摘　　要：目的通过分析不同言语识别能力老年性聋耳蜗电图的差异,探讨言语识别能力差的老年性聋耳蜗的电生理特征。方法42例老年性聋患者完成纯音测听、信噪比阈值SNR50言语测听、耳蜗电图(刺激速率11.1/s和55.1/s)检测,依据SNR50将84耳分为言语识别能力较差组(A组,38耳)和言语识别能力较好组(B组,46耳),以9例(18耳)听力正常年轻人作为对照C组,采用方差分析对比各组耳蜗电图的差异。结果AP幅度A组和B组均低于C组,A组和B组的差异无统计学意义;SP/AP比值A组高于B组和C组,但常规刺激速率时B组高于C组,高刺激速率时B组和C组之间无差异;随着刺激速率升高,所有组AP幅度下降,SP/AP比值升高,A组SP幅度下降。结论老年性聋耳蜗电图因AP幅度下降导致SP/AP升高,提示耳蜗突触或听神经末端退化,这或许是老年性聋噪声下言语识别能力差的一个原因。Objective To report characteristics of cochlear electrophysiological in patients with presbycusis and poor speech recognition ability.Methods Forty-two patients with presbycusis completed pure tone audiometry(PTA),signal-to-noise ratio threshold(SNR50)and electrocochleography(EcochG)at stimulus rates of 11.1/s and 55.1/s.The 84 ears were categorized as poor speech performance(Group A,n=38)and good speech performance(Group B,n=46)based on their SNR50 scores.Nine young people with normal hearing served as controls(Group C,n=18).Analysis of variance was used to compare electrocochleography differences among the three groups.Results AP amplitudes in Groups A and B were lower than in Group C for both stimulus rates.The SP/AP amplitude ratio in Group A was higher than in Group B,and higher in Group B than in Group C at 11.1/s,but similar between Groups B and C at 55.1/s.At 55.1/s,,AP amplitudes decreased and SP/AP amplitude ratios increased in all groups,while SP amplitudes decreased in Group A.Conclusion The SP/AP amplitude ratio is generally elevated due to decreased AP amplitudes in individuals with presbycusis,indicating degraded synapse or auditory nerve input,which may be a cause of worsening speech recognition in noise in presbycusis.

关 键 词：耳蜗电图 老年性聋 老龄化 言语测听 

分 类 号：R764[医药卫生—耳鼻咽喉科]