孤独症谱系障碍儿童听觉脑干反应特征分析  

Characteristics and Clinical Phenotypes of Auditory Brainstem Response in Children with Autism Spectrum Disorders

作　　者：刘玉林[1] 孙彩虹 刁甜甜[3] 宋鹏龙[1] 姜娜[1] 张贵新 胡琪[1] LIU Yu-lin;SUN Cai-hong;DIAO Tian-tian;SONG Peng-long;JIANG Na;ZHANG Gui-xin;HU Qi(Department of Otolaryngology,The First Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang,150001,China;Department of Children's and Adolescent Health,Public Health College,Harbin Medical University,Harbin,Heilongjiang,150081,China;Department of Pediatrics,The First Affiliated Hospital,Harbin Medical University,Harbin,Heilongjiang,150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院耳鼻咽喉科,黑龙江哈尔滨150001 [2]哈尔滨医科大学公共卫生学院儿少卫生与妇幼保健学教研室,黑龙江哈尔滨150081 [3]哈尔滨医科大学附属第一医院儿内科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2022年第4期702-706,共5页Progress in Modern Biomedicine

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(2019-KYYWF-0333)。

摘　　要：目的:探讨孤独症谱系障碍(autism spectrum disorder,ASD)儿童听觉脑干反应(auditory brainstem response,ABR)各波潜伏期和波间期特征与ASD行为表型间的关联。方法:对2019年7月-2020年12月来我科就诊的26例明确诊断的2~6岁ASD儿童的患儿进行声导抗,听性脑干反应,畸变产物耳声发射及多频稳态听觉诱发电位测试,以38例正常儿童为对照组,进行同样的测试,并对其测试结果进行统计分析。分析ASD儿童左右耳各波潜伏期,波间期特征及与ASD临床表型的关联。结果:ASD儿童左右耳Ⅰ,Ⅲ,Ⅴ波潜伏期分别为(1.42±0.09)ms,(3.67±0.09)ms,(5.65±0.13)ms;(1.45±0.11)ms,(3.69±0.08)ms,(5.62±0.15)ms。ASD组的右耳Ⅰ,Ⅲ波的潜伏期均值大于正常组(P值均<0.05);ASD儿童两组间左耳Ⅲ-V,右耳Ⅲ-V,右耳Ⅰ-V的波间期分别是(1.97±0.07)ms,(1.93±0.10)ms,(4.15±0.14)ms;ASD组的左耳Ⅲ-V,右耳Ⅲ-V,右耳Ⅰ-V波间期均小于正常组(P值均<0.05);ASD组中小于等于3岁组与大于3岁组间ABR波间期差异不具有统计学意义。关联性分析发现,ASD儿童语言能力与右耳Ⅲ波潜伏期,右耳最小阈值V波潜伏期负相关;社会行为能力与右耳Ⅰ-Ⅲ波间期负相关;社会生活能力与左耳最小阈值V波潜伏期负相关;而ABC评分与ASD儿童右耳Ⅲ波潜伏期,左耳Ⅰ-Ⅲ波间期,右耳Ⅰ-Ⅲ波间期正相关。结论:ASD儿童存在异常的听觉脑干反应特征,且异常程度与ASD儿童语言,社会行为能力,社会生活能力的严重程度存在明显关联。Objective: To explore the characteristics of Auditory brainstem response(ABR) in children with autism spectrum disorders(ASD), and analyze their associations with the core symptoms of ASD. Methods: A total of thirty-eight children with normal hearing and twenty-six autistic children were enrolled in this study. The data of acoustic immitance, auditory brainstem response, and distortion product otoacoustic emissions(DPOAEs) were collected. The association among the characteristics of latent period and interlatent period of each wave, core symptoms of ASD children behavior and clinical manifestation was analyzed. Results: ASD children left and right ear Ⅰ Ⅲ, Ⅴ wave latent period respectively,(1.42±0.09) ms,(3.67±0.09) ms,(5.65±0.13) ms;(1.45± 0.11)ms,(3.69 ±0.08)ms,(5.62±0.15)ms. The mean latent period of right ear Ⅰ and right ear Ⅲ in ASD group were longer than those in normal group(P<0.05). The left ear Ⅲ-Ⅴ, right ear Ⅲ-V and right ear Ⅰ-Ⅴ interlatent period respectively(1.97±0.07)ms,(1.93± 0.10)ms,(4.15± 0.14)ms. The left ear Ⅲ-Ⅴ, right ear Ⅲ-Ⅴ and right ear Ⅰ-Ⅴ interlatent period of ASD group were all shorter than those of normal group(P<0.05). In the ASD group, test was used to analyze the ABR peak interval differences between the groups 3 years or less and older than 3years, and the peak interval differences of both ears between the two groups were not statistically significant. The correlation analysis showed that the language ability of ASD children was negatively correlated with the right ear III latent period and the minimum threshold V-wave latent period in the right ear. Social behavior ability was negatively correlated with right ear Ⅰ-Ⅲ interlatent period. The social life ability was negatively correlated with the minimum threshold V-wave latent period of the left ear. ABC score was positively correlated with right ear Ⅲ latent period, left ear Ⅰ-Ⅲ and right ear Ⅰ-Ⅲ interlatent period. Conclusion: There are abnormal auditory behavior characteristi

关 键 词：孤独症 听觉脑干反应 儿童 

分 类 号：B844.1[哲学宗教—发展与教育心理学] R748[哲学宗教—心理学]