听性稳态反应在不同类型听力损失儿童听力筛查中的应用研究  

Application of Multifrequency Auditory Steady-State Response to Screening Children with Different Types of Hearing Impairment

作　　者：孙蕾[1] 李莹莹 谢园 SUN Lei;LI Ying-ying;XIE Yuan

机构地区：[1]南通市妇幼保健院眼耳鼻喉科,南通226000

出　　处：《中国听力语言康复科学杂志》2022年第4期281-284,共4页Chinese Scientific Journal of Hearing and Speech Rehabilitation

基　　金：南通市卫生健康委员会科研课题(MB2020042)。

摘　　要：目的分析听性稳态反应(ASSR)在不同类型听力损失儿童听力筛查中的应用价值。方法选择2020年1月~2021年6月入我院诊断先天性听力损失儿童共222例。检测患儿外周血4个耳聋基因(GJB2、GJB3、SLC26A4和线粒体12S rRNA)15个常见突变位点,听力检查包括ASSR和短声诱发听性脑干反应(click-ABR),判断听力损失程度。结果222例听力损失儿童中105例为耳聋基因突变,另外117例无耳聋基因突变。根据听力受损原因222例患儿分为传导性74例、感音神经性82例和混合性66例。基因突变组与无基因突变组比较,听力损失程度增加,在0.5、1、2和4 kHz频率下ASSR和Click-ABR反应阈均明显下降,差异有统计学意义(P<0.05);患儿性别和年龄比较差异不明显(P>0.05)。混合性听力损失组与传导性和感音神经性患儿组比较,听力损失程度增加,在0.5、1、2和4 kHz频率下ASSR和Click-ABR反应阈均明显下降,差异有统计学意义(P<0.05);患儿性别和年龄比较差异不明显(P>0.05)。各频率下ASSR和Click-ABR反应阈均有较好的相关性(P<0.05)。结论不同类型听力损失儿童,包括有无耳聋基因突变和不同听力损失原因,ASSR和Click-ABR反应阈有差别,对鉴别不同类型听力损失有一定的临床价值。Objective To analyze the value of multifrequency auditory steady-state response(ASSR)in screening children with different types of hearing impairment.Methods 222 children with congenital hearing impairment diagnosed in our hospital from January 2020 to June 2021 were chosed.15 common mutation sites of four deafness genes(GJB2,GJB3,SLC26A4 and mitochondrial 12S rRNA)in children's peripheral blood were detected.Hearing examination included ASSR and click evoked auditory brainstem response(Click-ABR)to judge the degree of hearing impairment.Results In 222 children 105 children were deafness gene mutations,other 117 children had no deafness gene mutations.According to the causes of hearing loss,they were divided into a group of 74 children of conductive hearing impairment,a group of 82 children of sensorineural hearing impairment and a group of 66 children of mixed hearing impairment.Compared with non-gene mutation group,the degree of hearing impairment in gene mutation group increased,response thresholds of ASSR and Click-ABR decreased significantly at the frequencies of 0.5,1,2 and 4 kHz(P<0.05);there were no differences of gender and age(P>0.05).Compared with conductive and sensorineural children,the degree of hearing impairment in the mixed hearing impairment group increased,and the response thresholds of ASSR and Click-ABR decreased significantly at frequencies of 0.5,1,2 and 4 kHz(P<0.05);there were no differences of gender and age(P>0.05).There were good correlations between ASSR and Click-ABR response threshold at each frequency(P<0.05).Conclusion The response thresholds of ASSR and Click-ABR are different in children with different types of hearing impairment,including whether there are deafness gene mutations and different causes of hearing impairment.It has a certain auxiliary clinical value for identifying different types of hearing impairment.

关 键 词：耳聋基因 传导性聋 感音神经性聋 听性稳态反应 短声诱发听性脑干反应 

分 类 号：R764[医药卫生—耳鼻咽喉科]