DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值  

Application value of distortion product otoacoustic emission and high stimulation rate auditory brainstem response in patients with normal hearing tinnitus

作　　者：段新艳[1,2] 宋忠义 王宁 訾希存 潘新良 DUAN Xinyan;SONG Zhongyi;WANG Ning;ZI Xicun;PAN Xinliang(Department of Otorhinolaryngology,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China;Department of Otorhinolaryngology&Head and Neck Surgery,Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,Shandong,China;Outpatient Unit,Qilu Hospital of Shandong University(Qingdao),Qingdao 266035,Shandong,China)

机构地区：[1]山东大学齐鲁医院耳鼻咽喉科,山东济南250012 [2]山东大学齐鲁医院(青岛)耳鼻咽喉头颈外科,山东青岛266035 [3]山东大学齐鲁医院(青岛)门诊单元,山东青岛266035

出　　处：《山东大学耳鼻喉眼学报》2022年第5期6-10,17,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：山东大学齐鲁医院(青岛)科研启动基金(QDKY2018ZD03)。

摘　　要：目的 观察分析听力正常的耳鸣患者畸变产物耳声发射(DPOAE)与高刺激率听性脑干反应(ABR)检测的特征,探讨其在耳鸣评估中的应用价值。方法 选取耳鼻咽喉科门诊听力正常的青年耳鸣患者31例(46耳)为耳鸣组,另外选取听力结果正常的青年无耳鸣者25例(50耳)为正常对照组,分别进行纯音听阈测定、声导抗测听、DPOAE和高低刺激率ABR的检测,对比两组受试者DPOAE各频检出率和信噪比以及高低刺激率ABR各波潜伏期(PL)、波间期(IPL)、波幅以及两种刺激速率下的潜伏期和波间期差值(△PL和△IPL)。结果 DPOAE各频检出率两组无显著性差异;信噪比在8 kHz,耳鸣组较对照组降低,差异有统计学意义(P<0.05);高低刺激率ABR结果中,不同刺激速率下两组Ⅰ、Ⅲ、Ⅴ波波幅差异均无统计学意义;高刺激速率下,耳鸣组Ⅰ~ⅤIPL较对照组延长,差异有统计学意义(P<0.05),两种刺激速率下,耳鸣组Ⅰ△PL较对照组缩短,差异有统计学意义(P<0.05),耳鸣组Ⅴ△PL、Ⅰ~Ⅴ△IPL较对照组延长,差异有统计学意义(P<0.05)。结论 DPOAE与高刺激率ABR可作为诊断耳鸣的一种客观检查方法,其对耳鸣的早期评估有重要的应用价值;增加ABR刺激速率,可提高耳鸣检测的敏感性。Objective This study aimed to observe and analyze the characteristics of distortion product otoacoustic emission(DPOAE) and high stimulation rate auditory brainstem response(ABR) in tinnitus patients with normal hearing and to explore their application value in tinnitus assessment.Methods Thirty-one(46 ears) young tinnitus patients with normal hearing were selected as the tinnitus group,and 25(50 ears) young people without tinnitus with normal hearing results were selected as the normal control group.Pure tone audiometry,acoustic conductance audiometry,DPOAE,and high and low stimulus rate ABR were detected,and the results in the tinnitus and healthy controls were compared.Results We found no significant difference in the detection rate of DPOAE and ABR wave Ⅰ,Ⅲ,and Ⅴ amplitudes with different stimulation rates between the two groups.The signal-to-noise ratio at 8 kHz in the tinnitus group was significantly lower than that in control group.Further,under a high stimulation rate,the Ⅰ~Ⅴ wave interval of tinnitus group was longer than that of the control group,and the difference was statistically significant(P<0.05).At two stimulus rates,the the wave Ⅰ latency difference was shorter and the wave Ⅴ latency difference was longer in the tinnitus group,indicating that the wave Ⅰ~Ⅴ interval difference was longer in the tinnitus group than in the control group(P<0.05).Conclusion DPOAE and high stimulation rate ABR can be used as an objective method to diagnose tinnitus and evaluate early tinnitus.Increasing the stimulation rate of ABR could improve the sensitivity of tinnitus detection.

关 键 词：耳鸣 高低刺激率 听性脑干反应 畸变产物耳声发射 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]