听阈正常耳鸣患者听性脑干反应研究  

Research on Auditory Brainstem Response of Tinnitus Patients with Normal Auditory Thresholds

作　　者：李刚 李明[2] 张剑宁 LI Gang;LI Ming;ZHANG Jianning(Yunnan University of Chinese Medicine,Kunming 650500,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]云南中医药大学,云南昆明650500 [2]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《云南中医药大学学报》2023年第1期23-28,共6页Journal of Yunnan University of Chinese Medicine

基　　金：云南省科技厅基础研究专项(202201AU070167);云南省科技厅中医联合专项-面上项目(202101AZ070001-044);云南省配方颗粒重点实验室(202105AG070014)。

摘　　要：目的通过研究听阈正常主观特发性耳鸣患者听性脑干反应(auditory brainstem response,ABR)测试结果的特点,浅析此类耳鸣可能的发病机制。方法选取20例听阈正常主观特发性男性耳鸣患者和15例健康对照者为研究对象,对比两者纯音听阈,耳声发射幅值和ABR各波振幅、潜伏期、波间期及振幅比的检测结果并进行统计分析。结果耳鸣耳与非耳鸣耳振幅分别与健康对照组相比均较低(P<0.05),但耳鸣耳与非耳鸣耳振幅比较无差异(P>0.05);与健康对照者和非耳鸣耳相比,耳鸣耳ABR III/I波振幅比升高(P<0.05),I波潜伏期明显缩短(P<0.05)。结论听阈正常主观特发性耳鸣患者ABR I波和III/I波振幅比的异常可能与耳蜗病变密切相关,同时中枢系统可能起着重要调作用。Objective To analyze the pathogenesis of the tinnitus by studying the characteristics of auditory brainstem response(ABR)for subjective idiopathic tinnitus in individuals with normal auditory thresholds and analyzing the relationship between the characteristics and the damage of cochlear low SR fibers and the synapses.Methods To analyze the results of pure tone hearing thresholds,distortion product otoacoustic emission and amplitude,latency,wave interval and amplitude ratio of ABR in 20 male patients with subjective idiopathic tinnitus and normal auditory thresholds and 15 normal controls.Results Compared with normal subjects,the amplitudes of I waves in tinnitus and non-tinnitus ears were significantly decreased(t=-2.621,P=0.012 and t=-2.087,P=0.042),but there was no difference between them.Compared with normal subjects and non-tinnitus ears,the amplitude ratio of III/I in tinnitus ears was significantly increased(t=3.512,P=0.001 and t=2.585,P=0.014)and the latency of ABR I wave was shortened(t=-3.715,P=0.001 and t=-2.049,P=0.047).Conclusion The difference of ABR I wave and the amplitude ratio of III/I between the tinnitus with a normal audiograms and healthy control group may be related to the cochlear damage and the central nervous systems play a vital role in the pathogenesis of subjective idiopathic tinnitus with normal auditory thresholds.

关 键 词：特发性耳鸣 听性脑干反应 耳蜗病变 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]