听力正常儿童宽频鼓室图能量吸收率特征研究  

Normative wideband absorbance measures in children: a cross-sectional study

作　　者：王雪瑶 王黎明 李颖[1] 周怡[1] 金欣[1] 史吉峰 郑之芃 刘鹏 刘海红[1] Wang Xueyao;Wang Liming;Li Ying;Zhou Yi;Jin Xin;Shi Jifeng;Zheng Zhipeng;Liu Peng;Liu Haihong(Department of Otolaryngology Head and Neck Surgery,Beijing Children′s Hospital,Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Department of Otolaryngology,Beijing Miyun Country Hospital,Beijing 101500,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,北京100045 [2]北京市密云区医院耳鼻喉科,北京101500

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第7期672-680,共9页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京市自然科学基金(7232059);北京市科技新星计划交叉合作课题(20220484211);首都卫生发展科研专项项目(2022-1-2023)。

摘　　要：目的分析0~12岁听力正常儿童宽频鼓室图能量吸收率(wideband absorbance,WBA)随年龄变化的特征及影响因素,获得与年龄相适应的参考值,为宽频鼓室图(wideband tympanometry,WBT)的临床应用提供参考。方法对首都医科大学附属北京儿童医院2019年10月至2021年2月0~12岁听力正常儿童384例(615耳)进行环境压力和峰压下WBT测试,其中男230例(376耳)、女154例(239耳),左耳306例、右耳309例。应用SPSS 24.0软件对226~8000 Hz区间1/3倍频程的16个频率点(226、324、408、500、667、841、1000、1297、1682、2000、2670、3364、4000、5339、6727、8000 Hz)的WBA值进行统计分析,以频率和测试压力(环境压力和峰压)为组内因素,年龄、性别、侧别为组间因素进行重复测量资料的方差分析和多元方差分析,探讨其对WBA的影响。结果绘制各年龄段儿童的WBT频率-吸收率曲线,将走势相近的曲线进行整合,最终分为7个年龄组:1月龄组、2月龄组、3月龄组、4~5月龄组、6~24月龄组、>2~6岁组与>6~12岁组。频率、年龄、测试压力对WBA有显著影响:(1)1月龄组与2月龄组的频率-吸收率曲线呈双峰型,峰值分别在2000和4897 Hz附近,在3886 Hz处有一个切迹,3月龄组与4~5月龄组为宽峰型,峰值在2000~4757 Hz之间;1月龄组至4~5月龄组的WBA在低频(226~408 Hz)及6727 Hz逐渐降低,中高频(2670~4000 Hz)升高;6~24月龄组的WBA在除3364和4000 Hz外的频率范围较2月龄组至4~5月龄组显著降低;6~24月龄组、>2~6岁组与>6~12岁组的频率-吸收率曲线呈单峰型,其WBA峰值频率依次向较低频率移动,6~24月龄组至>6~12岁组的WBA在低中频(667~2670 Hz)及8000 Hz逐渐升高,中高频(3364~5339 Hz)逐渐降低。(2)各年龄组16个频率中,环境压力下和峰压下的WBA差值在-0.09~0.06之间,43.75%~81.25%的频率处差异具有统计学意义(P值均<0.05),主要表现在226~1682 Hz环境压力下的WBA低于峰压下。除3月龄组和4~5月龄组外,性别对WBA�Objective This study was to investigate the main characteristics and related factors of wideband absorbance(WBA)in children with normal hearing and to obtain age-specific reference range of WBA.Methods384 children between 0-12 years old(615 ears)who visited the Beijing Children′s Hospital,Capital Medical University from October 2019 to February 2021 were enrolled,including 230 males(376 ears)and 154 females(239 ears),with totally 306 left ears and 309 right ears.Wideband tympanometry(WBT)was performed and normative WBA data were analyzed by SPSS 24.0 statistical software.Repeated measures and multivariate analysis of variance were applied to the data from 16 points at 1/3-octave frequencies(226,324,408,500,667,841,1000,1297,1682,2000,2670,3364,4000,5339,6727 and 8000 Hz)to evaluate the effects of frequency,age,external auditory canal pressures,gender and ear on WBA.ResultsAccording to the WBT frequency-absorbance curve,the subjects were divided into seven groups:1-month old group,2-month old group,3-month old group,4-5 month old group,6-24 month old group,>2-6 year old group and>6-12 year old group.The WBA of normal-hearing children underwent a series of developmental changes with age at both ambient pressure and tympanometric peak pressures.WBA results for 1-month group and 2-month old group exhibited a multipeaked pattern,with the peaks occurring around 2000 and 4897 Hz,and a notch around 3886 Hz.WBA results for 3-month group and 4-5 month old group exhibited a single broad-peaked pattern,with the peak occurring between 2000-4757 Hz.The WBA of 1-month old group to 4-5 month old group decreased gradually at low frequency(226-408 Hz)and 6727 Hz,and increased at middle to high frequency(2670-4000 Hz).The WBA of 6-24 month old group were significantly lower than that of 2-month old group to 4-5 month old group at all frequencies except 3364 and 4000 Hz.WBA results for 6-24 month old group,>2-6 year old group and>6-12 year old group exhibited a single-peaked pattern,and the peak frequency of WBA moved to the lower

关 键 词：声阻抗试验 宽频鼓室图 儿童 婴儿 

分 类 号：R764[医药卫生—耳鼻咽喉科]