歼击机飞行员主客观听觉功能联合评价方法及航空医学鉴定  

Joint evaluation method and aviation medical identification method of subjective and objective auditory function of fighter pilots

作　　者：黄凤月 章梦蝶 翟丽红 王蒙 党梓怡 金占国 HUANG Fengyue;ZHANG Mengdie;ZHAI Lihong;WANG Meng;DANG Ziyi;JIN Zhanguo(Vrtigo Clinic/Research Center of Aerospace Medicine,Air Force Medical Center,Air Force Medical University,PLA,Beijing 100142,China)

机构地区：[1]空军军医大学空军特色医学中心航空航天眩晕诊疗研究中心,北京100142

出　　处：《空军航空医学》2023年第6期499-503,共5页AVIATION MEDICINE OF AIR FORCE

摘　　要：目的探索现阶段歼击机飞行员听觉功能气导纯音平均听阈(pure tone threshold average,PTA)与对应频率言语识别阈(speech recognition threshold,SRT)、短声诱发听性脑干反应(click evoked auditory brainstem response,Click-ABR)阈值、40 Hz听觉相关电位(40 Hz auditoryevent event related potential,40 Hz AERP)阈值之间的相关性及航空医学鉴定原则。方法选取373例(746耳)歼击机飞行员作为研究对象,所有飞行员均进行0.5、1、2、3、4、6、8 kHz 7个频率的纯音听阈测定,其中84例进行纯音听阈测定,余随机分为3组再进行各项主客观测试,SRT测试组96例、Click-ABR测试组98例、40 HzAERP测试组95例,记录各项测试结果并与对应频率PTA进行比较。结果纯音听阈测定组左耳PTA1(0.5~3 kHz)为(13.33±0.13)dBHL,右耳PTA1为(12.62±0.13)dBHL;SRT测试组左耳PTA2(0.5~2 kHz)为(12.61±0.36)dBHL、SRT为(17.55±0.38)dBHL,右耳PTA2为(12.37±0.31)dBHL、SRT为(17.04±0.52)dBHL,SRT与PTA2呈正相关(r=0.237、0.209,P=0.020、0.041),两者间差值左耳为(4.94±0.44)dBHL、右耳为(4.67±0.47)dBHL;Click-ABR测试组左耳PTA3(2~4 kHz)为(17.31±0.17)dBHL、阈值为(24.69±0.12)dBHL,右耳PTA3为(16.33±0.12)dBHL、阈值为(24.59±0.14)dBHL,阈值与PTA3相呈正相关(r=0.355、0.375,P均<0.001),两者差值左耳为(7.45±0.17)dBHL、右耳为(8.26±0.15)dBHL;40 HzAERP测试组双耳阈值均为(25.95±0.20)dBHL,左耳PTA4(0.5~4 kHz)为(13.62±0.08)dBHL、右耳为(13.07±0.12)dBHL,阈值与PTA4呈正相关(r=0.439、0.272,P<0.001、=0.008),且两者差值左耳为(12.33±0.18)dBHL、右耳为(12.88±0.21)dBHL。结论本研究建立歼击机飞行员主客观联合听力筛查和鉴定的阈值范围,明确纯音听阈与其他主客观听觉功能筛查技术的相关性,为歼击机飞行员听觉功能提供评估方法和航空医学鉴定原则。Objective To explore the correlation between the mean hearing threshold of pure tone threshold average on one hand and the corresponding frequency speech recognition threshold,click evoked auditory brainstem response,and 40 Hz auditory event related potential(40 Hz AERP)threshold of fighter pilots on the other hand,and study medical identification methods.Methods A total of 373 fighter pilots(746 ears)were selected as subjects.All the pilots were tested for pure tone hearing thresholds at the frequencies of 0.5,1,2,3,4,6 kHz and 8 kHz.Among these pilots,84 were merely tested for pure tone hearing thresholds,while the rest were randomly divided into three groups for subjective and objective tests:SRT test group(96 cases),Click-ABR test group(98 cases)and 40 Hz AERP test group(95 cases).The test results were recorded and compared with PTA at the corresponding frequencies.Results In the pure-tone hearing threshold measurement group,PTA1(0.5-3 kHz)was(13.33±0.13)dBHL in the left ear and(12.62±0.13)dBHL in the right ear.In the SRT test group,the PTA2(0.5-2 kHz)of the left ear was(12.61±0.36)dBHL,the SRT was(17.55±0.38)dBHL,and the PTA2 of the right ear was(12.37±0.31)dBHL and SRT were(17.04±0.52)dBHL,the correlation between SRT and PTA2 was positively correlated(r=0.237,0.209,P=0.020,0.041),and the difference between SRT and PTA2 was(4.94±0.44)dBHL in the left ear,(4.67±0.47)dBHL in the right ear.In Click-ABR test group,PTA3(2-4 kHz))in the left ear was(17.31±0.17)dBHL,the threshold was(24.69±0.12)dBHL,PTA3 in the right ear was(16.33±0.12)dBHL,the threshold was(24.59±0.14)dBHL,the correlation between the threshold value and PTA3 was positively correlated(r=0.355,0.375,P both<0.001),the difference between the threshold and PTA3 was(7.45±0.17)dBHL in the left ear and(8.26±0.15)dBHL in the right ear;In the 40 Hz AERP test group,the thresholds of both ears were(25.95±0.20)dBHL,while PTA4(0.5-4 kHz)was(13.62±0.08)dBHL,and PTA4 in the right ear was(13.07±0.12)dBHL.There was positively correlated between the

关 键 词：主观听阈测试 客观听阈测试 听觉功能 歼击机飞行员 

分 类 号：R852[医药卫生—航空、航天与航海医学]