听觉皮层诱发电位在低龄人工耳蜗植入患儿中的应用  

Application of Cortical Auditory Evoked Potentials in Young Children with Cochlear Implant

作　　者：季慧[1] 姜耀锋 钟飞 李宝娜 范烨[1] 孟黎平[1] JI Hui;JIANG Yaofeng;ZHONG Fei;LI Baona;FAN Ye;MENG Liping(Department of Child Healthcare,Women's Hospital of Nanjing Medical University(Nanjing Women and Children's HealthCare Hospital),Nanjing,210004,China;Department of Technical Counseling,Jiangsu Children Rehabilitation Research Center,Nanjing,210004,China)

机构地区：[1]南京医科大学附属妇产医院(南京市妇幼保健院)儿童保健科,南京210004 [2]江苏省儿童康复研究中心(江苏省听力语言康复中心)技术指导部,南京210004

出　　处：《中华耳科学杂志》2023年第6期842-847,共6页Chinese Journal of Otology

基　　金：江苏省残疾人事业发展研究课题项目(2022SC03001);江苏省妇幼健康科研项目(F202017);南京医科大学科技发展基金(NMUB20210100)。

摘　　要：目的探究听觉皮层诱发电位在低龄人工耳蜗植入儿童中的应用价值。方法52例低龄人工耳蜗植入术后患儿,采用主观听觉言语能力评估量表,听觉行为分级量表(Categories of auditory performance,CAP)和言语可懂度分级量表(Speech intelligibility rating scale,SIR)和客观电生理检测[(皮层听觉诱发电位(cortical auditory evoked potential,CAEP)测试中的慢皮层反应P1-N1-P2和失匹配负波(mismatch negativity,MMN)]相结合,进行康复效果的评估,采用SPSS 25.0软件进行统计分析。结果随着听觉年龄的增长,人工耳蜗植入患儿的主观听觉言语能力评估量表分值呈现逐步升高趋势,CAP结果组间有统计学差异(F=22.387,P<0.001),SIR结果组间有统计学差异(F=25.780,P<0.001)。主观量表评估与客观电生理评估存在相关性,CAP结果与CAEP的P1波的阈值具有显著的负相关(r=-0.370,P=0.01),CAP结果与MMN的潜伏期具有显著的负相关(r=-0.309,P=0.029),SIR结果与CAEP的P1波的阈值具有显著的负相关(r=-0.335,P=0.021)。同时采用多因素回归分析探讨康复效果的可能影响因素。结论听觉皮层诱发电位的P1波反应阈值及MMN潜伏期为康复效果评估的独立影响因素。听觉皮层诱发电位可以有效地客观评估低龄人工耳蜗植入患儿的术后康复效果。Objective To explore the application value of cortical auditory evoked potentials in young children with cochlear implantation.Methods The rehabilitation effect of 52 young children after cochlear implantation was evaluated by the combination of subjective auditory speech ability assessment scale and objective electrophysiological cortical auditory evoked potentials detection.SPSS 25.0 software was used for statistical analysis.Results With the increase of hearing age,the score of the subjective auditory speech ability assessment scale of cochlear implant children showed a gradually increasing trend.The CAP results showed statistical differences between groups(F=22.387,P<0.001),while the SIR results showed statistical differences between groups(F=25.780,P<0.001).There was a correlation between the subjective scale assessment and the objective electrophysiological assessment.The CAP result has a significant negative correlation with the threshold of P1 wave in CAEP(r=-0.370,P=0.01),the CAP result has a significant negative correlation with the latency of MMN(r=-0.309,P=0.029),and the SIR result has a significant negative correlation with the threshold of P1 wave in CAEP(r=-0.335,P=0.021).Simultaneously,multiple linear regression analysis was used to explore the possible influencing factors of rehabilitation outcomes.Conclusion The P1 response threshold and mismatched negative latency of cortical auditory evoked potentials were independent factors for the evaluation of rehabilitation effect.Cortical auditory evoked potentials can effectively evaluate the postoperative rehabilitation effect of young children with cochlear implantation.

关 键 词：听觉皮层诱发电位 低龄 人工耳蜗植入 儿童 

分 类 号：R764[医药卫生—耳鼻咽喉科]