正常成年人水平特异性CE-Chirp刺激声与Click刺激声诱发听性脑干反应的比较  

Comparison of ABRs Induced by Level Specific CE-Chirps and Clicks in Normal Adults

作　　者：程荷英[1,2] 张运阁 CHENG Heying;ZHANG Yunge(Changzhou De'an Hospital,Changzhou 213004,China)

机构地区：[1]常州市德安医院,常州213004 [2]苏州大学基础医学与生物科学学院

出　　处：《中华耳科学杂志》2024年第4期622-626,共5页Chinese Journal of Otology

基　　金：常州市卫健委青年人才科技项目(QN202135)。

摘　　要：目的研究正常成年人水平特异性CE-Chirp(level specific CE-Chirp,CE-Chirp LS)刺激声与Click刺激声诱发听性脑干反应(auditory brainstem response,ABR)反应阈与纯音听阈的关系及在不同声强下两种刺激声所诱发的ABR波形特点,探讨CE-Chirp LS声诱发的ABR在听觉功能客观评估中的应用价值。方法选择正常成年人21例(共42耳)分别在0.5、1.0、2.0、4.0 kHz进行纯音气导听阈测试,获取其双耳各频率的纯音听阈,分别采用CEChirp LS刺激声与Click刺激声诱发ABR,测量2种刺激声在80、60、40 dB nHL的Ⅴ波波幅,获得2种刺激声下受试者的Ⅴ波反应阈,获取其在80 dB nHL刺激强度时Ⅰ、Ⅲ、Ⅴ波潜伏期。按照自身对照的方法对相同刺激强度下2种刺激声诱发的ABR潜伏期及波幅差异性进行统计分析,比较2种刺激声下Ⅴ波反应阈与纯音听阈差值。结果正常成年人80、60、40 dB nHL刺激强度下,CE-Chirp LS刺激声诱发的ABR的Ⅴ波波幅均大于Click刺激声,差异有统计学意义(P<0.001);CE-Chirp LS刺激声诱发的ABR的V波反应阈与纯音平均听阈差值均低于Click刺激声,差异有统计学意义(P<0.05);80 dB nHL声强下CE-Chirp LS刺激声Ⅰ波潜伏期长于Click刺激声,差异有统计学意义(P<0.001),CE-Chirp LS刺激声Ⅲ、Ⅴ波潜伏期与Click刺激声比较,差异无统计学意义(P>0.05)。结论正常成年人CE-Chirp LS刺激声与Click刺激声比较,无论在高强度还是低强度刺激下波幅均明显增大,Ⅴ波反应阈更接近于纯音听阈,更有利于纯音听阈判定,但潜伏期个体差异更大。Objective To report ABR responses induced by level specific CE-chirps(LS CE-chirps)and Clicks in normal adults and the relationship between their thresholds and pure tone thresholds for their potential values in objective evaluation of auditory function.Methods Air conduction pure tone thresholds at 0.5,1.0,2.0 and 4.0 kHz were obtained in 21 normal adults(42 ears).wave V amplitudes in response to LS CE-chirps and clicks at 80,60 and 40 dB nHL were measured,as well as wave V thresholds and latencies of waves I,III and V at 80 dB nHL.Latencies and amplitudes of ABRs induced by the two kinds of stimuli,as well as the relationship between wave V thresholds and pure tone thresholds,were compared.Results At 80,60 and 40 dB nHL,wave V amplitudes in LS CE-Chirp induced ABRs were greater than those in click induced ABRs(P<0.001).The difference between Wave V threshold and average pure tone threshold is smaller for LS CE-Chirp induced ABRs than click induced ABRs(P<0.05).At 80 dB nHL,wave I latency was longer in LS CE-Chirp ABRs than in click ABRs(P<0.001),but not for waves III and V latencies(P>0.05).Conclusion Compared with click ABRs,the amplitudes of LS CE-Chirp ABRs are greater in response to high and low intensity stimuli,with the wave V threshold closer to pure tone thresholds,which should be more conducive to inferring pure tone thresholds,but individual variabilities in latency are noticeable.

关 键 词：CE-Chirp LS声 Click声 听性脑干反应 V波反应阈 波幅 潜伏期 

分 类 号：R764[医药卫生—耳鼻咽喉科]