年龄相关性听力损失患者客观反应阈与纯音听阈相关性分析  

Correlation Between Objective Auditory Response Thresholds and Pure-Tone Thresholds in Age-Related Hearing Loss

作　　者：林少莲[1,2] 陈志锋 舒博[1,2] 胡婕[1,2] 林丁丁 池同翰 林昶[1,2,3,4] LIN Shaolian;CHEN Zhifeng;SHU Bo;HU Jie;LIN Dingding;CHI Tonghan;LIN Chang(Department of Otorhinolaryngology Head and Neck Surgery,First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院耳鼻咽喉头颈外科,福州350005 [2]福建医科大学附属第一医院滨海院区国家区域医疗中心耳鼻咽喉头颈外科 [3]福建省耳鼻咽喉研究所 [4]福建省耳鼻咽喉疑难疾病临床医学研究中心

出　　处：《中华耳科学杂志》2024年第6期955-960,共6页Chinese Journal of Otology

基　　金：福建省自然科学基金(2022J01679);福建省科技创新联合资金项目(2021Y9099)资助;福建省科技创新平台2021Y2002。

摘　　要：目的分析不同听力损失程度年龄相关性听力损失(ARHL)患者听性脑干反应(cABR)、40 Hz听觉相关电位(40 Hz-AERP)、多频稳态听觉诱发电位(ASSR)反应阈与纯音听阈(PTA)的相关性。方法选取2023年1月至12月期间福建医科大学附属第一医院耳鼻咽喉头颈外科收治的122例(男性67例,女性55例)年龄相关性听力损失患者,运用PTA、cABR、40 Hz-AERP、ASSR为一组测试组合,对122例ARHL患者进行检测,分析ABR、40Hz-AERP(0.5kHz、1kHz)、ASSR(0.5kHz、1kHz、2kHz、4kHz)客观反应阈与PTA0.5kHz、1kHz、2kHz、4 kHz的主观听阈的差值及相关性。结果除重度组外,cABR反应阈与PTA 2 kHz、4 kHz及2 kHz+4 kHz均值相关性均有统计学意义(P<0.05);40 Hz-AERP反应阈与PTA阈值差值在0.5 kHz处略小于1 kHz,其中最小差值为8.08±4.88 dB,最大为15.13±9.76 dB;除极重度组1 kHz外,40 Hz-AERP反应阈分别与PTA阈值相关性均有统计学意义(P<0.05);0.5 kHz处的ASSR与PTA反应阈的差值明显高于其他频率,尤其是在重度听力损失组,0.5kHz处的ASSR反应阈与PTA阈值的差值最大,为16.13±12.32dBHL;除极重度组2kHz外,不同听力损失组中ASSR反应阈与PTA听阈值之间的差异具有显著统计学意义(P<0.05),并且存在明显的相关性。结论40 Hz AERP和ASSR的联合应用有助于判断PTA 0.5 kHz和1 kHz频率的阈值;cABR和ASSR的联合应用有助于判断PTA 2.0 kHz和4.0 kHz频率的阈值。通过40Hz-AERP、cABR、ASSR以及PTA等联合应用有助于提高ARHL患者听力损失程度评估的准确性和可靠性。Objective To examine the correlation between thresholds of cortical auditory evoked potentials(cAEPs),40 Hz auditory event-related potentials(40 Hz-AERPs)and multiple-frequency auditory steady-state responses(ASSRs),and pure-tone audiometry(PTA)thresholds in patients with age-related hearing loss(ARHL).Methods A total of 122 patients(67 males and 55 females)with age-related hearing loss admitted to the Department of Otolaryngology Head and Neck Surgery,First Affiliated Hospital of Fujian Medical University,from January to December 2023 were selected.Correlations between PTA thresholds and thresholds of cAEPs,40 Hz-AERPs(0.5 and 1 kHz)and ASSRs(0.5,1,2 and 4 kHz)were analyzed.Results Except for the severe group ARHL,cAEP thresholds were correlated with PTA thresholds at 2 and 4 kHz(P<0.05).The difference(8.08±4.88~15.13±9.76 dB)between 40 Hz-AERP thresholds and PTA thresholds at 0.5 kHz was smaller than at 1 kHz.Excluding profound loss,at 1 kHz,40 Hz-AERP thresholds were correlated with PTA thresholds at 0.5 and 1 kHz(P<0.05).The difference between ASSR and PTA thresholds was greater at 0.5 kHz than at 1,2 and 4 kHz.In those with mild hearing loss,the greatest disparity between ASSR and PTA threshold at 0.5 kHz was 16.13±12.32 dB.Except for profound loss at 2 kHz,ASSR and PTA thresholds showed significant differences among different levels of hearing loss and correlation with each other(P<0.05).Conclusion Combined 40 Hz-AERPs and ASSRs can predict PTA thresholds at 0.5 and 1.0 kHz.and combined cAEPs and ASSRs can predict PTA thresholds at 2.0 and 4.0 kHz.Combining 40 Hz-AERPs,cAEPs,ASSRs and PTA can provide more accurate assessment of the degree of hearing loss in patients with ARHL.

关 键 词：年龄相关性听力损失 听性脑干反应 40 Hz听觉相关电位 多频稳态听觉诱发电位 纯音听阈 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]