持续正压通气治疗对重度OSAHS患者听功能的影响

The Effects of the Treatment with CPAP on Auditory Functions in Patients with Severe OSAHS

李熙星;崔卫娜;马建刚;王宝山;

1:河北医科大学第二医院耳鼻咽喉科

摘要
目的探讨重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者的听功能特征及持续气道正压通气(continuous positive airway pressure,CPAP)治疗对其听觉的影响。方法对12例重度OSAHS患者(OSAHS组)CPAP治疗前后、12例单纯打鼾者(单纯鼾症组)、12例正常人(正常对照组)行纯音测听、畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)及听性脑干反应(auditory brainstem responses,ABR)测试,比较其结果。结果 OSAHS组8 000Hz处纯音听阈提高,各频率DPOAE反应幅值不同程度下降,检出率明显降低,ABR波Ⅰ、Ⅲ、Ⅴ潜伏期及Ⅲ-Ⅴ波间期、Ⅰ-Ⅴ波间期均延长,与其它两组相比较差异有统计学意义(P<0.05);而其余频率纯音听阈、ABRⅠ-Ⅲ波间期及波Ⅴ反应阈差异无统计学意义(P>0.05)。OSHAS组CPAP治疗后与治疗前相比DPOAE反应幅值均有提高,除500、750、1 500Hz外,其余频率差异均有统计学意义(P<0.05);DPOAE检出率较治疗前提高(P<0.05),而纯音听阈、ABR反应阈与治疗前比较差异无统计学意义(P>0.05)。结论重度OSAHS患者的听功能受损,CPAP治疗可以在一定程度上改善其耳蜗功能。
关键词
持续气道正压通气;阻塞性睡眠呼吸暂停低通气综合征;纯音测听;畸变产物耳声发射;听性脑干反应
基金项目(Foundation):
作者
李熙星;崔卫娜;马建刚;王宝山;
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