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自闭症患儿的听功能及其传出神经功能评估

The Hearing Status and the Functions of Efferent System in Autistic Children

王陈荣;华清泉;黄治物;李丹;

1:武汉大学人民医院耳鼻咽喉-头颈外科

2:上海交通大学附属新华医院耳鼻咽喉头颈外科

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摘要

目的评估自闭症患儿的听功能和传出神经功能。方法对30例自闭症患儿和15例正常儿童分别行听性脑干反应(ABR)和耳声发射(OAE)测试,并以55 dB nHL白噪声为对侧抑制声,进行畸变产物耳声发射(DPOAE)和瞬态诱发耳声发射(TEOAE)对侧抑制效应测试,比较两组结果。结果①ABR检查结果:30例(60耳)自闭症患儿中,25例(50耳)的ABR阈值均在20 dB nHL以内,1例左耳阈值为30 dB nHL,右耳阈值为40 dBnHL,1例(2耳)阈值均为50 dB nHL,3例(6耳)ABR未引出;正常组15例(30耳)ABR阈值均在20 dB nHL以内;与正常组左、右耳Ⅰ-Ⅴ波间期(分别为4.30±0.14、4.31±0.14 ms)比较,自闭症组(分别为4.07±0.24、4.08±0.22 ms)有缩短的趋势(P<0.05);②OAE检查结果:正常组均可引出;30例自闭症患儿除3例ABR未引出者和1例双耳ABR阈值为50 dB nHL者OAE未引出外,其余26例均引出,且1、2 kHz OAE幅值与正常组差异有统计学意义(P<0.05);③对侧抑制结果:正常组幅值均降低;自闭症组26例OAE可引出者中,1例ABR阈值不对称者对侧给予55 dB nHL白噪声后,OAE幅值不降低反而升高,其余25例OAE幅值均降低;两组OAE对侧抑制幅值差值无统计学差异。结论与同龄正常儿童相比,自闭症患儿更容易出现听功能障碍。

关键词

自闭症;耳声发射;传出神经;对侧抑制;听性脑干反应

基金项目(Foundation):

作者

王陈荣;华清泉;黄治物;李丹;

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王陈荣华清泉黄治物李丹