高频畸变产物耳声发射在新生儿听力筛查中的应用

Application of High Frequency Distortion Product Otoacoustic Emission in Neonatal Hearing Screening

梁勇;欧阳天斌;谭曼玲;张威;李琦;

1:南方医科大学南方医院耳鼻咽喉头颈外科

摘要

目的探讨高频畸变产物耳声发射(high frequency DPOAE,HFDPOAE)在新生儿听力筛查中的特点及应用价值。方法对261例(522耳)新生儿(正常对照组93例186耳及疾病组168例336耳)同时进行常频畸变产物耳声发射(conventional frequency DPOAE,CFDPOAE)和HFDPOAE听力筛查测试,分别比较采用CFD-POAE和HFDPOAE的初筛阳性率以及不同组新生儿各频率DPOAE的平均幅值,并进行统计学分析。结果对照组CFDPOAE的阳性率显著高于HFDPOAE(P=0.000),疾病组采用CFDPOAE和HFDPOAE的阳性率无显著性差异(P>0.05);采用CFDPOAE时,对照组与疾病组的筛查阳性率无显著性差异(P>0.05);采用HFD-POAE时,疾病组的筛查阳性率显著高于对照组(P=0.007)。DPOAE的幅值在2、8、12和16kHz频率时各组间有统计学差异;各组DPOAE平均幅值:对照组最高,早产儿和非听损伤危险因素相关疾病组仅次于对照组,其次为新生儿窒息组和黄疸组,具有二种及以上听损伤危险因素相关疾病组最小;各组新生儿频率-幅值函数曲线呈双峰型,在4kHz为峰值低谷,在2和812kHz分别为二个峰值。结论HFDPOAE能较敏感地反映听觉的受损情况,并能降低CFDPOAE听力筛查的假阳性率,对高频听力障碍的早期发现可能具有一定的应用价值。

关键词

畸变产物耳声发射;高频;新生儿听力筛查

基金项目(Foundation):

作者

梁勇;欧阳天斌;谭曼玲;张威;李琦;

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畸变产物耳声发射高频新生儿听力筛查

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梁勇欧阳天斌谭曼玲张威李琦