婴儿听性稳态反应和听性脑干反应听力评估对比分析

The Comparison of cABR and Auditory Steady-State Responses in Assessing the Hearing of Infants who Failed Screening

王智楠;陈平;徐忠强;魏翠芬;刘艳;韩芳;姚薇;吴展元;

1:武汉市儿童医院耳鼻咽喉科

2:武汉大学人民医院耳鼻咽喉科

摘要
目的对新生儿听力筛查复筛未通过的婴儿的cABR及ASSR检测资料进行对比分析,了解它们各自的应用限度和相互关系。方法听力筛查复筛未通过,DPOAE、cABR及ASSR检测资料完整的婴儿546耳,男326耳,女220耳,年龄112月。分为3组:①听力正常组:DPOAE正常、cABR波V反应阈≤30 dB nHL,146耳;②可疑听力损失组:DPOAE未能引出或部分频率不能引出、即使cABR波V反应阈≤30 dB nHL也列入该组,126耳;③听力损失组:DPOAE正常或不正常、cABR波V反应阈>30 dB nHL,听力损失组中又按cABR反应阈分为3组:cABR反应阈≤60 dB nHL153耳、6112月。分为3组:①听力正常组:DPOAE正常、cABR波V反应阈≤30 dB nHL,146耳;②可疑听力损失组:DPOAE未能引出或部分频率不能引出、即使cABR波V反应阈≤30 dB nHL也列入该组,126耳;③听力损失组:DPOAE正常或不正常、cABR波V反应阈>30 dB nHL,听力损失组中又按cABR反应阈分为3组:cABR反应阈≤60 dB nHL153耳、6197 dB nHL75耳、无反应46耳。分别计算各组cABR波V反应阈与ASSR的0.5、1、2、4 kHz反应阈的均值和标准差、变异系数,并进行相关性分析。结果婴儿cABR波V反应阈正常平均值为24.7±5.0 dB nHL,0.5、1、2、4 kHz ASSR正常反应阈平均值分别为43.3±11.2、36.9±9.5、28.6±11.8、31.7±14.0 dB nHL。cABR反应阈正常平均值的标准差明显比ASSR小,cABR变异系数小于AS-SR,差异有统计学意义(P<0.05)。cABR最大输出无反应的46耳中ASSR各频率也未引出的有6耳,ASSR各频率都可以引出的有27耳,部分引出的有13耳。结论ASSR与cABR在婴儿听力评估中起重要的相互补充的作用,运用ASSR加cABR进行综合评估值得推荐。
关键词
婴儿;听性稳态反应;听性脑干反应
基金项目(Foundation):
作者
王智楠;陈平;徐忠强;魏翠芬;刘艳;韩芳;姚薇;吴展元;
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