皮层听觉诱发电位在听力评估中的应用

Hearing Assessment by Complex Wave N1-P2 of Cortical Auditory Evoked Potentials

张燕梅;王士杰;刘辉;张俊波;陈静;莫玲燕

1:北京大学第一医院耳鼻咽喉头颈外科

2:中国航天科工集团七三一医院耳鼻喉科

3:首都医科大学附属北京同仁医院北京市耳鼻咽喉科研究所

4:北京和睦家医院耳鼻喉科

摘要
目的 探讨短纯音刺激皮层听觉诱发电位(cortical auditory evoked potentials, CAEP)对听力评估的价值。方法 受试者为听力正常成人19例(36耳),感音神经性聋成人患者21例(21耳),以500、1 000、2 000和4 000 Hz短纯音作为刺激声,在醒觉状态下颅顶电极记录CAEP的N1-P2复合波,分析N1-P2阈值与纯音听阈的相关性,以及两者差值在不同人群中的差异。结果 所有受试者四个测试频率的N1-P2阈值与对应频率纯音听阈值的相关系数依次为0.971、0.967、0.958、0.955,呈显著的线性相关;听力正常组36耳500、1 000、2 000和4 000 Hz的N1-P2阈值上限(95%置信区间)依次为32、27、32、39 dB SPL,即正常人阈值上限为32.5 dB SPL;正常人N1-P2阈值与纯音听阈的差值依次为18.9±6.1、11.6±5.9、13.3±7.0、18.7±8.3 dB;感音神经性聋患者两者差值依次为10.3±6.0、6.8±8.9、6.5±9.5、12.9±11.4 dB,四个测试频率的差值在两组人群中的差异均有统计学意义(P<0.05)。结论 听力正常人短纯音CAEP的N1-P2平均阈值小于32.5 dB SPL; N1-P2阈值与对应频率纯音听阈相关性非常好,听力评估中使用N1-P2阈值预测听力时应注意刺激声的校准及校正值的使用。
关键词
皮层听觉诱发电位;听阈;纯音测听;感音神经性聋
基金项目(Foundation):
作者
张燕梅;王士杰;刘辉;张俊波;陈静;莫玲燕
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