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慢性噪声致听损伤患者的前庭功能分析

The Vestibular Function in Patients with Chronic Noise-induced Hearing Loss

郭向东;王庆林;梅祥胜;姚卫杰;杨晓刚;

1:河南中医药大学第一附属医院耳鼻喉科

2:河南医学高等专科学校

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摘要

目的探讨慢性噪声损伤对噪声致听损伤患者前庭功能的影响。方法 40例(80耳)慢性噪声致听损伤患者根据2～8 kHz平均听阈分为≤40 dB HL 32耳(A组),≥41 dB HL 48耳(B组),另选择40例年龄和性别相匹配的听力正常无噪声暴露者为对照组,分别进行纯音测听、冷热试验和颈性前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)等检查。结果与对照组相比,噪声性聋组2～8 kHz的平均听阈升高(t=26.478、41.252、42.279、36.258,P<0.05),cVEMP的P13和N23潜伏期延长,P13-N23振幅减小,差异有统计学意义(t=11.194、14.642、-4.804,P<0.05);噪声致听损伤组纯音听阈、cVEMP和冷热试验的异常率分别为100%(80/80)、66.3%(53/80)和26.3%(21/80),对照组分别为0(0/80)、7.5%(6/80)和3.8%(3/80),前者显著高于后者(χ2=160.000、59.312、15.882,P<0.05);B组cVEMP和冷热试验的异常率分别为83.3%(40/48)和27.1%(13/48),A组分别为40.6%(13/32)和25.0%(8/32),两组cVEMP的异常率差异有统计学意义(χ2=160.000、59.312、15.882,P<0.05);B组cVEMP和冷热试验的异常率分别为83.3%(40/48)和27.1%(13/48),A组分别为40.6%(13/32)和25.0%(8/32),两组cVEMP的异常率差异有统计学意义(χ2=15.663,P<0.05),而A、B两组冷热试验的异常率差异无统计学意义(χ2=15.663,P<0.05),而A、B两组冷热试验的异常率差异无统计学意义(χ2=0.043,P>0.05)。结论慢性噪声致听损伤患者除了耳蜗功能受损外,前庭功能受损的可能性也很大,且内耳下部(耳蜗和球囊)比内耳上部(半规管)更容易受到噪声暴露的影响。

关键词

噪声性聋;冷热试验;前庭诱发肌源性电位;球囊;椭圆囊

基金项目(Foundation):

作者

郭向东;王庆林;梅祥胜;姚卫杰;杨晓刚;

参考文献

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