【作者】 王涛；

【导师】 华清泉；

【作者基本信息】 武汉大学 ， 耳鼻咽喉科学， 2005， 硕士

【摘要】 目的 多频听觉稳态反应(multiple auditory steady-state response,MASSR)及短音诱发听性脑干反应(tone-pip evoked auditory brainstem response,Tp-ABR)对听力正常青年人听阈评估的探讨。 方法 对听力正常青年人28名(56耳),采用MASSR及纯音测听记录0.5、1、2、4kHz阈值,并记录0.5、1、2、4kHz Tp-ABR反应阈及Ⅰ、Ⅲ、Ⅴ波潜伏期及波间期,主观听阈。结果通过统计学软件SPSS11.5进行相关分析。 结果 ①MASSR反应阈左右耳无显著性差异(P>0.05);0.5kHz较其它有显著性差异(P<0.001),1、2、4kHz三个频率间无显著性差异(P>0.05)。MASSR反应阈与纯音听阈在0.5、1、2、4kHz各频率两者差值分别为13.9±5.8、10.3±4.7、10.2±3.9、8.1±4.5dB SPL,相关系数分别为0.71、0.83、0.86、0.87。②Tp-ABR反应阈0.5kHz处有显著性差异(P<0.001)外,1、2、4kHz三个频率均无显著性差异(P>0.05)。0.5、1、2、4kHz各频率Tp-ABR反应阈与纯音听阙在两者差值分别为23.8±5.8、20.1±6.6、14.6±4.1、15.6±5.2dB,相关系数分别为0.63、0.75、0.88、0.74,主观听阈与纯音听阈差值分别为20.0±5.1、17.1±5.5、13.8±4.9、13.6±4.1dB nHL。Tp-ABR波间期及潜伏期随频率增加递减。③MASSR反应阈,Tp-ABR反应阈0.5kHz处均有显著性差异(P<0.001),1、2、4kHz三个频率均无显著性差异(P>0.05)。0.5、1、2、4kHz各频率MASSR反应阈与Tp-ABR反应阈分别为34.6±7.9、24.2±7.6、25.5±7.5、26.7±7.9 dB SPL;31.0±7.8,26.3±8.7,22.1±7.5、21.3±7.1 dB nHL,Pearson相关系数分别为0.69、0.85、0.87、0.81。click-ABR反应阈与MASSR反应阈、Tp-ABR反应阈0.5、1、2、4kHz均值、1、2、4kHz均值、2、4kHz均值Pearson相关系数分别为0.71、0.76、0.85、0.67、0.72、0.88,前者无显著性差异,后者click-ABR反应阈与Tp-ABR反应阈2、4kHz均值Pearson相关系数有差异。(P<0.05)。 结论 MASSR与Tp-ABR均具有频率特异性,两者反应阈与纯音听阈各频率有一定相关性,特别是1、2、4kHz较好。两者均可用于评估纯音听阈。两者各有其优缺点,可结合应用提高临床诊断效能。更多还原

【Abstract】 Objective To explore the prediction of hearing thresholds in normal-hearing adults using multiple auditory steady- state response (MASSR) and tone-pip evoked auditory brainstem response(Tp-ABR).Methods The response thresholds of MASSR and the behavioral thresholds were recorded from 28 normal hearing adults(56ears) at 0.5,1,2,and 4kHz. The response thresholds of Tp-ABR、 the latency and the interpeak lantency of wave Ⅰ、 Ⅲ、Ⅳ and the behavioral thresholds of Tp-ABR, were recorded from 28 normal hearing adults(56ears) at 0.5,1,2, and 4kHz.The results were performed using statistical analysis software(SPSS11.5).Results ① There were no significant differences between the right and the left ear for the response thresholds(P>0.05). There were significant difference at 0.5kHz for MASSR (P<0.001) , at other three frequentcies, no siginificant differences(P>0.05). Pearson correlations between the response thresholds and the behavioral thresholds were 0.71,0.83,0.86,0.87,with averages between the response thresholds and the behavioral thresholds were 13.9±5.8,10.3±4.7,10.2±3.9,8.1±4.5dB SPL for carrier frequencies 0.5, 1, 2, and 4kHz. ②There were significant difference at 0.5kHz for Tp-ABR (P<0.001) , at other three frequentcies, no siginificant differences(P>0.05). At 0.5, 1, 2, and 4kHz, peaison correlations between the response thresholds of Tp-ABR and the behavioral thresholds were 0.63,0.75, 0.88, 0.74,with average differences between the response threshold of Tp-ABR and the behavioral thresholds were 23.8±5.8,20.1±6.6,14.6±4.1,15.6±5.2dB. The differences between the response threshold of Tp-ABR and the behavioral threshold of Tp-ABR were 20.0±5.1,17.1±5.5,13.8±4.9,13.6±4.1dB nHL at 0.5,1,2, and 4kHz.The latency and the inteipeak lantency shortened with increasing of frequencies from 0.5 to 4 kHz,③There were significant difference at 0.5kHz for MASSR and Tp-ABR (P<0.001) , at other three frequentcies, no siginificant differences(P>0.05). At 0.5,1, 2, and 4kHz, pearson correlations between the response thresholds of MASSR and Tp-ABR were 0.69 ,0.85,0.87,0.81,with the response thresholds of MASSR and Tp-ABR were 34.6±7.9,24.2±7.6,25.5±7.5,26.7±7.9 dB SPL; 31.0±7.8,26.3±8.7,22.1±7.5,21.3±7.1 dB nHL at 0.5, 1, 2 and 4kHz. Between click-ABR thresholds and MASSR thresholdsaveraged at 0.5,1, 2 and 4kHz;at 1, 2 and 4kHz and at 2 and 4kHz, pearson correlation coefficients were 0.71,0.76,0.85,respectively. Between click-ABR thresholds and Tp-ABR thresholds averaged at 0.5, 1, 2 and 4kHz;at 1, 2 and 4kHz and at 2 and 4kHz, pearson correlation coefficients were 0.67,0.72,0.88,respectively.Corelation values were significant(r=0.88) at 2 and 4kHz.Conclusion This study illustrate that MASSR, Tp-ABR and PTA were highly correlated each other,especially at 1, 2, and 4kHz.There results support the use of MASSR as an alternative to Tp-ABR for thresholds assessment in normal-hearing adults. There were some advantages and caveats between MASSR and Tp-ABR.We should use MASSR with Tp-ABR to predict hearing thresholds.更多还原