畸变产物耳声发射潜伏期对侧抑制现象的观察

Observation of Effects of Distortion Product Otoacoustic Emissions with Contralateral Suppression on Noise Exposure Individuals

目的探讨畸变产物耳声发射(DPOAE)及其对侧抑制效应在早期发现噪声性听力损伤中的临床应用价值。方法对38名噪声接触工人和40名耳科正常人,进行纯音听阈、声导抗及有、无对侧刺激声(60dB SPL白噪声)时DPOAE的幅值及相位反应进行测定。结果在对侧无刺激声时,实验组相应频率平均反应幅值较对照组降低(P<0.05),其相位反应差异无统计学意义(P>0.05);对侧有声刺激时,对照组各频率幅值降低(P<0.05),相位反应延长,实验组DPOAE幅值降低不明显,相位反应在1、2kHz表现延长(P<0.05),在4、6kHz则表现缩短(P<0.05)。结论在检测噪声引起的耳蜗损伤时,DPOAE反应幅值较纯音测听更敏感;在对侧抑制效应中,DPOAE的潜伏期也是早期发现噪声性听损伤的有用观察指标。

Objective To investigate the clinical application of distortion product otoacoustic emissions（DPOAEs） with contralateral suppression effects in early diagnosis of noise - induced hearing loss. Methods DPOAE amplitude and latencies were measured at f2 = 1,2,4 and 6 kHz with or without 60 dB SPL white noise contralateral acoustic stimulation in 40 healthy young people, control group of 80 ears, and 38 noise exposed individuals as test group with 60 ears. Results O Without contralateral acoustic stimulation, DPOAE amplitude was decreased obviously in noise exposed group（ P 〈 0.05 or P 〈 0.01 ）, but no significant difference was noted in DPOAE latencies between two groups at each frequency. ① During contralateral acoustic stimulation, the amplitude of DPOAE was reduced at each frequency（ P 〈 0.05）, and the latency prolonged significantly at frequency of 1,2 kHz （ P 〈 0.05） in normal young group; the amplitude of DPOAE was reduced at frequency of 1,2 kHz（ P 〈 0.05） in test group, but no significant changes were noted at the 4,6 kHz frequency. The latency of DPOAE was prolonged at frequency of 1,2 kHz（ P 〈 0. 05）, but reduced significantly at 4, 6 kHz in noise exposed group. Conclusion ① Comparing with the pure tone andiometry, DPOAE amplitude is more sensitive in detection of noise - induced cochlear injury. ②DPOAE latency with contralateral suppressionis is a useful measure for early diagnosing of noise- induced hearing loss.