114例言语发育延迟儿童听力学检测分析

Measurement and investigation of audiology in 114 language and speech disorder children

目的：分析言语发育延迟患儿听功能改变特点，听觉脑干诱发电位（ABR）、畸变产物耳声发射（DPOAE）测试的意义及应用价值。方法：对5岁以下114例言语发育延迟患儿进行ABR测试，与各年龄组正常标准值比较，并对异常ABR患儿同时进行DPOAE测试，与标准值比较。结果：ABR测试显示语迟患儿V波反应阈在正常范围者78例（68．4％），异常升高者36例（31．6％）。在36例听力障碍患儿中双耳听力障碍者33例，单耳听力障碍者3例。双耳听力障碍者中有17例（14．9％）无反应，10例（8.8％）重度听力障碍，中度、轻度听力障碍者各3例（2．6％）。3例（2．6％）单耳均为轻度听力障碍。对36例ABR测试异常患儿行DPOAE检查，其中双耳听力障碍的33例患儿共66耳中，有62耳DPOAE反应缺失，与ABR检查结果一致，考虑为耳蜗性聋；1例双耳DPOAE正常，而ABR无反应，该患儿有围产期重度窒息史，考虑为蜗后性聋，另1例轻度听力障碍患儿双耳和其它3例单耳轻度听力障碍患儿DPOAE幅值、信噪比（SNR）低频区正常，中高频区（3～8KHz）下降、SNR〈6。结论：言语发育延迟患儿听功能改变以双耳重度神经性耳聋为特点，ABR、DPOAE对于言语和语言障碍儿童的听力损害提供客观定位和频率特性。

Objective： To study the characteristics of evoked audiology in language and speech disorder children （ LSDC）, and evaluate the role of auditory brainstem response （ABR） /distortion product otoaeoustie emission （DPOAE） in hearing diagnosis for LSDC. Methods： ABR were measured in 114 LSDC of 0 -5 years old, 36 hearing disorders of children to evaluate the efficiency of diagnosis of DPOAE. Results： There were 36 hearing disorders of children found in 114 language and speech disorder childi＇en. There were 33 speech abnormality of children of both ear hearing disorders, 3 cases of one ear hearing disorders. There were 27 severe hearing disorders, 6 cases of mild and moderate hearing disorders. 36 hearing disorders of children tested DPOAE, and the accuracy of DPOAE were 97.1% respectively. The amplitude and S/N - ratio in LSDC were obvious lower than those in normal neonates. Conclusion： LSDC are characterized as severe and both ear hearing disorders. ABR and DPOAE could provide objective location and frequency figure for LSDC.