不同听力损失耳听觉稳态诱发反应阈值与纯音听阈的比较

Threshold comparison between ASSR and pure tone audiometry in ears with hearing loss

目的研究不同听力损失耳的听觉稳态诱发反应(auditory steady-state evoked response,ASSR)与纯音听阈的关系,为客观的听力评估提供指导。方法对67例(103耳)不同听力损失耳分别行ASSR与纯音测听检查,比较ASSR分别在0.5、1、24、kHz频率处的反应阈值与纯音听阈的相关性及差值。结果ASSR的反应阈与纯音听阈在0.5、1、24、kHz频率处的相关系数分别为0.84、0.83、0.89、0.91,呈极显著相关(P<0.01);ASSR的反应阈与纯音听阈在0.5、1、2、4 kHz频率处的差值在轻度耳聋组分别为(11.2±3.5)dBHL、(12.9±3.7)dBHL、(13.6±4.1)dBHL、(13.4±4.5)dBHL;在中度耳聋组分别为(3.4±4.6)dBHL,(4.9±4.3)dBHL,(6.8±5.7)dBHL,(7.1±5.6)dBHL;在重度耳聋组分别为(1.5±3.1)dBHL,(3.4±2.1)dBHL,(2.9±2.3)dBHL,(1.2±2.6)dBHL;其中轻度耳聋组的ASSR的反应阈与纯音听阈的平均差值与重度耳聋组的平均差值有统计学意义(P<0.01)。结论ASSR反应阈与纯音听阈有显著相关性,随着听力损失的加重,ASSR反应阈愈接近纯音听阈,ASSR可作为不同听力损失者客观的听力评估。

Objective To study the correlation between the thresholds of auditory steady-state evoked response （ASSR） and those of pure tone audiometry in ears with hearing loss to guide the impersonal hearing evaluation. Methods 103 ears （67 patients） with hearing loss of different degrees were tested with ASSR and pure tone audiometry, the correlations and differences between the thresholds of ASSR and pure tone audiometry at 0. 5, 1, 2 and 4 kHz were analyzed. Results The correlation coefficients of the thresholds were 0. 84, 0.83, 0. 89, 0. 91 at 0. 5,1, 2, and 4 kHz respectively. the positive correlations were significant （P d0. 01）. The differences of the thresholds were （11, 2±3. 5） dBHL, （12. 9±3. 7） dBHL, （13. 6±4. 1） dBHL, （13. 4±4.5） dBHL at 0. 5,1, 2, and 4 kHz respectively in the mild hearing loss group, those in the moderate group were （3. 4±4. 6） dBHL, （4. 9±4. 3） dBHL, （6. 8±5. 7） dBHL, and （7. 1±5. 6） dBHL respectively, and in severe group were （1. 5±3. 1） dBHL, （3. 4±2. 1） dBHL, （2. 9±2. 3） dBHL, and （1. 2±2. 6） dBHL. The average difference of threshold between the mild group and the severe group was statistically significant （ P 〈0. 01）. Conclusion The thresholds of ASSR are positively correlated with the thresholds of pure tone audiometry. The correlation becomes closer with the increase of hearing loss. ASSR can be applied to the impersonal hearing evaluation for hearing loss.