儿童阻塞性睡眠呼吸暂停低通气综合征对听功能影响的初步探讨

Influence of childhood obstructive sleep apnea-hypopnea syndrome on hearing

目的:探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)而致的低氧血症对听功能的影响。方法:对OSAHS患儿鼓室导抗图为"A"型的68耳进行听性脑干反应(ABR)监测,60耳行畸变产物耳声发射(DPOAE)监测,并与正常儿童30耳(对照组)进行比较。结果:轻度OSAHS患儿ABR各波潜伏期和波间期与对照组比较,均差异无统计学意义(均P>0.05);中重度OSAHS患儿Ⅰ波潜伏期延长,与对照组比较,差异有统计学意义(P<0.05),各波间期与对照组比较,均差异无统计学意义(均P>0.05)。轻度OSAHS患儿的DPOAE幅值在8kHz下降,与对照组比较差异有统计学意义(P<0.05);中重度OSAHS患儿的DPOAE幅值在6kHz和8kHz下降,与对照组比较均差异有统计学意义(均P<0.05)。结论:ABR和DPOAE可监测AHI≥10次/h的OSAHS患儿听功能的早期损害。

Objective：To explore the influence of hypoxemia on the hearing of children with childhood obstructive sleep apnea-hypopnea syndrome （OSAHS）. Method： Auditory brainstem response （ABR） and distortion-prod uct otoacoustic emission （DPOAE） was recorded in 68 ears and 60 ears respectively of children suffering from OSAHS with ＂A＂ tympanogram. Meanwhile, ABR and DPOAE was also recorded in 30 controls of children with ＂A＂ tympanogram. Result： There was no statistical difference between the mild OSAHS group and the control group in the latency of wave Ⅰ , Ⅲ and Ⅴ, the interval between wave Ⅰ and Ⅲ, Ⅲand Ⅴ , Ⅰ and Ⅴ. There was significant difference between the moderate and severe OSAHS group and the control group in the delayed la tency of wave Ⅰ. There was significant difference between the mild OSAHS group and the control group in the amplitudes of DPOAE at 8 kHz. There was significant difference between the moderate and severe OSAHS group and the control group in the amplitudes of DPOAE at 6 kHz and 8 kHz. Conclusion：Cochlear function was affected when AHI≥10/h. ABR and DPOAE could be used to detect the early damagement of auditory function in childhood OSAHS.