听力正常婴幼儿短音听性稳态反应的研究

Normal Auditory Steady-State Responses in Children

目的建立听力正常婴幼儿短音听性稳态反应正常值．并探讨年龄的影响。方法单、双耳听力正常婴幼儿53名（78耳），男36名，女17名，年龄在1～42月，中位数为4月龄。根据年龄将受试者分为2组，1～6月龄组55耳和≥6月龄组23耳。听性稳态反应（ASSR）刺激信号为0．5～4kHz的倍频程短音（tonepip）。0．5kHz刺激信号上升、下降时间均为4ms，1、2、4kHz为2ms。0．5、1、2、4kHz刺激信号的刺激速率左耳分别为77、85、93、101Hz，右耳为79、87、95、103Hz。双耳八个频率的刺激信号同时通过ER-3A插入式耳机给出，系统自动判定并记录反应。结果①78耳0．5～4kHzASSR反应阈值分别为50．20±7．73、41．30±6．96、36．46±6．16、39．60±8．48 dB SPL；②双因素方差分析（频率×年龄），两组间及各频率间反应阚值差异均有显著统计学意义（P=0．000和P=0．001）；③两组间0．5kHz反应阈值差异有显著统计学意义，其余频率反应阈值间差异无显著统计学意义；④≥6月龄组0．5kHz反应阈值显著高于其他各频率，其余频率反应阈值之间差异无显著统计学意义；1～6月龄组0．5kHz反应阈值显著高于其他各频率，此外2k与4kHz反应阈值之间差异具有显著统计学意义（P＝0．035）。结论短音具有一定的频率特异性，以短音作为刺激信号所记录到的昕性稳态反应阈值与调幅调制声或混合调制声信号的听性稳态反应结果近似，也是婴幼儿听力诊断的可靠方法。年龄因素对0．5HzASSR阊值的影响最大。

Objective To explore the thresholds of the normal hearing infants with auditory steady--state re sponses （ASSRs） to brief tone. Methods The ASSRs were recorded in a group of normal hearing infants（ 78 ears） aged between 1 and 42 （median 4） months old. The subjects were divided into two groups by their ages, the subjects in group 1 aged from 1 to 6 months while the others were in group 2. The stimuli of the ASSR were0.5,1,2, 4 kHz tone pips at the rates of 77-101 Hz. The stimuli were presentedsimuhaneously,4 in each ear andatotal of 8 stimuli, in both ears by the insert earphones. The responses were automatically detected by the testing system. All the subjects were sedated by Hydrate Chloride during ASSR testing. Results ①The mean ASSR thresholds and standard deviation at 0.5,1,2,4 kHz were 50.20±7.73,41.30±6.96,36.46±6.16,39.60±8.48 dB ppe SPL. ② Two way repeated measures ANOVA （frequency × group） showed significant effect on frequencies and between groups. ③The mean ASSR threshold between these two groups showed a significant difference at 0.5 kHz. ④The mean ASSR thresholds at 0. 5 kHz was significantly higher than that of the other three frequencies for the both groups. Conclusion The ASSR thresholds of tone pips were equivalent to those ASSRs of amplitude modulated and mixed modulated tones.