畸变产物耳声发射选择注意效应测试对糖尿病人听力的评价

A study on DPOAE in patients with diabetes mellitus

为观察畸变产物耳声发射（DPOAE）选择注意效应的临床应用价值，对19例控制良好的糖尿病人进行DPOAE测试，并以19例正常人作为对照。结果示，正常人在对侧声刺激（CAS）与视觉任务同时出现时，相对幅值（绝对值）增加，CAS与视觉任务有协同作用（协同效应）。2例（3耳）糖尿病人的DPOAE在3kHz以上频率区消失；4例（7耳）的对侧抑制效应、选择注意效应及协同效应显著减弱，DPOAE相对幅值显著小于正常人；3例（6耳）的相对幅值均为正值，CAS或视觉任务不但不抑制，反而使DPOAE幅值增加，即可能存在皮层和内侧橄榄耳蜗系统传出通路的亚临床损害或功能紊乱；1例（2耳）的DPOAE幅值在3kHz以上消失且三种效应测试均异常，即可能有听觉传出系统不同部位的共同损害。表明糖尿病人在可观察到的视网膜病变发生之前，DPOAE测试就可发现耳蜗和传出神经系统的早期微小损害和功能障碍，这为糖尿病人早期发现亚临床的末梢器官微小损害及听觉中枢和周围神经系统功能障碍提供了更灵敏的测试方法，为糖尿病人听力改变的早期诊断早期治疗提供了重要依据。

In present experiment we tested DPOAE in 19 patients with diabetes mellitus and compared with control subjects. Results showed that DPOAE (f2 above 3 kHz)disappeared in 2 pa-tients (3 ears) indicating cochlear lesion,both of DPOAE contralateral suppressive effects and se-lective attention effects significantly reduced in 4 patients (7 ears),and reversed in 3 patients (6ears) indicating disorders existing in cortex topdown and efferent of MOCS. It was suggested that tests of DPOAE and suppression (induced by CAS and selective attention) may be useful for mak-ing early diagnosis of cochlear-pathy and auditory efferent disoreders (cortex and MOCS) be fore retinalpathy happened. This study on DPOAE provided important evidence for early diagnosis and early treatment of diabetic complications.