不同月龄婴儿声反射与畸变产物耳声发射测试结果分析

An analysis of the acoustic reflex and distortion product otoacoustic emission results of infants of different ages

目的探讨不同月龄婴儿226 Hz和1000 Hz探测音的中耳声反射测试与畸变产物耳声发射（DPOAE）联合筛查的意义。方法测试对象为来泸州医学院附属医院进行听力筛查或复查的188例（350耳）3天～12月龄的婴儿，分为3天～1月龄组（125耳），2～3月龄组（89耳），4～6月龄组（76耳），7～12月龄组（60耳），分别进行226、1000Hz探测音声导抗，畸变产物耳声发射测试，对226、1000Hz探测音中耳声反射引出率和DPOAE的通过率进行比较分析。结果3天～1月龄组226、1000Hz探测音声反射引出率和DPOAE的通过率分别为81％、69％、73％；2～3月龄组分别为91％、72％、74％；4～6月龄组分别为90％、83％、79％；7～12月龄组分别为43％、66％、60％。226Hz声反射引出率与DPOAE通过率差异有统计学意义（P〈0．01），1000Hz声反射引出率与DPOAE通过率差异无统计学意义（P〉0．05），并且DPOAE筛查结果与1000Hz探测音的声反射结果较一致。结论1000Hz探测音声导抗测试对婴儿中耳功能的诊断价值比226Hz探测音的敏感性更高，与DPOAE协同用于婴儿听力筛查具有良好的临床价值。

Objective To explore the significance of the combined utilization of acoustic reflexes elicited with 226 Hz or 1000 Hz probe tone and DPOAEs in screening infants of different ages. Methods 188 infants （350 ears） from 3 days to 12 months old were divided into 4 groups： the infants of 3 days to 1 month old as Group 1（125 ears）, 2-3 months old as Group 2 （89 ears）, 4-6 months old as Group 3 （76 ears）, and 7-12 months old as Group 4 （60 ears）. All the infants received the acoustic reflex （AR） test elicited with 226 or 1000 Hz probe tones and DPOAE test. The correlations between the results of the two measurements were analyzed with SPSS respectively. Results For Group 1, the percentage of AR（＋） elicited with 226 and 1000 Hz probe tones and the pass rates of DPOAE were 81%,69% and 73%,respectively; for Group 2, these were 91%, 72% and 74%; for Group 3, 90%, 83% and 79% ; for Group 4, 43%, 66% and 60%. There were significant differences between the percentages of AIR （＋） elicited with 226 Hz probe tone and the pass rates of DPOAE （P〈0.01）, but no differences between the percentages of AR （＋） obtained with 1000 Hz probe tone and the pass rates of DPOAE （P〉0.05）. The results obtained with 1000 Hz probe tone were consistent with those of DPOAEs. conclusion The 1000 Hz probe tone tympanometry is more sensitive to the function of the middle ear of infants than 226 Hz probe tone.Therefore, it is considered as a valuable tool in the hearing screening of infants as combined with DPOAE test.