儿童有无平台短纯音诱发听性脑干反应研究

Auditory brain stem responses in children elicited by tone bursts with and without plateaus

目的比较有平台与无平台短纯音诱发的儿童听性脑干反应(Auditory Brain Stem Response,ABR)反应阈之间的相关性,选择更优化的频率特异性ABR刺激信号。方法应用SmartEP听觉诱发电位仪(美国IHS公司)记录0～4岁儿童短声、有平台及无平台短纯音诱发ABR各频率反应阈,共26例(17男/9女)41耳。结果 0.5kHz、1kHz、2kHz、4kHz有平台短纯音ABR反应阈与无平台短纯音ABR反应阈的线性相关系数分别为0.949、0.968、0.979、0.936,前者比后者反应阈分别高(5.0±7.6)、(9.4±5.8)、(8.2±5.2)、(7.6±10.3)dB,差异有统计学意义(t值分别为3.397、8.060、7.915、3.682,P值均<0.01)。极重度听力损失耳有平台短纯音各频率ABR反应阈值引出率均高于无平台短纯音。结论本实验室应用SmartEP听觉诱发电位仪评估儿童听力时,总体上,在测试非极重度听力损失患儿时,无平台短纯音诱发ABR优于有平台短纯音;但本仪器后者可提供更高强度的声刺激,以用于极重度听力损失耳。

Objective To compare auditory brainstem response（ABR） thresholds in children in response to tone bursts with and without plateaus for optimal frequency specific stimulus signals.Methods ABR thresholds were recorded in 26 children aged 0-4（17 males and 9 females,41 ears） using clicks,tone bursts with plateau and tone bursts without plateau,on a SmartEP（HIS,USA）.Results The linear correlation coefficients between ABR thresholds to tone bursts with no plateau and ABR thresholds to tone bursts with plateau was 0.949 at 0.5 kHz,0.968 at 1 kHz,0.979 at 2 kHz and 0.936 at 4 kHz.Thresholds to tone bursts without plateau was higher than those to tone bursts with plateau and the difference was 5.0 ± 7.6 dB at 0.5 kHz,9.4 ± 5.8 dB at 1 kHz,8.2 ± 5.2 dB at 2 kHz and 7.6 ± 10.3 dB at 4 kHz（p 0.01）.The trend was reversed in ears with profound hearing loss.Conclusion In our laboratory,and on the Smart EP system,tone bursts without plateau induce ABRs at a lower threshold in children than tone bursts with plateau,although the latter seem to provide higher stimulus intensity in testing ears with profound hearing loss.