新生儿226、1000Hz探测音镫骨肌声反射的研究

The Acoustic Stapedial Reflex with 226Hz and 1000Hz Probe Tones in Newborns

目的探讨新生儿的226、1 000Hz探测音镫骨肌声反射(acoustic stapedial reflex,AR)的引出情况及其在新生儿听力诊断中的临床价值。方法对双耳通过畸变产物耳声发射(DPOAE)筛查、无听力损失高危因素的174例2～7天龄的新生儿进行226、1 000Hz探测音声导抗测试,记录其鼓室导抗图分型及AR引出率。结果 174例(340耳)新生儿完成声导抗测试,226、1 000Hz探测音AR引出率分别为29.71%、65.29%,后者高于前者,差异有统计学意义(P<0.01)。226Hz探测音单峰型和双峰型鼓室导抗图者AR引出率分别为26.23%、33.76%,二者间差异无统计学意义(P=0.130);1 000Hz探测音单峰型和其他型鼓室导抗图者AR引出率分别是67.49%、23.53%,前者显著高于后者,差异有统计学意义(P<0.01)。结论新生儿宜采用1 000Hz探测音进行AR测试,在对新生儿进行听力学评估时,AR测试结果应结合其他听力学检查结果综合解释。

Objective To investigate acoustic stapedial reflex(AR) using 226 and 1 000 Hz probe tones in newborns who passed hearing screening and its value in neonatal audiological evaluation and diagnosis. Methods The acoustic immittance test were conducted using 226 Hz and 1 000 Hz probe tones in 174 newborns between 2 and 7 days with both ears passed the distortion product otoacoustic emission(DPOAE) screening.The newborns showed no high risk register(HRR) factors associated with hearing loss.The tympanogram type and AR status were recorded. Results 174 newborns(340 ears) were tested.The AR present rates at 226 Hz and 1 000 Hz were 29.71% and 65.29%,respectively,showing statistically significant difference between them(P<0.01).The AR present rates for single-peaked and double-peaked tympanogram at 226 Hz were 26.23% and 33.76%,respectively with no statistically significant difference between them(P=0.130).For single-peaked and other tympanogram at 1 000 Hz were the AR preseat rates 67.49% and 23.53%,respectively,with statistically significant differences between them(P<0.01). Conclusion It is better to use 1 000 Hz probe tone in order to obtain more reliable AR in newborns.While assessing hearing in newborns,AR should be interpretated in combination with other audiological tests.