糖尿病患者听性脑干反应及耳蜗电图检测结果分析

Analysis of ABR and Electrocochleography in Patients with Type 2 Diabetes Mellitus

目的探讨听性脑干反应(ABR)、耳蜗电图(ECochG)对2型糖尿病(diabetes mellitus,DM)患者听功能检测的价值。方法 76例DM患者,按年龄段分为DM青年组(<45岁,22例)和DM中老年组(≥45岁,54例),分别行纯音测听、听性脑干反应及耳蜗电图检查,并选择性别、年龄与之匹配的健康人40例(<44岁13例,≥45岁27例)作为对照组,比较各组检查结果。结果与同龄对照组相比,DM青年组ABR波Ⅰ潜伏期延长,差异有统计学意义(P<0.01),DM中老年组ABR波Ⅰ、Ⅲ、Ⅴ潜伏期及Ⅰ-Ⅲ、Ⅰ-Ⅴ波间期均延长,差异有统计学意义(P<0.05);DM青年组耳蜗电图AP潜伏期延长占18.18%(8/44),与对照组比较差异有统计学意义(P<0.01);DM中老年组中耳蜗电图AP、-SP均引出者占48.14%(52/108),对照组占62.96%(34/54)(P<0.05),DM中老年组-SP/AP幅值>0.40者占11.11%(12/108),对照组-SP/AP幅值均<0.4;ABR、耳蜗电图异常与年龄无相关性(P>0.05),而与病程相关(P<0.01)。结论 ABR、ECochG可对糖尿病患者听觉中枢及外周病变作出早期判断和定位。

Objective To explore the characteristics of hearing impairments in patients with type 2diabetes mellitus by auditory brainstem response（ABR）and EcochG.Methods According to the age,76patients with type 2diabetes mellitus were divided into 2groups,the younger group and the older group.Pure tone audiometry,ABR and EcochG were examined in 76cases with type 2diabetes mellitus（group DM）and in 40of age-and-sexmatched healthy subjects as a control group.The parameters of pure tone audiometry,ABR and EcochG were recorded and analyzed by SPSS.Results An obvious difference was found in the response threshold of waveⅤthan in the threshold of pure tone by comparing two groups with diabetic patients and their control groups.ABR and EcochG abnormalities were found in two groups of diabetic patients.Compared with control group,we found a significant longer latency period of wave I in the younger group（P0.01）.And we also found longer latency period of wave I,Ⅲand V in the older group（P0.05）.The interpeak latency intervals of wave I-Ⅲ,I-V in the older group were longer than those of in control group（P0.05）.Compared with control group,the EcochG abnormalities in two groups with diabetic patients were found.The longer latency period of AP presented in 18.18%（8among 44ears）of the younger group（P0.01）.Presence of both SP and AP was 48.14%（52among 108ears）in the older group and 62.96%（34among 54ears）in control group（P0.05）.The abnormal amplitude ratio of SP/AP presented in 11.11%（12among 108ears） in the older group（P0.01）.Age wasn ’ t the risk factor for hearing impairment in patients with type 2diabetes.While a positive correlation was found between the parameters of ABR,EcochG and the disease duration.Conclusion Both ECochG and ABR play important roles in the localization and early diagnosis of hearing impairments in diabetes mellitus.