扩展高频测听的临床分析

An analysis of extended high frequency auditory threshold data

目的：使用临床听力计ＡＣ－４０以ｄＢＨＬ表示，与纯音测听的零级标准单位一致。观察实验条件下扩展高频测听以ｄＢＨＬ表示的阈值特征与以往报道的阈值（以ｄＢＳＰＬ为单位）的规律是否一致。方法：纯音测听和耳镜检查正常受试者２２７例，男１１２例，女１１５例，共４４５耳，左２２３耳，右２２２耳。年龄１７～８７岁，每隔１０岁为一年龄组，共分为７组，使用丹麦奥迪康ＡＣ－４０型听力计进行扩展高频听力测试。结果：扩展高频测听的阈值随频率的增高而增高，１１ｋＨｚ以上的阈值增加幅度明显增大；阈值随年龄的增高而增高，３０～４０岁年龄组以上者阈值幅度增高明显；在听力计最大输出强度，从较低频率到较高频率，随年龄的增大，则给声信号的检出率逐渐下降；３０～４０岁以下年龄组各频率的检出率为１００．０％，而７０岁以上年龄组在１６ｋＨｚ的检出率只有１６．０％；受试者之间阈值变化的差异也因频率和年龄而表现不同的特征；１１～１４ｋＨｚ之间阈值的变化的差异最大，１４ｋＨｚ以下各频率阈值变化的差异随年龄的增高而增高，其中３１～４０岁年龄组变化最大；双耳间阈值差范围在０ｄＢＨＬ～８．７ｄＢＨＬ之间，绝大多数在５ｄＢＨＬ以下，Ｐ＞０．０５，差别无显著性，说?

Objective: To investigate the high frequency(8kHz～16kHz) auditory threshold andexplore the relationship among the threshold,frequency and age,when used dBHL in extended high frequency audiometry. Method: The auditory thresholds of 227 subjects(445 ears)(112 males and 115 females) with normal conventional hearing ranging in age from 17 to 87 years old in seven decade age categories were measured by clinical audiometer-AC 40. Results: Our experiment results showed that the mean and standard deviation of auditory threshold in intra-age category for frequency from 8kHz to 16kHz were present; the threshold increased with aging; the threshold increased monotonically as a function of frequency for all age groups; the incidence of ear with response to maximum output reduced as a function of aging and frequency; inter-subjects variability in high frequency thresholds in creased as a function of both age and frequency; average inter-ear threshold differences ranged from 0dBHL～8.7dBHL for each category and test frequency(P>0.05). It is exhibited a symmetrical diminution of high frequency sensitivity. Conclusion:The result of this study revealed significant affects of both age and frequency upon high frequency sensitivity. High frequency auditory threshold and threshold variability(standard deviation) expressed in dBHL increased with increased test frequency and aging,these data are in accordance with several publications of previous investigators,so the test frequency and age factors should be considered in evaluation of preliminary hearing loss for high frequency sensitivity. [Chinese Arch Otolaryngol Head Neck Surg,2002;9(1):3～6 From the Department of Otolaryngology-Head and Neck Surgery,First Hospital of Beijing University,Beijing 100034(Dr. Liu Shiyuan)]