正常听力婴幼儿骨导ABR的特征研究

The study of bone conduction auditory brainstem responses in infants with normal hearing

目的：研究0～2岁的听力正常婴幼儿骨导听性脑干反应（ABR）的波形特点、波V反应阈值及波V潜伏期-强度函数曲线,为临床上开展婴幼儿骨导ABR提供一定的参考依据。方法：于镇静睡眠状态下对24例0～2岁听力正常婴幼儿（0～1岁12例,1～2岁12例,共36只耳）进行气骨导短声ABR检测。结果：1气骨导ABR在其阈值及阈上强度下的波形相似,在给声强度为35 d Bn HL时均可记录到清晰、稳定、重复性好及分化好的骨导ABR波形,其中Ⅰ、Ⅲ、Ⅴ波引出率分别为29.2%、46.7%和100%。2骨导ABR的波V反应阈为（15.00±5.48）d Bn HL,阈值处Ⅴ波的潜伏期为（8.32±0.54）ms。3不同年龄组间骨导ABR波V反应阈值和潜伏期差异有统计学意义（P〈0.05）,即0～1岁组波V阈值较1～2岁组高,阈值处波V潜伏期较1～2岁组延长。不同性别间骨导ABR波V反应阈值和潜伏期差异无统计学意义（P〉0.05）。4骨导ABR的V波潜伏期-强度函数曲线表明骨导ABR的V波潜伏期随着Click给声刺激强度的递减而逐渐延长。结论：骨导ABR在一定刺激强度下可记录到清晰稳定的波形,其波形与相应刺激强度下的气导ABR波形相似。联合应用气骨导ABR的潜伏期-强度函数曲线,可望对婴幼儿听力筛查、听力损失性质的判断提供重要的临床参考价值。

Objective：To study the characteristics of wave forms of the bone-conduction click-evoked auditory brainstem responses in 0～2 years old infants with normal hearing and to evaluate initially the value of its application in clinic.Methods：Air-and bone-conduction click-evoked ABRS in 24 cases of 0-2 years old infants（0-1 years,1-2 years every 12 cases,36 ears） with normal hearing were performed.The data were statistically analyzed with SPSS17.0.Results：The wave forms of bone-conduction ABR were almost the same as those of air-conduction at the thresholds or above.The detection rates of wave I,III and V were 29.2%,46.7% and 100%,respectively at 35 d Bn HL.The thresholds to bone-conducted ABR were（15.00±5.48） d Bn HL,with the latencies of wave V were（8.32±0.54） ms.There were significant differences between ages for the thresholds and the wave V latencies（P〈0.05）,for aged 0-1 years infants,the thresholds to bone-conducted ABR were higher than that aged 1-2 years infants,and the wave V latencies were prolonged than aged 1-2 years groups.There were no significant differences between male and female for the thresholds and the wave V latencies.The bone-conducted wave V latency-intensity functions exhibited increased latencies as intensity decreased.Conclusion：The boneconduction ABR is a valuable and effective method in children＇s hearing test with special values in newborn hearing screening,more information on ascertaining the presence and magnitude of a conductive hearing loss can be obtained when both air and bone-conducted ABR wave V latency-intensity functions are administered.