正常新生儿宽频声导抗能量吸收率及其可重复性研究

Test-Retest Reliability of the Wideband Absorbance in Mormal Hearing Neonates

目的探讨正常新生儿中耳宽频声导抗（wideband acoustic immittance,WAI）能量吸收率及其相关的影响因素,评价宽频声导抗测试的可重复性。方法选取通过瞬态诱发耳声发射（transient evoked otoacoustic emissions,TEOAE）听力初筛的正常新生儿124例（193耳）,在其出生48~72小时进行WAI测试,分析不同频率能量吸收率的变化规律、两次测试的重复性及外耳道处于不同压力、性别、侧别、分娩方式对WAI能量吸收率的影响。结果正常新生儿宽频声导抗能量吸收率随频率增大呈＂两峰两谷＂形态,即在低频及3 363 Hz附近较低、在1 296Hz附近及高频较高;两次测试的重复性显示外耳道处于峰压时,1 000Hz和2 000Hz两次测试差值的绝对值较外耳道压力处于0daPa时小,且差异有统计学意义（P〈0.05）,而其余各频率差异无统计学意义（P〉0.05）。外耳道压力处于0daPa时与峰压时相比,除1 000、6 727Hz外,其余各频率WAI能量吸收率的差异均有统计学意义（P〈0.05）;不同性别、侧别、分娩方式的新生儿WAI能量吸收率差异无统计学意义（P〉0.05）。结论正常新生儿外耳道处于峰压时,两次WAI测试的重复性较好;外耳道处于不同压力对大部分频率WAI能量吸收率有一定影响;性别、侧别、分娩方式对WAI能量吸收率无明显影响。

Objective To study wideband absorbance,and the effects of related factors in mormal hearing neonates,and to evaluate the test-retest reliability of WAI test.Methods A total of 124 neonates Born in Peking Union Medical College Hospital from July 2014 to September 2014（193ears）,who passed TEOAE screening test at the age between 48 and 72hours were induded in this study.WAI test was performed,then the characteristics under different frequencies and test-retest reliability were analyzed.The effects of different test pressure,genders,laterability and delivery mode on wideband absorbance were studied.Results The normal value of wideband absorbance was lower at low frequencies and frequencies around 3363 Hz,while higher at frequencies around 1 296 Hz and high frequencies.For the test-retest reliability,the absolute values of differences between two tests for tympanometric peak pressure were smaller than ambient at 1 000 Hz and 2 000 Hz.The differences were statistically significant（P〈0.05）,while differences among other frequencies were not statistically significant（P〉0.05）.At all frequencies except 1 000 Hz and 6 727 Hz,the differences of wideband absorbance were statistically significant（P〈0.05）between ambient and tympanometric peak pressure,while the differences of wideband absorbance were not statistically significant（P〉0.05）for different genders,laterabilities and delivery modes.Conclusion The test-retest reliability is better at tympanometric peak pressure.The differences of wideband absorbance at different test pressure were statistically significant under most frequencies.The differences of wideband absorbance for different genders,laterabilities,and delivery modes were not statistically significant.