正常婴儿骨导听性脑干反应研究

Bone Conduction Clicks-Induced Auditory Brainstem Responses in Normal-Hearing Infants

目的研究正常婴儿短声骨导听性脑干反应(bone conduction click auditory brainstem responeses,BC-ABR)的阈值、潜伏期及其与气导听性脑干反应(air conduction click auditory brainstem responeses,AC-ABR)的关系,为BC-ABR在婴儿听力评估中的应用提供参考依据。方法将20例听力正常婴儿按月龄分为两组:A组婴儿<6月,共10例20耳;B组婴儿≥6月,共10例20耳。分别进行短声AC、BC-ABR测试,对测试结果进行统计分析。结果 1BC-ABR波形与AC-ABR波形相似,BC-ABR波V潜伏期为7.45±0.35ms,反应阈为7.50±4.24d B n HL,反应阈的第95百分位数为15.00d B nHL。2不同性别、不同耳别间BC-ABR波V阈值和潜伏期差异均无统计学意义(P>0.05)。3A组、B组BC-ABR波V潜伏期分别为7.48±0.37ms和7.42±0.34ms,差异无统计学意义(P>0.05);波V阈值分别为8.00±4.70d B nHL和7.00±3.77d B nHL,差异无统计学意义(P>0.05);AC、BC-ABR阈值的差值分别为9.75±4.44d B nHL和9.25±2.94d B nHL,差异无统计学意义(P=0.68)。4AC-ABR波V阈值为17.00±2.95d B nHL,明显高于BC-ABR波V阈值,差异有统计学意义(P<0.05);AC-ABR与BC-ABR阈值的差值为9.50±3.72d B n HL,第95百分位数为15.00d Bn HL。结论 BC-ABR波形特点与AC-ABR极为相似;婴儿BC-ABR阈值的正常值可采用统一的参考标准;本研究为婴儿听力的早期评估和干预提供了可靠依据。

Objective To report thresholds and latencies of air and bone conduction clicks-induced auditory brainstem responses in normal infants and to evaluate their values in clinical application. Methods Bone conduction click auditory brainstem responses（BC-ABR） and air conduction click auditory brainstem responses（AC-ABR） were tested in 20 normal-hearing infants（group A：〈 6 months, group B：≥6months）. Data were analyzed with the SPSS 13.0 software. Results Waves of BC-ABRs and AC-ABRs were similar. The mean BC-ABR threshold was 7.50±4.24 d B nHL（95th percentile： 15 d B nHL） and the mean wave V latency was 7.45±0.35 ms. There was no significant difference in threshold or latency between the left and right ears, or between males and females. The wave V latencies were 7.48±0.37 ms and 7.42±0.34 ms,and the BC-ABR thresholds were 8.00±4.70 d B nHL and 7.00±3.77 d B n HL for groups A and B, respectively. The AC-ABR/BC-ABR threshold difference was 9.75 ± 4.44 d B and 9.25 ± 2.94 d B for groups A and B, respectively（P〉0.05）. AC-ABR thresholds were higher than BC-ABR thresholds（9.50±3.72 d B, 95 th percentile： 15 d B）. Conclusion BC-ABR is a valuable and effective tool in newborn hearing screening,assessment and identification of hearing loss.