畸变产物耳声发射在糖尿病前期患者听功能检测中的应用

Application of distortion product otoacoustic emission in auditory function test for pre-diabetes patients

目的通过对糖尿病前期（pre-diabetes）患者畸变产物耳声发射（DPOAE）的筛查，了解糖尿病前期患者是否存在早期听力损失。方法通过口服葡萄糖耐量试验入选〈60岁的糖尿病前期患者40例，同时选取年龄、性别匹配的血糖正常者40例为对照组，对入选人群进行纯音测听、DPOAE检查。结果糖尿病前期组40例中17例存在纯音测听异常，对照组40例中仅3例纯音测听异常（X^2=13．067，P〈0．001）。糖尿病前期组DPOAE幅值在各频率点均较对照组降低，其中在1．5，2，3，4，6kHz差异有统计学意义（P〈0．05）。在1，2，4kHz相同频率下DPOAE较纯音测听异常检出率升高（P〈0．001）。结论糖尿病前期存在听力损失，DPOAE检测可在纯音测听出现异常之前发现耳蜗外毛细胞功能状态的改变，敏感性较纯音测听高，临床上可作为糖尿病前期患者耳蜗功能早期变化的有效客观检测方法。

Objective To perform the auditory function screening among the pre-diabetes patients by distortion product otoacoustic emission （DPOAE） in order to determine whether there is hearing loss in the patients. Methods Forty pre-diabetes patients screened out through oral glucose tolerance test, and 40 age- and sex-matched controls with normal blood glucose were enrolled in the study. Pure tone audiometry （PTA） and DPOAE were carried out on them. Results Abnormal results of FFA were found in 17 cases of 40 pre-diabetes patients and only 3 cases of 40 controls （X^2 = 13. 067, P 〈0.001 ）. The DPOAE amplitude at each frequency was lower in the pre-diabetes patients than in the controls, and significant differences were found at the frequencies of 1.5, 2, 3, 4 and 6 kHz （ P 〈 0.05 ）. The detection rates of abnormal results by DPOAE were obviously higher than those by PTA at the frequencies of 1,2 and 4 kHz （P 〈 0.001 ）. Conclusion Pre-diabetes patients have hearing loss. DPOAE, with higher sensitivity than PTA, can detect the changes of cochlear outer hair cells earlier, and can be used as an effective and objective detection for early alterations of cochlear function in pre-diabetes patients.