听性脑干反应及听觉稳态反应对听力筛查未通过婴幼儿的听力学评估

Auditory assessment of auditory brainstem response and auditory steady-state response to infants failed in hearing screening

目的探讨听性脑干反应(ABR)及听觉稳态反应(ASSR)对听力筛查未通过的婴幼儿的听力学评估价值,为早期诊断及干预提供科学依据。方法对839例听力筛查初筛及复筛均未通过的婴幼儿进行ABR及ASSR测试,分析其检查结果 ,作出听力学评估;并比较ABR及ASSR对受试儿听力反应的引出率。结果 839例听力筛查未通过的婴幼儿中,第1次听力学评估双侧听力正常73例(假阳性率8.70%),6月龄内第2次听力学评估听力恢复正常者29例(可恢复率3.46%),最终确诊听力损失737例(最终确诊率87.84%)。ASSR的听力反应引出率(90.35%)高于ABR(77.71%),差异有统计学意义(χ2=99.79,P<0.01)。结论 ABR联合ASSR可对6月龄以内的先天性听力损失婴幼儿做出全面准确的听力学评估,为听力损失的早期干预提供有力依据。

Objective To investigate the audiological assessment value of auditory brainstem response（ABR） and auditory steady-state response（ASSR） to infants failed in hearing screening, so as to provide scientific basis for early diagnosis and intervention. Methods A total of 839 infants failed in hearing screening all received ABR and ASSR test, and their test results were analyzed for auditory assessment. Comparison were made on elicit rate of hearing response by ABR and ASSR. Results Among 839 infants failed in hearing screening, there were 73 bilateral normal hearing cases（false positive rate as 8.70%） in the first auditory assessment in infants within 3 months and 29 hearing back to normal cases（recoverable rate as 3.46%） in the second auditory assessment in infants within 6 months. 737 cases were finally diagnosed as hearing loss（final diagnosis rate as 87.84%）. ASSR had higher elicit rate of hearing response（90.35%） than ABR（77.71%）, and the difference had statistical significance（χ~2=99.79, P〈0.01）. Conclusion Combination of ABR and ASSR can make a comprehensive and accurate auditory assessment in congenital hearing loss infants within 6 months, and provide a powerful basis for early intervention of hearing loss.