不同程度感音神经性听力损失儿童的Chirp-ASSR测试结果分析

Relationship between Evoked Auditory Steady—state Responses and Pure Tone Audiometry in Children with Different Levels of Hearing Loss

目的观察不同程度感音神经性听力损失儿童Chirp声听性稳态反应(Chirp auditory steady-state responses,Chirp-ASSR)的特点,探讨Chirp-ASSR测试的临床意义。方法对136例(272耳)5~10岁不同程度感音神经性听力损失儿童进行纯音听阈测试(pure tone audiometry,PTA)和Chirp-ASSR测试,根据500、1 000、2 000和4 000Hz的平均听阈,将受试者分为四组,即20~dB HL组、40~dB HL组、60~dB HL组和≥80dB HL组,比较不同程度感音神经性听力损失儿童各频率纯音听阈与Chirp-ASSR反应阈的相关性。结果 (1)纯音听阈≥80dB HL组的Chirp-ASSR反应阈值比纯音听阈值高,差异有统计学意义(P<0.05)。(2)PTA和Chirp-ASSR的相关系数γ随着听力损失程度加重而逐渐降低,随着测试频率的增加有增大的趋势,在500 Hz和4 000Hz之间差异有统计学意义(P<0.05)。结论 Chirp-ASSR有频率特异性,能够较好的反映听力水平,特别在轻度、中度和重度感音神经性听力损失患者中更明显。

Objective To study the clinical significance of Chirp-ASSR and the characteristics of hearing loss patients by ASSR(auditory steady-state responses)under Chirp stimulation.Methods A total of 136 hearing loss children(5~10 years old)with 272 ears were distributed into four groups based on 500 Hz,1 000 Hz,2 000 Hz and 4 000 Hz auditory threshold arithmetic average:20~dB HL,40~dB HL,60~dB HL,and≥80 dB HL groups.To compare the correlation of the PTA and Chirp-ASSR in different frequencies domain through SPSS statistics 19.0 software,the data were used T-test and Pearson analysis.Results(1)The group(≥80 dB HL)achieved a statistically significant higher reaction threshold than pure tone threshold.(2)The correlation indexγof PTA and Chirp-ASSR showed a decline along with the hearing loss increase;It increased along with the test frequency,there was a significant difference between 500 Hz and 4 000 Hz(P<0.05).Conclusion Chirp-ASSR is a frequency-specific electrophysiological test method,it could reflect the truthful listening ability,especially in mild,moderate,and severe hearing loss children.