婴幼儿自动听性脑干诱发电位不同测试时间的比较及意义

Comparison and significance of different automated auditory brainstem response testing times in infants

目的探讨不同测试时间对婴幼儿自动听性脑干诱发电位(AABR)测试结果的影响。方法将97例受试婴幼儿分为A组(30例60耳,听力正常),B组(33例60耳,轻度听力损失),C组(34例60耳,中度及以上听力损失),设定AABR的测试时间为60 s、600 s,分别对三组进行测试,采用kappa一致性检验评价A、B、C三组组内AABR的结果一致性,T检验和单因素方差分析比较三组实际测试所需时间。结果测试时间设定为1 min、10 min时A、B、C三组组内AABR的结果比较,κ值分别为1.000,0.854,0.896。A组实际筛查所需时间为(17.82±7.99)s和(26.73±75.48)s,差异无统计学意义(P=0.328)。B、C组听力障碍婴幼儿测试时间为60 s时每耳所需时间显著短于测试时间为600 s时,差异有统计学意义[B组:(35.62±20.04)s,(239.05±277.69)s,C组:(54.15±11.92)s,(481.63±228.51)s,P均<0.001)]。在同一时间设置下,三组所需时间差异均有统计学意义(P<0.001),检测所需时间随听力损失程度的增加而增加。结论设定时间为1 min时进行AABR测试对结果无影响,能显著缩短听力筛查的检测时间,提高听力筛查效率和质量。

Objective To explore the effect of different testing times on the automated auditory brainstem response（ AABR） results in infants. Methods Ninety-seven infants were assigned to the following groups： group A（ 60 ears in 30 infants,normal hearing）,group B（ 60 ears in 33 infants,mild hearing loss）,and group C（ 60 ears in 34 infants,moderate to profound hearing loss）. AABR testing times of 60 s and 600 s were employed in all three groups. The consistency of AABR results in groups A,B,and C were evaluated by the kappa consistency test. The t-test and one-way analysis of variance（ ANOVA） were used to compare the time required among the three groups. Results The results showed a concordance of κ = 1.000,0.854, and 0.896,respectively. The times required for actual screening in group A were 17.82 ±7.99 s and 26.73 ±75.48 s,with no significant difference（ P = 0.328）. The times required for actual screening in groups B and C were 60 s with a testing time of 35.62±20.04 s and 54.15±11.92 s,were 600 s with a testing time of 239.05±277.69 s and 481.63±228.51 s; the time required for each ear was significantly shorter than the testing time（ P0.001）. With the same time settings,there was a significant difference among the three groups（ P0.001）,and the time required for testing increased with the increase in hearing loss. Conclusions Setting the AABR testing time at 60 s had no effect on the results,indicating that the testing time can be reduced while maintaining the same screening efficiency and quality.