乙肝病毒携带者与慢性乙肝患者畸变产物耳声发射特征分析

Analysis of Distortion Product Otoacoustic Emissions in Hepatitis B Carrier and Chronic Hepatitis B Patients with Normal Pure Tone Findings

目的探讨纯音听阈正常的乙型肝炎病毒(HBV)携带者与慢性乙型肝炎患者畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)的特征。方法对纯音听阈正常的HBV携带者29例(HBV携带组,58耳)、慢性乙肝患者30例(慢性乙肝组,60耳)及正常对照组33例(66耳)分别行DPOAE检测,比较三组各频率DPOAE的检出率和幅值差异。结果对照组各频率DPOAE检出率均高于HBV携带组和慢性乙肝组,其中,在553、6 250Hz HBV携带组与对照组差异有统计学意义(P<0.05或P<0.01),在553、783Hz慢性乙肝组与对照组差异有统计学意义(P<0.01);HBV携带组与慢性乙肝组间各频率DPOAE检出率差异无统计学意义(P>0.05)。与对照组比较,慢性乙肝组、HBV携带组各频率DPOAE幅值均下降;HBV携带组各频率DPOAE幅值均高于慢性乙肝组,除553、783Hz外,1 105、1 560、2 211、3 125、4 416、6 250 Hz频率处差异有统计学意义(P<0.05或P<0.01)。结论慢性乙肝组较HBV携带组有潜在的耳蜗功能损失,考虑其肝病的进展与听力损失有一定关系。

Objective To investigate the characteristics of distortion products otoacoustic emission(DPOAE)in hepatitis B carriers and chronic hepatitis B patients with normal pure tone results.Methods DPOAE was detected in29hepatitis B carriers(58ears),30chronic hepatitis B patients(60ears)and30normal controls.The three groups had normal pure tone results.The detection rate and amplitude difference of DPOAE at553~6250Hz were compared between the two groups.Results The incidence of the DPOAE in HBV carriers for all the frequencies was higher than that in the chronic hepatitis B group,but there was no significant difference(P>0.05).The level of the DPOAE in HBV carriers for all the frequencies was higher than that in chronic hepatitis B group,and there were significant differences at1105,1560,2211,3125,4416,6250Hz(P<0.05),and at1560,2211,6250Hz(P<0.01),except at553,783Hz(P>0.05).Conclusion There is a potential loss of cochlear functions in the chronic hepatitis B group compared with the HBV carrying group.We suspect that the progress of liver disease is related to the potential hearing loss.