强噪声暴露青年人群的扩展高频和ABR特征分析

Extended High Frequency and ABR Characteristics of Young People with Excessive Noise Exposure

目的探究在高噪声暴露下青年人群的扩展高频和听性脑干反应测试中的特征。方法选取23例常规听阈正常的无噪声暴露的正常青年人(对照组)和23例有噪声暴露的工人(噪声暴露组)进行高频扩展测听、噪声下言语测听和听性脑干反应,比较两组间扩展高频的阈值、噪声下言语测听信噪比损失情况和Ⅰ波潜伏期和振幅的差异。结果噪声暴露组和对照组比较,高频扩展听力测试在12.5kHz、14kHz、18kHz的阈值有显著差异(P<0.05);噪声下言语测听信噪比存在极显著性差异(P<0.01);在听性脑干反应中,在90dBnHL中Ⅰ波潜伏期和振幅存在极显著差异(P<0.01),在80dBnHL中Ⅰ波潜伏期和振幅存在显著差异(P<0.05),在70dBnHL中Ⅰ波潜伏期存在极显著差异(P<0.01)。结论高噪声暴露下青年人群纯音测听常规听阈正常,扩展高频阈值升高,噪声下言语识别能力较差,在听性脑干反应中,高强度刺激下Ⅰ波潜伏期延后、振幅下降,对噪声引起的隐性听力损失具有一定的参考价值。

Objective To explore the application of extended high frequency and auditory brainstem response tests to young people exposed to excessive noise. Methods Twenty-three normal young people with normal hearing and no noise exposure(control group) and twenty-three workers with noise exposure(noise exposure group) were selected for highfrequency extended audiometry, speech audiometry and auditory brainstem response tests. The threshold of extended high frequency, the loss of speech-to-noise ratio under speech, the difference between I-wave latency and amplitude were compared between the two groups. Results The noise exposure group showed the following characteristics compared with the control group:the high-frequency extended hearing test had different thresholds at 12.5 kHz, 14 kHz, and 18 kHz(P<0.05);there was a significant difference in speech recognition under noise(P<0.01);in brainstem response, there was a significant difference in I wave latency and amplitude between 90 dB nHL(P<0.01);there was a difference in I wave latency and amplitude between 80 dB nHL(P<0.05), and a significant difference in I wave amplitude at 70 dB nHL(P< 0.01).Conclusion For young people exposed to high noise, the thresholds of pure tone audiometry is normal, the extended high frequency thresholds are increased, and the speech recognition ability under noise is poor. ABR I wave latency is delayed and the amplitude decreased under high intensity stimulation. These tests have certain reference value for identifying potential noise related hearing loss.