噪声性听力损失人群听觉稳态诱发反应及听性脑干反应的特征分析

Characteristics of auditory brainstom response and auditory steady state evoked responses in noise-induced hearing loss population

目的探讨噪声暴露所致听力损失者听觉稳态诱发反应(auditory steady state evoked responses,ASSR)以及听性脑干反应(auditory brainstem response,ABR)的特征,分析其各频率反应阈与纯音听阈测试(pure tone audiometry,PTA)的关系。方法于2019年2月,采用横断面调查方法,选择2014年10月~2018年10月在上海市肺科医院完成主客观听力检查的噪声性听力损失(noise-induced hearing loss,NIHL)的193例患者作为研究对象,分析PTA、ABR、ASSR结果与主客观听力检查的相关性。结果共纳入193例患者381耳,0.5、1.0、2.0、4.0 kHz ASSR阈值与PTA差值分别为5.9、6.9、11.8、1.8 dB,相关系数分别为0.638、0.680、0.657、0.608;1.0、2.0、3.0、4.0 kHz频率的ABR V波阈值与PTA差值均值分别为44.2、35.0、19.0、2.0 dB,随着频率增高,ABR V波阈值以及PTA差值逐渐缩小(P<0.05)。结论对于NIHL、ASSR、ABR反应阈在相应频率的主观听力评估中有应用价值,4 kHz频率时ASSR、ABR阈值与PTA基本接近。

Objective To explore the characteristics of auditory steady state evoked responses(ASSR)and auditory brainstem response(ABR)in noise-induced hearing loss population and the relationship between the response threshold of corresponding frequency and pure tone audiometry(PTA).Methods Noise-induced hearing loss patients who completed subjective and objective audiometry in our hospital from October 2014 to October 2018 were collected.The results of PTA,ABR,ASSR and the correlation between subjective and objective audiometry were discussed.ResultsA total of 381 ears of 193 patients were enrolled.The difference of 0.5,1.0,2.0 and 4.0 kHz between ASSR threshold and PTA was 5.9,6.9,11.8 and 1.8 dB,respectively.The correlation coefficients were 0.638,0.680,0.657 and 0.608.The difference of 1.0,2.0,3.0 and 4.0 kHz between ABR threshold and PTA was 44.2,35.0,19.0 and 2.0 dB.With the increase of frequency,the threshold difference between ABRt V wave and PTA decreased gradually.Conclusion ASSR and ABR response thresholds are valuable in subjective assessment on noise-induced hearing loss.The thresholds of ASSR and ABR at 4 kHz are close to those of PTA.