ASSR联合ABR在感音神经性耳聋儿童听力评估中的应用价值

Application value of auditory steady-state response combined with auditory brainstem response for hearing assessment in children with sensorineural hearing loss

目的探讨听觉稳态诱发反应(ASSR)联合短声听性脑干反应(ABR)在感音神经性耳聋患儿听力评估中的应用价值,为临床诊断提供依据。方法选取2020年1月至2021年6月就诊于嘉兴市妇幼保健院的感音神经性耳聋患儿90例为研究对象进行前瞻性研究,采用随机数字表法分为对照组(n=45)与观察组(n=45)。对照组采用ABR检测,观察组在对照组的基础上联合ASSR检测。比较两组患儿听力损伤情况,观察组不同听力受损程度患儿的ABR与ASSR阈值及2 kHz、4 kHz载波频率时ABR与ASSR的相关性。结果观察组听力损伤总异常率为68.89%(31/45),显著高于对照组的44.44%(20/45)(χ^(2)=5.48,P=0.019)。在0.5 kHz的载波频率时,观察组中、重度听力受损患儿的ASSR阈值分别为(63.11±6.82)dB nHL、(84.65±5.31)dB nHL,均显著高于ABR阈值的(56.12±4.63)dB nHL、(76.87±5.15)dB nHL(t=2.94、2.78,均P<0.05)。观察组不同听力受损程度患儿2 kHz、4 kHz载波频率时ABR与ASSR均呈正相关(r=0.896、0.901,均P<0.05)。结论 ABR联合ASSR的测试方法对感音神经性听力障碍患儿听力损伤程度的判断更为准确,可为后期临床治疗提供可靠依据。

Objective To investigate the application value of auditory steady-state response(ASSR)combined with short sound auditory brainstem response(ABR)for hearing assessment in children with sensorineural hearing impairment,providing evidence for clinical diagnosis of the disorder.Methods A total of 90 children with sensorineural hearing impairment who received treatment at Jiaxing Maternity and Child Health Care Hospital from January 2020 to June 2021 were included in this prospective study.These children were randomly divided into a control group and an observation group(n=45 per group).The children in the control group underwent ABR testing,while those in the observation group underwent ASSR testing in addition to ABR thresholds testing.The hearing impairment was compared between the two groups.The ABR and ASSR thresholds were compared among children with different degrees of hearing impairment.The correlation between ABR and ASSR at 2 and 4 kHz carrier frequencies was analyzed in the observation group.Results The abnormal rate of hearing in the observation group was 68.89%(31/45),which was significantly higher than 44.44%(20/45)in the control group(χ^(2)=5.48,P=0.019).At a carrier frequency of 0.5 kHz,the ASSR thresholds of children with moderate and severe hearing impairment in the observation group were(63.11±6.82)dB nHL and(84.65±5.31)dB nHL,respectively,which were significantly higher than the ABS thresholds(56.12±4.63)dB nHL and(76.87±5.15)dB nHL(t=2.94,2.78,both P<0.05).There was a positive correlation between ABR and ASSR thresholds at 2 and 4 kHz carrier frequencies in children with different degrees of hearing impairment in the observation group(r=0.896,0.901,both P<0.05).Conclusion The combination of ABR and ASSR testings is more accurate in judging the degree of hearing impairment in children with sensorineural hearing impairment than the ABR testing,and can provide a reliable basis for later clinical treatment.