听性脑干反应与多频稳态反应联合评估婴儿轻度感音神经性听力损失的研究

Combined application of auditory brainstem response and auditory steady⁃state response in the evaluation of infants with mild sensorineural hearing loss

目的探讨听性脑干反应(auditory brainstem response,ABR)与多频稳态反应(auditory steady-state response,ASSR)联合评估婴儿轻度感音神经性听力损失的意义。方法回顾性分析确诊的114例轻度感音神经性听力损失的婴儿,收集其ABR和ASSR的结果,进行秩和检验和相关性分析。结果在秩和检验中,短纯音刺激ABR(Tb-ABR)和ASSR在0.5、1、2、4 kHz的反应阈值差异有统计学意义(P<0.05),两者在0.5、1、2、4 kHz呈正相关(P<0.05),r=0.613、0.569、0.616、0.71。按照性别、耳别进行分组后,ABR和ASSR在0.5、1、2、4 kHz也呈正相关(P<0.05),男性:r=0.61、0.56、0.671、0.774;女性:r=0.581、0.558、0.546、0.608;左耳:r=0.61、0.558、0.576、0.715;右耳:r=0.631、0.581、0.662、0.71。按照诊断年龄分组后,只有7~12月龄被诊断的婴儿在0.5 kHz和1 kHz不具备相关性(P>0.05),其余各组均呈正相关(P<0.05),0~3个月:r=0.686、0.643、0.671、0.742;4~6个月:r=0.671、0.626、0.616、0.693;7~12个月在2 kHz和4 kHz:r=0.571、0.706。结论对于轻度感音神经性听力损失的婴儿,ABR和ASSR在各频率的评估听阈具有相关性,二者联合应用可以更准确的评估受试者的真实听力。

Objective To investigate the significance of auditory brainstem response(ABR)combined with auditory steady⁃state response(ASSR)for the assessment of mild sensorineural hearing loss in infants.Methods Data from 114 infants with mild sensorineural hearing loss were retrospectively analyzed,and their ABR and ASSR results were collected for rank sum test and correlation analysis.Results In the rank sum test,the difference in thresholds between tone⁃burst ABR(Tb⁃ABR)and ASSR at 0.5,1,2,4 kHz was statistically significant(P<0.05),and they were also correlated at 0.5,1,2,4 kHz(P<0.05),r=0.613,0.569,0.616,0.71.After grouping by gender and ear,there was a correlation between ABR and ASSR at 0.5,1,2,and 4 kHz,male:r=0.61,0.56,0.671,0.774;female:r=0.581,0.558,0.546,0.608;left ear:r=0.61,0.558,0.576,0.715;right ear:r=0.631,0.581,0.662,0.71.And after grouping by age at diagnosis,only infants diagnosed from 7~12 months of age did not correlate at 0.5 kHz and 1 kHz(P>0.05),while the rest of the groups had a good correlation(P<0.05),0~3 months:r=0.686,0.643,0.671,0.742;4~6 months:r=0.671,0.626,0.616,0.693;7~12 months at 2 kHz and 4 kHz:r=0.571,0.706.Conclusion In infants with mild sensorineural hearing loss,ABR and ASSR correlate in assessing hearing thresholds at all frequencies,and the combination of the two tests could provide a more accurate assessment of the subject's true hearing.