噪声暴露者的噪声下信噪比损失与耳蜗电图的关系研究

Study on the Relationship between Signal-to-Noise Ratio Loss and Electrocochleography in Noise Exposure

目的探究噪声暴露者的噪声下信噪比损失(SNR loss)与耳蜗电图的关系及其对隐性听力损失的辅助诊断价值。方法选取有噪声暴露史的工人41例(41耳),分别进行纯音测听、声导抗、噪声下的言语识别以及耳蜗电图测试,依据噪声下言语识别能力分为两组,A组:SNR loss<0(19耳),B组:SNR loss≥0(22耳),分析两组耳蜗电图的差异。结果噪声下言语识别测试结果显示,A、B两组受试者的信噪比损失差异有统计学意义(P<0.05);耳蜗电图结果显示,在96、90、80 dB nHL三个刺激强度下A组AP振幅大于B组,差异有统计学意义(P<0.05);在96、90、80、70、60 dB nHL五个刺激强度下B组SP振幅大于A组,差异有显著统计学意义(P<0.001);在96、90、80、70 dB nHL四个刺激强度下,B组SP/AP振幅比大于A组,差异有统计学意义(P<0.05)。结论信噪比损失<0与≥0的噪声暴露者耳蜗电图SP/AP振幅比在不同声强下有显著差异。

Objective To investigate the relationship between signal-to-noise ratio loss and electrocochleogram in noise exposed subjects and its assistive diagnosis value for hidden hearing loss.Methods Forty-one workers with a history of noise exposure were tested with pure tone audiometry,acoustic immittance,speech recognition under noise and electrocochleogram.They were divided into two groups according to their speech recognition ability under noise:Group A:SNR loss<0(19 ears),Group B:SNR loss≥0(22 ears).The difference of electrocochleogram between the two groups was recorded and analyzed.Results The results of speech recognition test showed that there was significant difference in SNR loss between Group A and Group B(P<0.05).The results of cochlear electrogram showed that the AP amplitudes of the two groups were significantly different at 96,90 and 80 dB nHL(P<0.05).At 96,90,80,70,60 dB nHL,there were significant differences in SP amplitudes between the two groups(P<0.001).At 96,90,80 and 70 dB nHL,there was significant difference in SP/AP amplitude ratio between the two groups(P<0.05).Conclusion There is a significant difference of SP/AP amplitude ratio between subjects with SNR loss of<0 and≥0 at different sound intensities.