不同月龄婴儿听性脑干反应的变化规律分析

Analysis on the change rule of auditory brainstem response in infants of different ages

目的研究不同月龄婴儿听性脑干反应(ABR)的变化规律,为临床建立健全正常的ABR数据库、促进新生儿听力正常发育提供科学依据。方法选择2015年7月-2018年6月在山西阳泉阳煤集团总医院进行ABR测试的115例婴儿作为研究对象,根据其月龄分为新生儿组15例,1~3月组30例,4~6月组30例,>6月组40例。比较4组婴儿70 d B n HL给声强度以下的波Ⅰ、Ⅲ、Ⅴ的潜伏期,Ⅰ~Ⅲ、Ⅲ~Ⅴ、Ⅰ~Ⅴ波的波间期,Ⅴ/Ⅰ波振幅比,阈值附近Ⅰ、Ⅲ、Ⅴ波的引出情况。结果4组婴儿左耳的Ⅰ波潜伏期比较差异均无统计学意义(P>0. 05);新生儿组左耳和右耳Ⅲ波、V波的潜伏期显著高于4~6月组和>6月组,1~3月组左耳和右耳III波、V波的潜伏期显著高于4~6月组和>6月组,差异均有统计学意义(P<0. 05)。新生儿组、1~3月组、4~6月组左耳和右耳Ⅰ~Ⅲ波、Ⅲ~Ⅴ波、I~Ⅴ波的波间期显著高于> 6月组,差异均有统计学意义(P<0. 05)。新生儿组和1~3月组左耳ABR反应阈显著高于>6月组,新生儿组、1~3月组、4~6月组左耳V/I波振幅比显著低于>6月组;新生儿组、1~3月组、4~6月组右耳ABR反应阈显著高于>6月组,Ⅴ/Ⅰ波振幅比显著低于>6月组,差异均有统计学意义(P<0. 05)。4组左耳Ⅰ、Ⅲ、Ⅴ波引出率均为100. 00%,新生儿组和1~3月组右耳Ⅰ、Ⅲ、Ⅴ波引出率均为93. 33%,4~6月组右耳Ⅰ、Ⅲ、Ⅴ波引出率96. 67%,6>月组右耳Ⅰ、Ⅲ、V波引出率100. 00%,各组两两比较差异均无统计学意义(P>0. 05)。结论随着月龄的增大,婴儿ABR测试的各波潜伏期和波间期呈逐渐缩短趋势,但左耳与右耳的听觉通路神经发育不完全平衡,需要结合实际情况具体判断。

Objective To research the change rule of auditory brainstem response(ABR)in infants of different ages,provide a scientific basis for clinical establishment of normal ABR database and promotion of normal development of neonatal hearing.Methods A total of115 infants receiving ABR test in Yangquan Coalmine Group General Hospital from July 2015 to June 2018 were selected and divided into neonate group(15 cases),1-3-month group(30 cases),4-6-month group(30 cases),>6-month group(40 cases)according to age.The latency of waveⅠ,Ⅲ,Ⅴunder 70 d B n HL,wave interval ofⅠ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ,the amplitude ratio ofⅤ/ⅠandⅠ,Ⅲ,Ⅴwave extraction vicinity thresholds were compared among the four groups.Results There was no statistically significant difference inⅠwave latency of left ears among the four groups(P>0.05).The latency ofⅢwave and V wave of left and right ears in neonate group was statistically significantly higher than that in 4-6-month group and>6-month group,the latency ofⅢwave and V wave of left and right ears in 1-3-month group was statistically significantly higher than that in 4-6-month group and>6-month group(P<0.05).The wave interval ofⅠ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴin neonate group,1-3-month group,and 4-6-month group was statistically significantly higher than that in>6-month group(P<0.05).ABR response thresholds of left ears in neonate group and 1-3-month group were statistically significantly higher than that in>6-month group,the amplitude ratios ofⅤ/Ⅰof left ears in neonate group,1-3-month group,and 4-6-month group were statistically significantly lower than that in>6-month group,ABR response thresholds of right ears in neonate group,1-3-month group,and4-6-month group were statistically significantly higher than that in>6-month group,the amplitude ratios ofⅤ/Ⅰof right ears in neonate group,1-3-month group,and 4-6-month group were statistically significantly lower than that in>6-month group(P<0.05).The extraction rates ofⅠ,Ⅲ,Ⅴwaves of left ears in the four groups were all 100.00%,the extraction rates ofⅠ,Ⅲ,Ⅴwaves of right ears in neonate group and 1-3-month group both were 93.33%,the extraction rate ofⅠ,Ⅲ,Ⅴwaves of right ears in 4-6-month group was96.67%,the extraction rate ofⅠ,Ⅲ,Ⅴwaves of right ears in>6-month group was 100.00%,there was no statistically significant difference among the four groups(P>0.05).Conclusion With the increase of age,wave latency and inter-wave period of ABR test gradually shorten in infants,but neurodevelopment of auditory pathway of left and right ears is not completely balanced,which needs to be judged according to the actual situation.