听神经病患者最大言语识别率与纯音听阈的相关性分析

目的 分析听神经病患者最大言语识别率与纯音测听之间的相关性,探讨听神经病患者与言语识别率不成比例的临床意义.方法 对106例(212耳)经纯音测听、声导抗、畸变产物耳声发射、听件脑干反应测试确诊为听神经病的患者,行最大言语识别率测试,并与不同程度损失及不同类型听力曲线进行分类、分型比较.依据损失分出轻度、中度、中重度和重度;依据听力曲线分为平坦型、低频上升Ⅰ型、低频上升Ⅱ型、山型、谷型、不典型.统计数据应用SPSS 11.0对不同程度的损失、最大言语识别率采用方差分析和相关性分析.结果 106例(212耳)具有相同听力损失或相同类型听力曲线的听神经病患者,可表现出不同程度的最大言语识别率,在听神经病患者群体水平整体评估,最大言语识别率百分比与全频听力阈值旱负相关(r=-0.602;P<0.01),另外,听力损失程度较接近的听力曲线类型,高频听力损失程度轻者其最大言语识别率也相对较好;106例听神经病患者中有26例(52耳)患者双耳分别记录逐步递增的6个刺激声级的言语识别率曲线,其中平均阈上10 dB出现的最大言语识别率频次最高.结论 听神经病患者最大言语识别率在个体问存在明显差异,相同的听力损失,可以出现不同的最大言语识别率;但在群体水平上最大言语识别率与阈值有一定相关性,即听力阈值越大,言语识别率百分比数值越小,且当听神经病患者听力损失在同一水平时,其最大言语识别率程度与听神经病患者听力曲线类型相关.

Correlation between phonetically balanced maximum and pure tone auditory threshold among 106 auditory neuropathy patients

OBJECTIVE: To estimate correlation between phonetically balanced maximum (PB max) and pure tone auditory threshold in auditory neuropathy (AN) patients. METHODS: One hundred and six AN patients were identified using multiple criteria including PB max, a metric for speech recognition, pure tone auditory threshold, acoustic emission test, distortion products otoacoustic emission (DPOAE) and auditory brainstem response (ABR). SPSS statistical software was used to estimate the Pearson's correlation between PB max and pure tone auditory threshold and to test whether pure tone auditory threshold, or auditory configuration had a significant impact on PB max. RESULTS: Even the patients had the same or similar values for pure tone auditory threshold or auditory configuration, varied values of PB max were found in two hundreds and twelve ears for 106 patients. Analysis of the data for 106 patients revealed a negative correlation (r = -0. 602, P <0. 01) between PB max and pure tone auditory threshold, i. e. hearing loss at a mild relates to a lower PB max. By using analysis of variance (ANOVA) method, it was found that both pure tone auditory threshold and auditory configuration had a significant (P <0.01) impact on the patients' PB max. CONCLUSIONS: This analysis implicated the promise and potential of pure tone auditory threshold and auditory configuration for predicting PB max of the AN patients, and improving the diagnosis of AN.