3～4月龄及5～6月龄婴儿听性脑干反应的正常值分析

目的观察正常婴儿听性脑干反应(ABR)潜伏期及阈值正常值范围,为早期干预治疗提供依据。方法应用美国ICS CHARTR诱发电位仪对40例(80耳)听力正常的婴儿和20例听力正常成人进行ABR检测,根据年龄分为A组(3~4月龄)、B组(5~6月龄)、对照组。建立不同月龄婴儿ABR正常值范围,讨论性别、耳别、月龄对测试结果的影响及阈值测定的临床应用。结果80dB nHL短声刺激下,A组A easeBR波Ⅰ、Ⅲ、Ⅴ潜伏期的正常值范围分别是:(1.52±0.19)m s、(4.20±0.20)m s、(6.34±0.26)m s;B组ABR波Ⅰ、Ⅲ、Ⅴ潜伏期的正常值范围分别是:(1.50±0.09)m s、(4.05±0.16)m s、(6.16±0.25)m s;对照组ABR波Ⅰ、Ⅲ、Ⅴ潜伏期的正常值范围分别是:(1.43±0.10)m s、(3.63±0.15)m s、(5.50±0.16)m s。随着月龄的增长,婴儿各波的潜伏期(PL)和波间期(IPL)均缩短;但6月龄时仍未达成人水平。A、B两组各波的潜伏期及波间期与对照组比较差异均有统计学意义(P0.05);A组与B组比较Ⅲ、Ⅴ波潜伏期及Ⅰ-Ⅲ、Ⅰ-Ⅴ波间期差异具有统计学意义(P0.05)。女婴潜伏期和波间期短于男婴(A组内Ⅰ-Ⅲ波间期除外),A组内男女间Ⅴ波潜伏期差异具有统计学意义(P0.05);B组内男女Ⅲ、Ⅴ波潜伏期及Ⅰ-Ⅴ波间期差异有统计学意义(P0.05);各组内左右耳差异无统计学意义(P0.05)。各月龄组及正常成人ABR反应阈差异无统计学意义。结论建立不同月龄婴儿ABR潜伏期及阈值正常值标准,为听损伤的早期诊断和随访监测提供可靠依据。

Normal values of auditory brainstem responses in 3-4 months and 5-6 months old infants

Objective To investigate normal parameters of the latency and the thresholds of auditory brainstem response (ABR) in infants of 3-6 months old for early treatment. Methods 40 normal infants and 20 normal adults underwent ABR tests. The infants were divided into 2 groups: group A(3-4months) and group B(5-6 months). Each group consisted of 20 infants (40 ears). The ABR data were analyzed to determine normal ranges for ABR. The influences of gender, age and ears on different sides on testing results were analyzed. Results At 80dB nHL, the range of latency for wave Ⅰ, Ⅲ, Ⅴ of ABR in 3-4 months old infants was (1.52±0.19) ms, (4.20±0.20) ms, (6.34 ±0.26) ms, respectively; In 5-6 months old infants, the corresponding results were (1.50 ±0.09) ms, (4.05 ±0.16) ms, and (6.16±0.25) ms; In normal adults, counterparts were (1.43±0.10) ms, (3.63±0.15) ms, and (5.50±0.16) ms. The Peak latency (PL) and interval peak latency ( IPL) of infants became shorter with the increase of the age, but failed to reach adult levels even in 5 6 months old infants. There were significant differences for PL and IPL between group A and control group, and between group B and control group. The PL of wave Ⅲ, Ⅴ and IPL of Ⅰ-Ⅲ,Ⅰ-Ⅴ between group A and group B were significantly different. PL and IPL of female infants were shorter than the males, except for the IPL of Ⅰ-Ⅲ in group A. There were significant differences in the PL of wave Ⅴ between male and female infants in group A. The data showed that there were significant differences in the PL of Ⅲ, Ⅴ and the IPL of Ⅰ-Ⅴ between male and female infants in group B (P<0.05), but not between the sides of ears (P>0.05). The thresholds of ABR among all infants and adults demonstrated no significant difference. Conclusion It is necessary to set up normal criteria of ABR for infants so as to diagnose early and follow-up effectively, which makes early interventions possible.