瞬态诱发耳声发射在新生儿听力筛查中的应用

采用丹麦生产的Echo—Screen筛查型耳声发射仪对2598名新生儿，30天-2岁小婴儿330名进行听力筛查，现将结果报告如下。     

利用瞬态诱发耳声发射信号进行耳蜗病变的定位

提出一种通过AR谱分析，直接由瞬态诱发耳声发射信号判断听力损失部位（高频、中频或低频）的方法。所得结果与目前临床使用的DPGRAM（由（DPOAE取得）方法所得结论一致，从而为瞬态诱发耳声发射的应用开辟新的前景。     

住院期间未做听力筛查新生儿瞬态诱发耳声发射延期筛查结果分析

目的:了解住院期间未做听力筛查婴儿的瞬态诱发耳声发射(TEOAE)延期筛查结果,以发现高危听力损失儿童.方法:对2012年7月1日～2013年12月31日在该单位听力筛查中心门诊的婴儿进行TEOAE筛查,采用自制问卷对婴儿的家庭情况及一般情况进行调查.结果:在947名婴儿中,TEOAE初筛总体未通过率为11.83％,其中左耳未通过率为3.06％,右耳未通过率为3.17％,双耳未通过率为5.60％,男孩未通过率为12.97％,女孩未通过率为10.36％,城区婴儿未通过率为10.87％,农村婴儿未通过率为15.35％.经x2检验,初筛未通过率性别、地区及筛查年龄差异无统计学意义(P＞0.05).结论:TEOAE筛查可以为早期发现婴幼儿听力损失提供参考,加强对TEOAE未通过高危儿童的密切随访和及早干预,是避免听力损失影响儿童发育的重要措施.     

影响新生儿通过瞬态声诱发耳声发射听力筛查的因素分析

目的探讨影响新生儿通过瞬态声诱发耳声发射(TEOAE)听力筛查的相关因素。 方法选择2005年10月至2006年9月在首都医科大学附属北京同仁医院出生并于本院儿科接受初次听力筛查的746例正常新生儿的临床病历资料为研究对象,采用TEOAE技术于新生儿出生后(2～3)d进行听力测试。探讨影响新生儿未通过TEOAE听力筛查的因素,如性别、耳别、娩出方式、脐带和胎盘因素、新生儿黄疸、母亲妊娠期疾病等(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准)。 结果本组746例接受新生儿普遍听力筛查者中,未通过初筛者为115例(15.42%)。新生儿不同性别、不同娩出方式的TEOAE通过率间比较,差异均无统计学意义(P>0.05);而耳别、脐带和胎盘因素、新生儿黄疸、母亲妊娠期疾病(如先兆流产、细菌或病毒感染、妊娠期高血压、妊娠期糖尿病)的TEOAE通过率间比较,差异有统计学意义(P<0.05)。 结论耳别、脐带和胎盘因素、新生儿黄疸、母亲妊娠期疾病是影响新生儿通过TEOAE听力筛查的因素。     

诊断职业性听力损伤的瞬态诱发耳声发射方法

目的探讨瞬态诱发耳声发射（transient evoked otoacoustic emlssions,TEOAE）在职业性听力损伤诊断中的应用价值。方法对长期接触噪声,听阈明显下降的93名工人及93名正常体检人员,进行纯音听阈和TEOAE测试。结果听力损伤组与对照组纯音听阈测试,所有频区听阈值差异均有统计学意义（在语频听阈区P〈0.05,高频听阈区,（P〈0.01）,以高频区听阈下降为主;听力损伤组TEOAE总重复率、幅值和信噪比及各频段重复率、幅值和信噪比均明显低于对照组（P〈0.05或P〈0.01）,250～3 500 Hz和3 500～4 500 Hz频段为最敏感频段。结论TEOAE检测可用于职业性听力损伤的评估和诊断。     

单片机在瞬态诱发耳声发射检测中的应用

概括总结了瞬态诱发耳声发射(TEOAB)信号提取和信息处理的几种方法，并讨论了单片机在TEOAB信号检测中的现状和可行性。     

4000例新生儿瞬态诱发式耳声发射测试结果分析

目的：探讨应用瞬态诱发式耳声发射(TEOAE)进行新生儿听力筛查的可行性及临床意义。方法：采用丹麦瑞声达听力技术有限公司生产的Echo-Screen听力筛查耳声发射分析仪筛查3624名正常新生儿和376名住院新生儿的听力。连续听力异常者，由脑干诱发电位(ABR)确诊。结果：4000例新生儿中共筛查出8例听觉障碍儿(单耳重度聋1名，轻度聋1名；双耳重度聋4名，极度聋2名)，其中住院新生儿4例，正常新生儿4例。结论：对新生儿进行听力筛查非常必要。瞬态诱发式耳声发射(TEOAE)适合于新生儿听力筛查，可早期发现听力异常。     

瞬态耳声发射对1404例新生儿听力筛查分析

目的:探讨瞬态耳声发射(TEOAE)与听性脑干反应(ABR)联合应用于新生儿听力筛查的可行性。探讨听力损伤与疾病的关系。方法:应用丹麦产MADSEN CAPEILA耳声发射仪对该院新生儿重症监护病房(NICU)住院的新生儿265例和同期在该院产科出生正常足月新生儿1 139例进行听力跟踪筛查。结果:NICU住院新生儿179例(67.55%)通过初筛,66例(24.91%)通过复筛,20例未通过,经ABR检测有11例(4.20%)不合格,假阳性率为3.39%。产科正常新生儿初筛通过1 050例(92.19%),80例(7.02%)通过复筛,9例未通过,经ABR检测有1例(0.1%)不合格,假阳性率为0.7%,两组新生儿通过率差异显著(P<0.01)。结论:TEAOE测试具有方便、快捷、无创、客观等优点,但其只能反映耳蜗功能,不能用来诊断听神经病损,结合ABR测试,互相补充,才能提高新生儿听力筛查精确性、可靠性。早诊断早干预,最大限度地降低耳性失聪引起的伤残。     

瞬态诱发耳声发射对高危新生儿听力筛查的临床意义

目的：通过瞬态诱发耳声发射（TEOAE）对高危新生儿听力筛查的情况，探讨某些高危因素对新生儿听力的影响，以利于听力障碍的早期发现、早期干预。方法：应用CAPELLA耳声发射分析仪对73例高危新生儿和66例正常新生儿分别于病情稳定后或出院前（生后7～32天）、生后3～8天进行TEOAE测试。结果：高危新生儿TEOAE未通过率为41．10％（30／73），与正常新生儿3．03％（2／66）比较，差异具有极显著意义（P〈0．01）。其中窒息组未通过率为45．16％，早产儿组为47．83％，低出生体重儿组为47．62％，高胆红素血症组为21．43％，3例重症肺炎1例未通过。结论窒息、早产、低出生体重及高胆红素血症等是影响新生儿听力常见的高危因素，对有高危因素的新生儿宜在出院前常规进行听力筛查，并追踪随访。TEOAE可作为高危新生儿听力筛查的一种有效的方法。     

纯音听阈正常冲压工诱发性耳声发射检测分析

目的对纯音听阈正常冲压工进行诱发性耳声发射检测,早期发现该人群噪声性听力损害。方法采用Capella耳声发射分析仪对纯音听阈正常的冲压工(29例,58耳)及健康对照者(13例,26耳)分别进行接触前及接触半年后的诱发性耳声发射(瞬态声诱发性耳声发射和畸变产物耳声发射)检测,并记录结果进行统计学分析。结果与对照组相比,冲压组的畸变产物耳声发射的高频信噪比、瞬态声诱发性耳声发射的反应波及各频带信噪比均降低(P<0.05或P<0.01)。结论纯音听阈正常的冲压工可能存在着早期听觉损害,应当重视听力动态监测,加强早期防护,诱发性耳声发射可能是较为灵敏的检测手段。     

Feasibility of community-based hearing screening using transient evoked otoacoustic emissions

This study investigated the feasibility of obtaining transient evoked otoacoustic emissions for hearing screening purposes from infants and children at seven child health clinics. Factors affecting the outcomes of the community hearing screening program were examined. The subject group comprised 2305 children aged two weeks to 11 y 11 mon. Many children were attending the clinics for initial immunisation at two months of age. While there were no exclusion criteria for the 1305 young infants tested who were in this category, all other children were screened only upon receipt of a referral from clinic nurses. Results indicated that 182 children (7.9%) did not complete the screening for both ears within the time constraint (usually 15 min) of a child health clinic visit. Three hundred and sixty-two children (15.7%) failed the first screening. Of the 226 children who returned for a second screening test, separated from the first by at least two weeks, 121 children failed. With parents' consent, 107 children (4.6% of all participants) were referred for diagnostic or medical assessment. Subsequently, 77 out of 94 children who received audiological or medical assessment were found to have some degree of hearing impairment. The majority of positive screening results were associated with middle ear disorder. The results suggest that TEOAE screening has potential as a technique in the community health setting but improvements in instrumentation are required to reduce ‘could not test’ cases and to separate probable conductive hearing loss from cases likely to have other disorders.     

新生儿听力筛查研究分析

目的:探讨新生儿听力障碍的发病率,减少听力残疾儿的发生。方法:用OTICONMAICOERO·SCAN瞬态诱发耳声发射(TEOAE)在28d内初筛,在3个月内复筛,听性脑干反应(ABR)在6个月进行确诊。结果:初筛率65.41%(50271/76855),异常率23.03%(11577/50271);复筛率61.26%(30800/50271),异常率5.63%(1734/30800);复筛异常转诊率2.09%(643/30800),经ABR检测听力异常率0.44%(135/30800)。其中,左耳55例,右耳38例,双耳42例。结论:TEOAE和ABR听力筛查技术可以提高新生儿听力筛查的敏感性、精确性,确诊听力障碍患儿,指导其听力障碍早期干预和康复。     

TEOAE和ABR联合应用于高危新生儿听力筛查的分析

目的:瞬态耳声发射(TEOAE)及听性脑干反应(ABR)联合应用于高危新生儿听力筛查的敏感性和准确性分析.方法:对120名高危新生儿(240耳),采用TEOAE及ABR技术对其进行听力筛查.结果:240耳经TEOAE检测,82耳(34%)未通过筛查,在未通过TEOAE的耳中有53耳通过ABR筛查.而在通过TEOAE的158耳(66%)中有27耳未通过ABR.两种筛查方法相比,ABR筛查的通过率高于TEOAE筛查,其差异有显著的统计学意义(P＜0.01).结论:联合采用TEOAE和ABR听力筛查技术,可以减少单纯用TEOAE进行筛查的假阳性和假阴性,从而提高高危新生儿听力筛查的敏感性和精确性.     

Otoacoustic emissions,auditory evoked potentials,and traits related to sex and sexual orientation

A number of trait measures, possibly reflective of prenatal hormonal effects, were obtained in studies of otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) carried out with male and female heterosexual and homosexual/bisexual college students. Most of the measures were from a self-report questionnaire; others were from experimenters' ratings or cognitive tests (Mental Rotation Test and Water Level Test). The questionnaire, test, and rating measures included physical characteristics (e.g., height, body type, eye color); spatial abilities; sex roles and sexual orientation; childhood gender nonconformity; and, in the OAE study, presence of homosexuality or bisexuality among relatives. Correlations with sexual orientation were most often consistent with the hypothesis that male homosexuals were undermasculinized and female homosexuals overmasculinized. Some correlations of the questionnaire, test, and rating measures with auditory measures were observed, but most of these were reduced or eliminated by statistically controlling for sex. In supplementary analyses, pigmentation measures appeared to be unrelated to OAEs, and data relevant to several hypotheses in the sexual orientation literature were briefly examined, including childhood gender nonconformity, X-linkage, handedness, and the tendency of homosexuality to run in families.     

新生儿行为神经测定与听力筛查的关系

目的:探讨以新生儿行为神经测定(NBNA)进行听力筛查的可行性。方法:新生儿出生后2~7 d分别进行新生儿行为神经测定和瞬态声耳声发射检查,将两项结果进行比较。结果:①NBNA听行为能力评分与TEOAE通过率呈正相关关系;②未通过TEOAE筛查的听力障碍患儿,存在NBNA满分的现象;③高危儿有NBNA及听行为能力低分而听力正常的现象。结论:NBNA用于听力筛查有一定的实用性,但运用NBNA听行为能力评分进行新生儿听力筛查还需进一步改进和完善。