年龄对自然更年期后女性脑干言语编码能力的影响

目的 分析年龄对更年期后女性脑干言语编码能力的影响.方法 对纯音听阈、声导抗 、短声听性脑干反应(click-ABR)测试结果均正常的20例双侧卵巢切除女性(43~53岁)和20例自然更年期后女性(50~61岁)行言语诱发听性脑干反应(speech-ABR)测试,刺激声为/da/音,采用插入式耳机,右耳给声,比较两组speech-ABR测试结果.结果 双侧卵巢切除女性和自然更年期后女性speech-ABR波形特征类似,均由瞬态反应(V、A和O波)、过渡部分C波以及周期性反应(D、E、F波)构成;与更年期后女性相比,双侧卵巢切除女性除瞬态成分O波潜伏期(48.10±0.98 ms)显著短于更年期后女性(48.87±0.50 ms)(P<0.01),周期成分F波幅值(-0.13±0.07 μV)显著大于更年期后女性(-0.09±0.04 μV)(P<0.05),其余各波的幅值、潜伏期及V/A复合波斜度差异均无统计学意义(均为P>0.05).将两组数据合并后就年龄对speech-ABR各波幅值及潜伏期的关系进行相关性分析,结果显示仅O波潜伏期与年龄成轻度正相关关系(P<0.05),其余各波幅值及潜伏期与患者年龄均无相关性.结论 年龄对更年期后脑干言语编码能力的影响较小,仅表现为使脑干听觉神经元对刺激末信号放电的同步性和时间分辨力降低.     

学龄儿童与青年人言语诱发听性脑干反应的比较

目的 比较学龄儿童与青年人言语诱发听性脑干反应( speech-ABR)的基本特征,探讨学龄期儿童脑干言语处理能力的发育情况.方法 对纯音听阈、声导抗、耳声发射和短声听性脑干反应(click-ABR)测试结果均正常的20名青年人(21～ 26岁)和18名学龄儿童(6～11岁)行speech-ABR测试.刺激声为/da/音,采用插入式耳机,右耳给声.结果 学龄儿童与青年人speech-ABR波形均由瞬态反应(V、A、C、O波)及周期性反应(D、E、F波)等几部分构成.学龄儿童的O波潜伏期(47.80 ±0.38)ms短于青年人(48.10±0.40) ms,差异具有统计学意义(t=2.330,P=0.026);学龄儿童F波波幅(-0.21±0.15)μV大于青年人(-0.12±0.08)μV,差异具有统计学意义(t=2.146,P =0.043);二者其余各波的潜伏期及波幅差异均无统计学意义(P值均＞0.05).结论 学龄儿童与青年人speech-ABR的基本特征相近,其脑干言语处理能力不亚于青年人.     

健康青年人言语诱发听性脑干反应的成分及特性

目的 探讨正常青年人言语诱发听性脑干反应(speech evoked auditory brainstemresponse,speech-ABR)的电生理特性及其与诱发言语声学特性的关系,并比较和分析与短声诱发听性脑干反应(click evoked auditory brainstem response,click-ABR)的差异.方法 记录31名31耳正常听力青年短声及合成言语/da/诱发的听性脑干反应.计算/da/和speech-ABR的时域及频域参数,并分析两者的关系.结果 正常青年人speech-ABR由一系列主波组成,可分为起始部分(包括V,A波)、过渡部分(C波)、频率跟随部分(D-E-F波)和终止部分(O波).A波分别与V、C、D、E及F波潜伏期有相关性(P＜0.05),其中与V波潜伏期的相关性最强(r=0.847,P＜O.01);D、E及F波潜伏期相互间相关(P＜0.01);C波只与OR部分的V波和A波有相关性(P＜0.05);O波潜伏期呈相对独立性,与其他主波无相关(P＞0.05).与click-ABR相比,speech-ABR的V波和Ⅲ波潜伏期延迟(P＜0.01),Ⅲ波出现率降低(P＜0.01),而Ⅰ波潜伏期的延迟和出现率的降低无统计学意义(P＞0.05).结论 speech-ABR是研究人类听觉诱发电位的一种新手段,其成分主要来源于脑干.speech-ABR主要成分关联密切,类似于听性脑干诱发电位中短声诱发的Ⅰ～Ⅴ波、SNIO及低频声诱发的FFR的结合,较好地反应了刺激言语的声学信息,是研究听觉言语处理机制的良好工具.     

学龄前儿童言语诱发听性脑干反应的性别差异

目的 探讨学龄前儿童的言语诱发听性脑干反应(speech-ABR)的性别差异及其与语言、音乐能力的关系。方法 研究对象为135例3～6岁学龄前儿童，均通过了新生儿听力筛查且无听觉系统疾病；其中，男65例，女70例，在清醒状态下进行speech-ABR测试，并由儿童的父母填写幼儿多元智力量表。结果 相较于男生，女生speech-ABR的波V、波A潜伏期均显著缩短(P<0.05),波A波幅显著增大(P<0.05)。排除年龄干扰进一步分析发现，女生的波V、波A波幅与语言智力得分显著正相关(分别为r=0.421,P<0.001;r=0.267,P<0.05),男生波V的潜伏期、女生波V波幅与音乐智力得分显著相关(分别为r=-0.296,P<0.05;r=0.295,P<0.05)。结论 学龄前儿童言语诱发听性脑干反应存在显著的性别差异；脑干听觉功能与学龄前儿童的语言和音乐能力的发展密切相关，且性别是其中不可忽略的重要因素。     

言语诱发听性脑干反应的潜伏期特性分析

目的探讨不同刺激强度下健康成人言语诱发听性脑干反应（speech evoked auditory brainstem response,speech-ABR）的潜伏期特性及其在脑干神经元编码言语信息中的意义。方法记录32例健康成人32耳在4种刺激强度（20、40、60、80dBSPL）、11.1次/s速率下的speech-ABR,分析不同强度条件下speech-ABR的潜伏期和相关性。结果 speech-ABR由一系列主波组成,分为起始部分（包括V和A波）、过渡部分（C波）、频率跟随部分（D-E-F波）和终止部分（O波）。随着强度的降低,各主波潜伏期逐渐延长,差异有统计学意义（P〈0.05）。强度降低20dBSPL级差时,潜伏期的平均延长值表现为V、A、C、O波接近,D、E、F波接近。不同强度下,V-A-C波潜伏期之间、D-E波潜伏期、E-F波潜伏期的相关性均有统计学意义,且相关系数大于0.40,其中V-A波潜伏期的相关系数大于0.80;强度降低时,潜伏期间的相关性有统计学意义的主波逐渐增多。结论健康成人speech-ABR各主波的潜伏期随着刺激强度降低而显著延长;起始反应和频率跟随反应的潜伏期及其显著相关性具有不同的变化特点。言语强度降低时,speech-ABR主波潜伏期的显著延长以及主波潜伏期间相关性的改变可能与言语的不易被识别有关。     

言语诱发听性脑干反应的主波特性

目的探讨正常成人言语诱发听性脑干反应(speech evoked auditory brainstem response,speech-ABR)主波的电生理特性。方法记录64例正常成人右耳的speech-ABR,分析主波的极性、潜伏期及幅值及其与性别、年龄的相关性。结果 speech-ABR的主波主要为正极性;除E波极性与性别显著相关外,其他主波极性的性别和年龄差异无统计学意义。V波和A波潜伏期女性较男性显著缩短,V波幅值女性较男性显著增大;而两者潜伏期和幅值的年龄差异无统计学意义。在C、D、E、F和O波中,两种极性的潜伏期差异(除E波和O波外)以及幅值差异无统计学意义;而其潜伏期和幅值的性别和年龄差异亦无统计学意义。结论 speech-ABR各主波的潜伏期和幅值受极性、性别和年龄差异的影响较小,具有较高的稳定性,是言语感知机制基础及临床研究的良好指标。     

正常听力青年人言语诱发ABR与扩展高频测听的性别与年龄差异

目的 探讨正常听力青年人言语声诱发听性脑干反应(speech-evoked auditory brainstem response, s-ABR)以及扩展高频测听的性别、年龄差异，旨在提供不同性别、年龄正常听力人群的参考数据。方法 招募171例(171耳)18～42周岁纯音听阈正常、无噪声暴露史的正常听力青年人，其中，女82耳，男89耳；18～30岁(大于18岁小于等于30岁)组96耳(男46耳，女50耳),30～42岁(大于30小于等于42岁)组54耳(男、女各27耳),分别进行常频及扩展高频测听、s-ABR测试，比较s-ABR各波潜伏期和幅值以及各频率阈值的差异，分析s-ABR各波潜伏期、幅值以及V/A复合体与常频及扩展高频纯音测听的相关性。结果 性别比较：(1)女性s-ABR的波V、C和F潜伏期显著短于男性(P<0.05),V/A幅值显著高于男性(P<0.05);(2)除4 kHz外，其余各频率平均听阈无明显性别差异(P>0.05)。年龄比较：(1)18～30岁组波O幅值显著高于30～42岁组(P<0.05),V/A斜率显著大于30～42岁组；(2)除0....     

学龄前期自闭症谱系障碍儿童与健听儿童言语诱发听性脑干反应的比较研究

目的　比较学龄前期自闭症谱系障碍（autism spectrum disorders,ASD）患儿与健听儿童言语诱发听性脑干反应（speech evoked auditory brainstem responses,speech-ABR）的基本特征,探讨ASD患儿脑干言语处理能力。方法　对声导抗、耳声发射、短声听性脑干反应测试结果正常的10例ASD患儿（3～6岁）和9名健听儿童（3～6岁）行speech-ABR测试,采用强度为80 dB SPL的/da/作为刺激声。结果　两组speech-ABR曲线均由瞬态成分（V、A、C、O）和周期性成分（D、E、F）组成,两组潜伏期及波幅差异均 无统计学意义（P＞0.05）。结论　学龄前ASD患儿与健听儿童speech-ABR具有相似的基本特征,两者脑干言语处理能力相近。     

刺激声时程对有无噪声暴露史听力正常青年人言语声诱发听性脑干反应的影响北大核心CSCD

目的分析不同时程言语声诱发听性脑干反应(speech evoked auditory brainstem responses,s-ABR)在有无噪声暴露史听力正常青年人中应用的差异,探讨其用于隐性听力损失诊断的临床应用价值。方法选取18~40周岁听阈正常、有噪声暴露史的男性工人15例(接噪组,平均年龄31.53±6.56岁)以及听阈正常、无噪声暴露史的男青年25例(对照组,年龄23.20±4.60岁)进行40 ms/da/音和170 ms/da/音的s-ABR测试,比较两组两种时程刺激声s-ABR潜伏期、波间期和幅值。结果接噪组170 ms/da/音s-ABR的O波潜伏期明显较对照组延长(P<0.05),其余V、A、D、E、F波潜伏期及各波振幅、波间期两组间差异均无统计学意义(均为P>0.05);两组40 ms/da/音s-ABR各波潜伏期、波间期及振幅差异均无统计学意义(P>0.05);对照组170 ms/da/音s-ABR各波潜伏期明显较40 ms/da/音s-ABR延长,各波波间期明显较40 ms/da/音s-ABR增宽(均P<0.05);接噪组170 ms/da/音s-ABR V、A、F、O波潜伏期显著延长(P<0.05),而两种时程刺激声s-ABR各波间期差异无统计学意义(P>0.05)。结论不同时程言语声诱发s-ABR测试可以用于不同的听觉处理机制分析;40 ms时程/da/音的s-ABR各波潜伏期可能对于隐性听力损失的诊断更有价值。     

双耳同侧记录的言语诱发听性脑干反应的对比研究

目的:比较左、右耳记录的言语诱发听性脑干反应(speech-ABR)在时域及频域上的差异,探讨脑干编码不同耳别来源的言语信息的差异及其可能原因。方法:以合成言语/da/为刺激声对健康成人进行双耳同侧记录的speech-ABR测试,分析反应的潜伏期、幅值及波形评分。对反应20～50ms部分进行快速傅立叶变换,计算基频及第一共振峰的幅值。结果:不同耳别记录的speech-ABR主波的潜伏期差异无统计学意义;右耳记录的A波幅值显著大于左耳记录,O波幅值则显著小于左耳记录,其他主波幅值的耳别差异均无统计学意义。右耳记录的波形评分大于左耳记录,两者差异有统计学意义。无论记录耳别,基频的幅值均大于第一共振峰的幅值,差异有统计学意义;无论是基频的幅值还是第一共振峰的幅值,耳别差异均无统计学意义。结论:speech-ABR在脑干的来源和分布无明显偏向性,与大脑半球言语功能的不对称性无明显对应性。听觉传导通路、功能性what-where通路以及大脑两侧半球不是简单的对应关系。     

Effects of age and sex on auditory brain stem response. A new aspect

The age and sex dependence of the latencies and interpeak intervals (IPI) of the auditory brain stem response (ABR) was investigated in 86 males and 69 females. The latencies of the waves I, III and V as well as the IPI I-V and III-V are significantly shorter in females than in males. A correlative linear dependence on age could be shown for the latencies of waves I, III and V in males and for the wave V latency in females. The slopes of the regression lines calculated for the dependence of ABR latencies I, III and V on age tend to be steeper in males than in females. The slope increases from wave I to wave V. The male and female regression lines intersect the latency axis at about the same point (at the same latency value at age A = O). On the basis of these results, the hypothesis is established, that age and sex dependence is not caused by different mechanisms. The ABR latency differences between males and females are in the main the result of the ABR age dependence being less pronounced in females than in males.     

正常成人发不同元音时口腔压力和鼻流量研究

目的：探讨正常成年人发不同元音时口腔压力和鼻流量值的差异,并分析二者之间是否有相关性。方法对30例正常成人（男女各半）在发／pa／、／pi／、／pu／时测量其口腔压力,在发／a／、／i／、／u／时测量其鼻流量,对结果进行统计学分析。结果①男性发／pa／、／pi／、／pu／时口腔压力平均值分别为4．53±0．70、5．21±0．80、5．87±1．45cmH2O,女性分别为4．09±0．30、4．47±0．30、4．77±0．32cmH2O,男性较女性高（P＜0．05）;不同元音间口腔压力值差异有统计学意义（P＜0．05）,但不同性别和不同元音间无交互作用。②男性发／a／、／i／、／u／时鼻流量平均值分别为30．2％±5．75％、38．8％±8．54％、26．5％±6．03％,女性分别为32．4％±7．14％、40．5％±11．8％、30．1％±4．83％;女性较男性高,但差异无统计学意义（ P＞0．05）,不同元音间鼻流量后差异有统计学意义（ P＜0．05）,但不同性别和不同元音间无交互作用。③口腔压力和鼻流量值呈弱相关（ r＝－0．240）。结论不同性别成人发相同元音时,男性的平均口腔压力值较女性高,但男女之间鼻流量值差异无统计学意义;相同性别不同元音间口腔压力和鼻流量值差异有统计学意义;口腔压力与鼻流量弱相关。     

正常成年人言语声刺激诱发的听性脑干反应

目的　探讨听力正常成人言语声诱发听性脑干反应（auditory brainstem response to speech sounds,s-ABR）各波的电生理特性。方法　以40 ms时程复合语音/da/为刺激声,诱发40名母语为汉语的健听成人（男性20名,女性20名）的s-ABR,分析s-ABR各波的引出率,潜伏期与受试者年龄、性别的关系。结果　S-ABR引出的7个反应波形中,女性受试者V、A波潜伏期较男性短（V波t =-3.601,P =0.001;A波t =-2.829,P =0.007）,其余各波潜伏期受性别影响小;各波潜伏期受年龄影响较小;各波振幅受性别及年龄影响较小;均无统计学差异（P＞0.05）。结论　S-ABR各波稳定性较好,是研究听觉言语处理机制的良好工具。     

Auditory brainstem responses as a clinical evaluation tool in children after perinatal encephalopathy

Auditory brainstem responses (ABR) reveals the neurophysiological status of the neural axis. In this study we compared the ABR of healthy children, under 1-year-old, with children who suffered from perinatal encephalopathy (PE). OBJECTIVE: The purpose of this study was to characterize the ABR differences between children with PE and healthy children in order to identify groups with specific neurophysiological profiles, associated with their neurological condition. METHODS: Thirty-six children with perinatal encephalopathy (PE) and 36 healthy children, ages 1-12 months, were studied. The variables considered were: latencies of waves I, II, N1, III, V, and N2; interpeak latency interval (IPL) of waves I-III, III-V, and I-V; as well as amplitudes of waves I, III, and V. The results were analyzed using ANOVA, as well as Ji(2), and Ward's cluster analysis. RESULTS: The absolute latencies of the ABR showed an inverse correlation with the children's age. Latencies of waves I, II, N1, V, and N2, IPL III-V, and amplitude of waves III and V show significant differences (p<0.05) between healthy and PE children. Children with PE showed greater absolute latencies and larger wave amplitudes than the control group. Ward's cluster analysis, used to define the groups with similar functional characteristics, revealed three groups: fast, intermediate, and slow-responders, depending on their wave latencies and IPL wave amplitudes. These groups were gender- (p<0.03), age- (p<0.0001), and neurological damage- (p<0.01) related. CONCLUSIONS: Our data clearly show that the ABR obtained from PE children differ from ABR obtained from healthy children. PE infants showed larger wave latencies, intervals amplitudes than the control group. Three functional profiles resulted from the groups established using the Ward's method, and these indicate their neurological functional condition.     

程序性死亡受体1及其配体调控变应性鼻炎免疫偏移的实验研究

目的探讨程序性死亡受体1(PD-1)及其配体PD-L1、PD-L2在变应性鼻炎(AR)中的表达及其对AR免疫偏移的调控作用。方法收取2018年5月至2019年5月,因鼻腔高反应症状于武汉大学人民医院耳鼻咽喉头颈外科门诊就诊,或因鼻中隔偏曲住院行鼻中隔矫正手术的82例患者,男42例,女40例,年龄14~38岁。收集相应患者的临床资料、血液、下鼻甲黏膜标本。根据临床表现、皮肤点刺试验和血清特异性变应原筛查特异性IgE(sIgE)检测结果,将患者分为AR组和对照组。免疫组织化学法检测鼻黏膜中PD-1及配体的表达情况。流式细胞术检测外周血PD-1^+CD4^+T细胞、PD-L1^+髓样树突状细胞(mDCs)、PD-L2^+mDCs及Th2细胞比例。酶联免疫吸附(ELISA)法检测血清中总IgE、PD-1及配体分泌型(sPD-1、sPD-L1、sPD-L2)的表达水平。正态分布或经Ln转换后呈正态分布的计量资料组间比较采用t检验,相关性分析采用Spearman或Pearson相关,设P<0.05为差异有统计学意义。结果AR组鼻黏膜中免疫细胞表面PD-1及其配体的表达明显高于对照组。AR组外周血中PD-1^+CD4^+T细胞、PD-L1^+mDCs、Th2细胞比例明显高于对照组[(15.24±6.45)%比(8.71±5.33)%,(8.79±2.01)%比(5.74±2.90)%,(7.89±1.95)%比(2.52±1.34)%,P值均<0.05],两组PD-L2^+mDCs比例无明显差异。PD-1^+CD4^+T细胞比例与AR病情总体视觉模拟量表(VAS)评分、血清总IgE、sIgE浓度呈正相关(r值分别为0.501、0.541、0.608,P值均<0.05),PD-L1^+mDCs比例与AR病情总体VAS评分、sIgE浓度呈正相关(r值分别为0.604、0.563,P值均<0.05),Th2细胞比例与PD-L1^+mDCs、PD-1^+CD4^+T细胞比例呈正相关(r值分别为0.538、0.623,P值均<0.05)。AR组sPD-1、sPD-L1及总IgE表达水平较对照组明显升高[(4.40±1.01)pg/ml比(3.79±1.21)pg/ml、(3.88±0.25)pg/ml比(3.57±0.23)pg/ml、(6.34±1.38)ng/ml比(4.89±1.10)ng/ml,P值均<0.05],sPD-L2表达水平无明显差异。相关性分析发现sPD-L1与总IgE、sIgE浓度呈正相关(r值分别为0.32、0.45,P值均<0.05)。结论AR患者外周血及鼻黏膜组织中免疫细胞表面均高表达PD-1及PD-L1,AR患者外周血中sPD-1及sPD-L1表达水平升高,PD-1/PD-L1信号通路可通过诱导Th2型免疫反应促进AR炎性反应。     

Could Tailored Chirp Stimuli Benefit Measurement of the Supra-threshold Auditory Brainstem Wave-I Response?

Auditory brainstem responses (ABRs) to broadband clicks are strongly affected by dyssynchrony, or “latency dispersion”, of their frequency-specific cochlear contributions. Optimized chirp stimuli, designed to compensate for cochlear dispersion, can afford substantial increase in broadband ABR amplitudes, particularly for the prominent wave-V deflection. Reports on the smaller wave I, however, which may be useful for measuring cochlear synaptopathy, have been mixed. This study aimed to test previous claims that ABR latency dispersion differs between waves I and V, and between males and females, and thus that using wave- and/or sex-tailored chirps may provide more reliable wave-I benefit. Using the derived-band technique, we measured responses from frequency-restricted (one-octave-wide) cochlear regions to energy-matched click and chirp stimuli. The derived-band responses’ latencies were used to assess any wave- and/or sex-related dispersion differences across bands, and their amplitudes, to evaluate any within-band dispersion differences. Our results suggest that sex-related dispersion difference within the lowest-frequency cochlear regions (< 1 kHz), where dispersion is generally greatest, may be a predominant driver of the often-reported sex difference in broadband ABR amplitude. At the same time, they showed no systematic dispersion difference between waves I and V. Instead, they suggest that reduced chirp benefit on wave I may arise as a result of chirp-induced desynchronization of on- and off-frequency responses generated at the same cochlear places, and resultant reduction in response contributions from higher-frequency cochlear regions, to which wave I is thought to be particularly sensitive.

     

健听成人言语呼吸声学参数的特征研究

目的 通过分析健听成人言语呼吸声学参数的特征,得到健听成人呼吸声学参数测量的取值标准,并讨论其临床含义.方法 测量言语呼吸声学参数--最长发声时间(MPT),用Phonation声学分析仪对其进行声学分析,记录基频范围、基频标准差、基频微扰等指标;分析性别对不同声学指标的影响,并得出相应的参考范围.结果 ①成年男女MPT的基频范围无显著差异(P>0.05),基频范围参考标准为34.55±16.74 Hz.②成年男女MPT的基频标准差无显著差异(P﹥0.05),基频标准差参考标准为3.43±1.37 Hz.③成年男女MPT的基频抖动存在极显著性差异(P<0.01),成年男性MPT的基频微扰参考标准为0.03±0.019 Hz,成年女性MPT的基频微扰参考标准为0.02±0.006 Hz.结论 基频范围、基频标准差及基频抖动均可作为言语呼吸参数测量的取值标准,其临床含义有待进一步证明.     

Effects of caloric restriction and aging on the auditory function of rhesus monkeys (Macaca mulatta): The University of Wisconsin Study

The present study is part of a larger project that investigates the effect of caloric restriction on longevity in the rhesus monkey. The purpose of the present study was to document presbycusis and the effect of caloric restriction on presbycusis in monkeys. The control group had 35 monkeys allowed to eat freely and the caloric-restricted group (CR) had 33 monkeys with a 30% reduction in caloric intake. Monaural and binaural auditory brainstem response (ABR) and middle latency response (MLR) were obtained from 27 female and 41 male monkeys that were 11-23 years of age and had been in the study for 102, 42, or 36 months when tested. Significant findings were the following: (1) wave I amplitudes were larger for females and for younger monkeys, and amplitudes decreased in aging males but not in aging females; (2) wave IV amplitudes were larger for females than males, and amplitudes for CR females were larger than for female controls, whereas the amplitudes from control and CR males were not different; (3) wave Pa latencies were shorter for females, and shorter latencies were maintained for aging females but not for aging males; (4) interwave interval IV-Pa was shorter for females, and intervals lengthened for aging males but not aging females; (5) binaural wave IV amplitude decreased faster with age for control monkeys than for CR monkeys, and the L+R Pa amplitude decreased with age. Additional trends were identified for longitudinal monitoring as monkeys enter old age.