脑干听觉诱发电位在听神经瘤的早期诊断和预后评估中的作用

目的　观察听神经瘤患者的听力及脑干功能受损情况。方法　应用日本光电产MEB - 710 2型诱发电位仪对12例疑似听神经瘤的患者进行了脑干听觉诱发电位的检测 ,并对部分患者进行手术前后的观察。结果　 12例患者均异常 ,异常率为 10 0 % ,主要表现在I、III、V波峰潜伏期延长 ,I-III和I-V峰间期延长 ,III-V I-III>1及反应阈升高。术后 4例患者的III-V峰间期有所缩短。结论　脑干听觉诱发电位有早期了解听神经瘤的听通道功能受损情况的价值 ,是筛选听神经瘤理想而敏感的方法。III-V I-III的比值可以作为观察手术效果的一项指标。     

听觉脑干诱发电反应在职业噪声聋中的应用

近年来听觉脑干诱发电反应(ABR)的生理学研究日益深入,同时在临床中利用ABR进行客观听力检查及脑干疾病的诊断等方面进展较快,但用ABR方法来观察接触噪声工人听力及在职业噪声聋诊断中的意义报道不多,为此我们对长期接触噪声(90～106dB)听阈明显下降的75名工人,进行听觉脑干诱发电反应测定,现将结果作初步分析。     

脑干听觉诱发电位在术中监测中的应用

脑干听觉诱发电位是指给耳高频短声刺激后在大脑皮层记录到的电位,临床广泛用于颅脑肿瘤的手术监测中,术中通过对潜伏期和波幅的监测,对帮助术者保护神经功能及判断预后脑干功能有重要价值。     

脑干听觉诱发电位在脑瘫患儿听力障碍诊断中的应用

目的：探讨脑干诱发电位（BAEP）在脑瘫患儿听力障碍诊断中的临床应用。方法：收集39例脑瘫患儿,应用amplaid MK 12型脑干诱发电位仪测试,在双耳垂或耳后茎突为信号电极,颅顶区为参考电极,前额或手腕为地电极。用1000Hz短声单耳膨胀刺激的BAEP资料进行分析。结果：39例脑瘫患儿,BAEP异常为32例,正常7例,阳性率82%,其中周围性听路损害13例,中枢性听路损害16例,混合性损害3例。结论：BAEP检查对早期发现小儿脑瘫听路损害有重要临床价值,是早期筛查新生儿、婴幼儿听力障碍及判断脑干中枢性听功能异常的优良技术。     

冲锋枪脉冲噪声对豚鼠听觉损伤的影响

为了研究轻武器噪声对听觉损伤的影响，观察了冲锋枪射击时产生的脉冲噪声对豚鼠听力和耳蜗毛细胞的作用。结果表明，各组动物经受峰值１５５，１６０，１６５和１７０ｄＢ各５发的脉冲噪声后４８小时，听力损失分别为７．０，１５．０，２２．７，和２７．５ｄＢ。２周后除了１５５ｄＢ组外，大多数动物的听力未恢复到正常水平。耳蜗毛细胞损伤以外毛细胞为主，其缺失率随噪声暴露强度的增加而增多。１５５ｄＢ组损伤轻微，缺失率为６．９％，１７０ｄＢ组损伤最重，缺失率高达３０．８％，而且内毛细胞也出现了损伤。实验结果同《常规武器发射或爆炸时压力波对人体作用的安全标准》（ＧＪＢ２－８２）相对照，发现在安全标准限值之内的动物亦出现了不同程度的损伤。提示该标准不够安全，可能不适合轻武器噪声的暴露条件。     

鼓膜穿孔对噪声性听损伤豚鼠听功能的影响

[目的]观察鼓膜穿孔对噪声性听损伤的豚鼠脑干诱发电位和畸变产物耳声发射的影响。[方法]10只豚鼠分别行右鼓膜穿孔,穿孔面积约占整个鼓膜的25%,左耳为对照耳。每天定时暴露于稳态噪声4h,连续暴露6d,观察左右两耳听觉脑干诱发电位(auditory brainstem response,ABR)和畸变产物耳声发射(distort product otoacoustic e-mission,DPOAE)的变化。[结果]两耳均出现ABR反应阈的上升和DPOAE幅值下降,脱离噪声暴露一段时间后,正常耳可恢复,穿孔耳仍有听阈的暂时性阈移,二者差异有统计学意义。[结论]鼓膜穿孔后,耳蜗外毛细胞对噪声更敏感,听阈的暂时性阈移恢复延迟。     

脑性瘫痪患儿听力学特征118例分析

[目的]分析脑性瘫痪患儿听功能改变特点及听觉脑干诱发电位（auditory brainstem response,ABR）、畸变产物耳声发射（distortion product otoacoustic emission,DPOAE）测试的意义及应用价值.[方法]对4岁以下118例脑性瘫痪患儿进行ABR测试,与各年龄组正常标准值比较,并对异常ABR患儿同时进行DPOAE测试,与标准值比较.[结果]118例脑瘫患儿经ABR测试各波反应阈在正常范围76例（64.4%）,异常42例（35.6%）.在42例听损伤患儿中双耳听损伤33例,单耳听损伤9例.双耳重度以上听损伤27例,中度、轻度听损伤各3例.单耳均为轻度听损伤9例.在42例听损伤患儿中未引出波形18例,均为重度脑瘫患儿;14例Ⅰ波峰潜伏期延长;13例Ⅰ～Ⅲ峰间期延长,10例Ⅲ～Ⅴ峰间期延长.对42例ABR测试异常患儿行DPOAE检查,其中双耳听损伤33例中,有4例双耳DPOAE反应缺失,与ABR检查结果一致,考虑为双侧耳蜗性听损伤;28例双耳DPOAE大致正常,而ABR波形异常,考虑为双侧蜗后性听损伤.1例双耳轻度听损伤患儿和9例单耳轻度听损伤患儿DPOAE幅值高频区下降,考虑为蜗性高频区听损伤.14例为蜗性听损伤,28例为蜗后性听损伤.[结论]脑性瘫痪患儿听功能改变以双侧性、重度性、神经性听损伤为特点,主要为耳蜗后听路损害.ABR、DPOAE对于脑瘫患儿的听力损害提供客观定位和频率特性.     

脑干听觉诱发电位在新生儿缺氧缺血性脑病中的临床应用

为了解脑干听觉诱发电位(brainstem auditory evokedpotential,BAEP)检测对(hypoxic-ischemic encephalopathy,HIE)预后的临床意义,现将梧州市人民医院新生儿住院的52例HIE进行了BAEP检测和头颅CT检查。对其中33例BAEP异常者进行早期干预,随访到1岁,结果报告如下。1对象和方法1.1对象52例均为2004~2005年收治的足月出生的HIE患儿,男36例,女16例。出生1~5 d,诊断标准按照2004年长沙会议制定的标准[1]。其中轻度25例,中度18例,重度9例,均于早期进行黄疸干预治疗,未出现高胆红素血症。1.2方法采用丹麦生产的keypoint EMG-EP检测仪,…     

荣成地区14634例新生儿听力筛查分析

目的了解山东荣成地区新生儿听力损失的发生率和筛查工作状况,探索和研究该地区新生儿听力筛查的临床策略和工作方法。方法选择出生的新生儿于出生后3d接受耳声发射（OAE）测试,所有接受初筛的婴儿在出生42d后,再次接受OAE检查,未通过者做自动听性脑干反应（AABR）检查。单耳不通过即为不通过,不通过者均经2次以上重复测试。结果14634名新生儿中,12731名（87．0％）初筛通过;1903名未通过,于出生42d后复查,1852例通过。51例接受』u出R检查,其中34例出现不同程度听力损伤,总计在筛查的新生儿中,听力损失的发病率0．23％,其中,双耳听力损失24人。发病率0．16％o,34人均显示不同程度的听力损伤,其中,双耳重度听力损失8人,双耳中度听力损失26人。结论对新生婴儿进行听力筛查非常必要,耳声发射仪联合自动听性脑干反应检测能提高高危儿听力损伤的诊断率,是新生儿听力筛查比较理想的方法。新生儿听力缺陷可以通过筛查尽早发现并进行诊断和干预,避免和减少耳聋发生,提高听障人群生活质量。     

性别和年龄对脑干诱发电位的影响研究

目的 探讨性别和年龄对脑干听觉诱发电位的影响。方法 检测53例（106耳）正常人的BAEP,用多元线性相关分析和逐步回归分析对其进行分析。结果 20－58岁期间的正常人Ⅲ波潜伏时、Ⅰ-Ⅲ及Ⅲ-Ⅴ峰间期与年龄有线性相关,但相关不高;Ⅰ、Ⅲ波潜伏时及Ⅲ－Ⅴ峰间期与性别有线性相关关系,其相关性亦不高,V波潜伏时及I－V峰间期与性别有线性相关关系,其相关较高;女性各波潜伏时及峰间期均较男性短,其中以V波潜伏时表现更为明显,比男性短0.2ms。结论 性别和年龄是影响BAEP的两个主要生理因素。在临床应用时,如能排除其影响,诊断则更客观、准确。     

Effects of aircraft noise on hearing and auditory pathway function of school-age children

Summary This study was conducted to investigate the influence of high-frequency aircraft noise on the function of the auditory system of school-age children. A total of 228 students attending a school near an airport (school A) and 151 students attending a school far from an airport (school B) were analyzed. Audiometry and brainstem auditory evoked potential (BAEP) detection were performed in all subjects to evaluate cochlear and retrocochlear function. The results of audiometry indicated that hearing ability was significantly worse in the children of school A, which was located under the flight paths. The values of pure tone average, high pure tone average, and threshold at 4 kHz were all higher in children who were frequently exposed to aircraft noise. There was no consistent difference in BAEP latencies between the two schools. These results indicate that central transmission is not affected in children who have been exposed to aircraft noise for several years. The results of the present study showed a significant association between aircraft noise exposure and prevalence of noise-induced hearing loss. Although damage to peripheral cochlear organs was confirmed in school-age children, involvement of the central auditory pathway could not be verified.     

Suppression of experimental allergic encephalomyelitis after dietary zinc deprivation in guinea pigs

The effects of different levels of zinc (Zn) in the diet were tested in the animal model of acute experimental allergic encephalomyelitis (EAE), which is considered a prototype for cell-mediated autoimmune disease of the central nervous system (CNS).

Acute EAE was induced in guinea pigs maintained with normal, high and low levels of Zn in the diet.

The animals fed normal and Zn-supplemented diets showed the same survival rates; the incidence and severity of the disease was similar for both groups. Zn-deficient animals exhibited the expected symptoms of Zn deficiency and after sensitization did not develop neurological signs of EAE; some of them presented only focal inflammatory alteration in CNS.     

七氟烷暴露新生儿术后早期脑干听觉诱发电位的变化

目的:观察七氟烷暴露新生儿术后早期脑干听觉诱发电位的变化.方法:行胃肠手术新生儿60例,胎龄37～42周,出生体重≥2 500 9,出生后1 min和5 min Apgar评分≥8分,ASA Ⅰ或Ⅱ级,按七氟烷暴露剂量,将患儿随机均分为3组(n=20):呼气末七氟烷浓度(CET-SEV)×吸入七氟烷时间(h)≤3.3％组(S1组)、3.3％＜CET-SEV×吸入七氟烷时间(h)＜6.6％组(S2组)、CET-SEV×吸入七氟烷时间(h)组≥6.6％(S3组),同期选取符合纳入标准、未接受手术的新生儿20例作为对照组(C组,n =20).实验组以4％七氟烷行吸入诱导,术中以七氟烷维持,采用气体监护仪监测呼气末七氟烷浓度.实验组在术后48 h和7天分别测试脑干听觉诱发电位(BAEP),对照组同期测试BAEP.结果:术后48 h时七氟烷暴露组BAEP异常率为45％,主要表现为V波分化不良或消失、V波潜伏期(PL)延长、Ⅰ-V波波间期(IPL)延长,与C组比较,S2组与S3组BAEP异常率及S3组Ⅰ-V波IPL差异有统计学意义(JP＜0.05);术后7天时七氟烷组BAEP主要表现为V波PL延长、Ⅰ-V波IPL延长,与C组比较,BAEP异常率、PL及IPL差异均无统计学意义(P＞0.05).结论:吸入较大剂量七氟烷新生儿术后早期出现一过性BAEP异常.     

锌对天冬氨酸转氨酶和线粒体酶功能的影响

目的 研究锌对血浆天冬氨酸转氨酶(AST)和肾上腺皮质细胞线粒体酶活力的影响。方法 用含不同浓度ZnSO4的水饲养鱼,观察ZnSO4对血浆AST和肾上腺皮质细胞线粒体酶功能毒作用的剂量-效应关系。应用分光光度法检测AST活力以及线粒体酶的活力。结果 ZnSO4引起血浆AST活力升高及肾上腺皮质细胞线粒体酶活力降低。结论 ZnSO4可引起鱼的血浆AST活力升高及肾上腺皮质细胞线粒体功能损害。     

声波除灰器低频噪声对豚鼠组织形态学与生理学指标的影响

在实验室条件下，观察了声波除灰器低频噪声对实验动物的影响。选用健康、耳廓反应灵敏的豚鼠３４只，随机分为４组，其中３组豚鼠暴露于主频为５０Ｈｚ的低频噪声环境，噪声强度分别为８５、９５、１０５ｄＢ（Ａ），每日接噪１．５小时，历时８周；另一组作对照。结果显示：接噪豚鼠的耳蜗及主要脏器的组织形态、听觉脑干电反应阈（ＡＢＲ）、血压和血象等无明显变化，尿香草扁桃酸（ＶＭＡ）含量较对照组明显增高（Ｐ＜０．０１）。     

视听诱发电位在正常婴幼儿中的检测分析

【目的】探讨6个月～3岁正常婴幼儿听性脑干反应（auditory brainstem response，ABR）和闪光视觉诱发电位（flash visual evoked potentials，FVEP）的特点及正常值范围。【方法】对144例听力学和视力学检查正常的婴幼儿进行ABR和FVEP检测。【结果】分别得到6个月～3岁婴幼儿ABR波Ⅰ、Ⅲ、Ⅴ波潜伏期和Ⅰ-Ⅲ、Ⅰ—Ⅴ、Ⅲ-Ⅴ波间期及FVEP波N1、P1、N2波潜伏期的正常值范围，发现ABR和FVEP各波潜伏期随年龄增长有缩短的趋势；无性别和左右侧差异（P〉0．05）；ABR于1．5岁、FVEP于1岁时逐渐发育成熟。【结论】ABR和FVEP检测应用于婴幼儿听功能和视功能检查是可行的，临床应用时。应参照不同年龄段的ABR和FVEP参考值进行判断。     

新生儿高胆红素血症血清神经元特异性烯醇化酶及脑干听觉诱发电位变化的临床价值

目的探讨血清神经元特异性烯醇化酶(NSE)及脑干听觉诱发电位(BAEP)在评价新生儿高胆红素血症合并脑组织损伤的临床价值。方法根据血清总胆红素含量不同将90例新生儿高胆红素血症患儿分为A、B两组;40例正常足月新生儿为对照组,分别抽取静脉血行NSE测定和BAEP检测。结果高胆红素血症A、B两组的NSE水平、BAEP异常发生率均明显高于对照组,差异有统计学意义(P<0.01);高胆红素血症A、B两组之间比较,NSE水平及BAEP异常发生率差异也有统计学意义(P<0.01),且TSB水平与NSE水平呈正相关;同时,BAEP异常发生率也增高。结论NSE与BAEP在高胆红素所致神经毒性评价方面均具有较高敏感性,可作为临床监测指标。     

Effects of methylmercury on neurodevelopment in Japanese children in relation to the Madeiran study

Objectives: A cross-sectional study was carried out to assess the effects of methylmercury exposure on neurodevelopment in Japanese children, in relation to the Madeiran cross-sectional study, and to estimate benchmark dose (BMD) levels using the data of two studies. Methods: Mercury levels in hair samples obtained from 327 Japanese mothers and their 7-year-old children, and methylmercury levels in the umbilical cord, were determined. Neurodevelopmental examinations, including the brainstem auditory evoked potential (BAEP), were performed on the children. Results: The medians of hair mercury were 1.63 (0.11–6.86) g/g for mothers and 1.65 (0.35–6.32) g/g for children, and a significant correlation was seen between the hair mercury levels in mothers and children. The maternal hair mercury was significantly correlated with the methylmercury in the umbilical cords obtained from 49 children. In 210 children whose mothers had not changed their dietary habits since pregnancy, most of the neurodevelopmental variables were not significantly related to hair mercury levels. The BAEP latencies were significantly shorter in the Japanese children than in the 113 Madeiran 7-year-old children, whose mothers had hair mercury of 1.12–54.5 (median 10.9) g/g. Significant relationships between the maternal hair mercury level and BAEP latencies (peaks III and V, and interpeak I–III) were found only in the merged data of Japanese and Madeiran children. When the lower 95% confidence limit of BMD (BMDL) was calculated, the BMDLs of mercury exposure for BAEP latencies in the merged data were between 6.9 and 10.5 g/g, and lower than those in the Madeiran children. Conclusions: It is suggested that Japanese children may ingest similar doses per body weight of methylmercury to their mothers. If maternal hair mercury was used as a proxy for mercury exposure at birth, no significant dose–effect associations with the BAEP latencies were observed in Japanese children with exposure levels below 6.9 g/g of hair mercury, but only when higher-level exposures from Madeiran children were included. The BMDL was lower for the merged data than for Madeiran children alone.     

振动负荷试验对振动作业工人脑干听觉诱发电位影响的研究

本文研究了振动性白指患者（白指组）、振动作业工人（接振组）振动负荷前后脑干听觉诱发电位（ＢＡＥＰ）的变化，并同对照组进行了比较。结果表明，振动负荷前后白指组ＢＡＥＰ的Ⅰ、Ⅲ、Ⅴ波潜伏期及各峰间期和接振组Ⅰ波潜伏期均较对照组明显延长（Ｐ＜００５，Ｐ＜００１）；白指组ＢＡＥＰ的Ⅰ、Ⅲ、Ⅴ波、各峰间期及接振组Ⅰ、Ⅴ波潜伏期在振动负荷后较振动负荷前明显缩短（Ｐ＜００５）。从而提示，振动可致脑干听通路受累，并使中枢神经系统对刺激的反应性下降；ＢＡＥＰ结合振动负荷试验对评价手传振动引起的中枢神经系统损害具有一定意义。