豚鼠听觉脑干电反应信号小波变换分析

目的：将小波变换这种时频域信号分析方法用于豚鼠听觉脑干电位分析,以了解小波变换是否适用于ＡＢＲ信号分析,较之传统法有否优越之处。方法 雄性纯白豚鼠３０只分成正常,传导性聋,感音性聋三组,每组１０只,要集各组７５ｄＢｎＨＬ短声诱发的ＡＢＲ,用小波处理软件进行变换,将变换前后信号的时域值作配对统计处理,结果 小波２尺度变换使原信号失真,４尺度变换增加原信号的背景噪声,３尺度变换可保持原信号的时域特征,     

听性脑干反应的相位谱分析和阈值测定

目的 证实相位谱分析方法－－以同步度（ＳＭ）为指标测定听性脑干反应（ＡＢＲ）阈值的帝用性。方法 基于对正常组（４０耳）３０ｄＢ短声诱发ＡＢＲ相位谱所解析出的有铲傅里叶成分１００－１１７０ＨＺ，并根据Ｆｒｉｄｍａｎ建立的阳性诱发反应阈值判断公式ＳＭ〉ＳＭ＿ＺｐＱｓｍ，计算出ＳＭ阈值标准为０．１３，进而应用于受试组（４６耳）ＡＢＲ的谱分析及阈值测试，同时与ＡＢＲ时域分析阈值进行比较。结果 受试耳中，谱     

相位谱结合功率谱分析在听性脑干反应阈值客观自动化测试的应用

目的：建立能够进行听性脑干反应（ＡＢＲ）阈值客观自动化测试的方法。方法：采用Ｆｒｉｄｍａｎ相位谱分析法，即同步度（ＳＭ）测试法，并结合功率谱分析法，对接近阈值强度的４０ｄＢｎＨＬ短声诱发的ＡＢＲ进行频域的有效成分分析。根据实验所得有效成分及相关理论公式ＳＭ＋３бｓｍ，计算出相位谱分析定量ＡＢＲ阈值的参考标准。结果：由２１正常耳实验所得ＡＢＲ有效傅里叶成分为５００～６８０Ｈｚ，则定量ＡＢＲ阈值的标准值是０．１６７。基于建立的阈值标准，相位谱分析定量了测试组３６耳的ＡＢＲ阈值，并与ＡＢＲ时域分析所测阈值进行了比较：谱分析和时域分析阈值相同的有１３耳，其它２３耳阈值不同，但差别仅１０ｄＢｎＨＬ，在本实验测试强度变化步长之内。结论：相位谱结合功率谱分析是一种有效的客观自动化测试ＡＢＲ阈值的方法。     

全麻状态下听性脑干反应的变化

全麻状态下听性脑干反应的变化桂晓钟，潘晓玲，蒋家启听性脑干反应（ＡＢＲ）是客观反映听觉、听神经及脑干功能的测试方法之一。有关ＡＢＲ用于临床诊断已有较多报道，但对全麻状态下ＡＢＲ的变化较少，对近年因胸腹部疾病行全麻手术的患者１０例（２０耳），分别在全麻...     

相位谱分析在听觉脑干反应阈值自动测试的应用

采用Ｆｒｉｄｍａｎ提出的相位谱分析方法，即同步度（ｓｙｎｃｈｒｏｎｙｍｅａｓｕｒｅ，ＳＭ）测试法，进行听觉脑干反应（ＡＢＲ）阈值自动测试的研究。基于在正常组（４２耳）计算出的判别电位反应的标准ＳＭ值为０．１７，本实验分析了测试组的ＡＢＲ阈值，并与时域肉眼观察的结果进行了比较分析。测试组的２８耳中，有９耳两种方法分析的阈值相同，１９耳的谱分析阈值大于时域分析阈值１０ｄＢ，但差别在强度变化的步长之内，且因两种方法采样电位的叠加次数不同而造成的。结果表明，相位谱分析是一种有效的客观自动化测试ＡＢＲ阈值的方法。     

小于胎龄儿听性脑干反应的研究

对２６例（５１耳）小于胎龄儿听性脑干反应（ＡＢＲ）的阈值、各波潜伏期及波间期等项参数进行测试。并以１０５例（１９９耳）正常新生儿和４４例（８８耳）窒息新生儿作对照。结果显示：小于胎龄儿ＡＢＲ的阈值提高者较正常新生儿组高（Ｐ＜０．００５）；且波Ｉ、ＩＩ潜伏期延长明显（Ｐ＜０．００１），波Ｖ潜伏期亦延长（Ｐ＜０．０５）。     

相位谱分析在听觉脑干反应阈值自动测试的应用

采用Ｆｒｉｄｍａｎ提出的相位谱分析方法，即同步度测试法，进行听觉脑干反应（ＡＢＲ）阈值自动测试的研究，基于正常组（４２耳）计算出的判别电位反应的标准ＳＭ值来０．１７，本实验分析了测试组的ＡＢＲ阈值，并与时域肉眼观察的结果进行了比较分析。测试组的２８耳中，有９耳两种方法分析的阈值相同，１９耳的谱分析阈值大于时域分析阈值１０ｄＢ，但差别在强度变化的步长之内，且因两种方法有采样电位的叠加次数不同而造成的     

1241例聋儿40Hz听觉相关电位和听性脑干反应

本文对１２４１例（２４８２耳）聋儿同时作了４０Ｈｚ听觉相关电位（４０ＨｚＡＥＲＰ）和听性脑干反应（ＡＢＲ）测试，均用ＮＩＣＯＬＥＴＰＡＴＨＦＩＤＥＲⅡ型诱发电位仪测试。结果：（１）在用睡眠药组４０ＨｚＡＥＲＰ和ＡＢＲ的引出率均低于不用睡眠药组；（２）４０ＨｚＡＥＲＰ和ＡＢＲ阈值差显示：用睡眠药组４０ＨｚＡＥＲＰ阈值＜ＡＢＲ阈值的占３５６％明显低于不用睡眠药组的５９８９％。表明：（１）４０ＨｚＡＥＲＰ检出残余听力优于ＡＢＲ；（２）服用睡眠剂可使患儿４０ＨｚＡＥＲＰ反应阈值增高     

婴幼儿缺铁性贫血治疗前后脑干听性反应的变化

对５０例（９４耳）缺铁性贫血（ＩＤＡ）患儿治疗前后脑干听性反应（ＡＢＲ）的结果进行分析，认为ＩＤＡ可造成听传导路的周围性损害，主要表现为ＡＢＲ波形分化不良，反应阈值提高，Ⅰ、Ⅲ、Ⅴ波绝对潜伏期（ＰＬ）延长，少数患儿的Ⅰ－Ⅲ峰间期（ＩＰＬ）达临界值，而Ⅲ－ⅤＩＰＬ无异常，经补铁治疗后，ＡＢＲ各参数恢复正常，说明这种改变是可逆的。提示，对小儿ＩＤＡ应早期发现，早期治疗。     

听性脑干反应波Ⅴ潜伏期－强度函数曲线斜率变化的多因素分析

为探讨影响听性脑干反应（ＡＢＲ）波Ⅴ潜伏期－声刺激强度函数曲线斜率的主要因素，我们将８８耳ＡＢＲ资料分别按聋病原因、听力曲线类型分类，行方差分析、线性回归分析以及多元逐步回归分析．结果表明．ＡＢＲ短声反应阈是影响斜率的主要因素，其原因是阈上声刺激不足，造成斜率增大。     

Mechanisms in noise-induced permanent hearing loss: an evoked otoacoustic emission and auditory brainstem response study

In this study 22 patients (44 ears) with noise-induced permanent hearing loss were audiologically evaluated using transient-evoked otoacoustic emissions (TEOAE) and auditory brain-stem response (ABR). Twenty-one normal subjects (42 ears) without exposure to occupational noise were used as controls. Based upon the hearing loss at 4, 3, 2 and 1 kHz on the pure-tone audiogram, they were classified into four groups. In group 1 (eight ears), emissions were present in all ears but their TEOAE-noise level and their reproducibility (percentage) proved to be weak. The auditory brain-stem response (ABR) indicated that the I/V amplitude ratio, the latency values of wave V and the I-V intervals fell within the normal range in all ears. In Group 2 (14 ears), 40 per cent had no emissions, whereas the remaining ears showed weak emissions. The ABR revealed that in all ears the I/V amplitude ratio became small while wave V peak latency as well as I-V intervals were within the normal range. In Group 3 (10 ears), emissions were absent in 50 per cent, while in the other ears the emissions were very weak. The ABR revealed that the I/V amplitude ratio, which could be calculated in the 60 per cent in which wave I was present, was smaller than in Group 2. Wave V latency as well as I-V intervals were within the normal range. In Group 4 (12 ears), none of the ears showed emissions. The ABR indicated that the I/V amplitude ratio was much smaller when wave I was present (27 per cent) as well as I-V interval values being within the normal range. Wave V absolute latency value (delta V index) indicated a positive index in 17 per cent of this group (two ears) when wave I was absent. In the present study a dynamic process from cochlear outer hair cells to cochlear neurons was seen, correlating with an increasing hearing loss.     

Effects of presbycusis and other types of hearing loss on auditory brainstem responses

Auditory brainstem responses were studied in 373 healthy individuals of various ages and with sensorineural hearing loss of differing degrees. 209 subjects were elderly and had a hearing loss which included a component of presbycusis. The remainder were young or middle-aged with cochlear hearing loss. Altogether 606 ears were tested. The old individuals had generally longer ABR wave latencies than the young subjects. The I-V interpeak latency (IPL) was also prolonged in the older age groups compared with the group of younger individuals, except for subjects with pronounced hearing loss. The results of the study indicate that an age-related dysfunction of the auditory pathway in the brainstem can be present in presbycusis.     

Transient evoked otoacoustic emission measurement in infants

Transient evoked otoacoustic emissions (TEOAEs) were measured and evaluated in 194 ears of 101 subjects under 4 years old who were suspected of hearing loss, using a ILO88 Otoacoustic Emission Analyzer, to study the basic characteristics of this measure and its utility for hearing screening. The mean time necessary to record TEOAEs in both ears was short, about 3 minutes. In 58 ears judged as normal hearing within 30 dB in ABR, TEOAE levels in infants aged less than 2 months were significantly higher than in those aged more than 1 year, especially in the high frequency bands (4-kHz and 5-kHz bands). One case which had been judged as bilateral moderate-to-profound hearing impairment in initial ABR testing showed good responses in TEOAEs, indicating normal cochlear function, and obvious wave Vs in follow-up ABRs recorded at 30 dB nHL confirmed normal auditory function. Therefore, in a case like this one, suspected of retardation in brain stem maturation, TEOAE is more useful than ABR as a hearing screening technique. Since external and middle-ear factors caused poor TEOAE responses in some cases which had been judged as normal hearing by ABR. TEOAE seems to be more sensitive in detecting external and middle ear problems than ABR. Moreover, TEOAE measurement of infants was easy and noninvasive. We conclude that TEOAE is an excellent tool for screening auditory function in infants.     

儿童chirp听性脑干反应与行为测听的相关性

目的 采用chirp信号作为声刺激进行听性脑干反应(ABR)测试,观察chirp ABR阈值与行为测听的相关性,探讨chirp ABR作为儿童临床客观听力评估的可行性.方法 选择2007年8月至9月佛山市听觉语言康复中心的听力障碍儿童和广州市儿童医院听力门诊的正常听力儿童共22例(共35耳)作为研究对象,分别进行行为测听和chirp ABR测试,并对chirp ABR反应阈和行为测听阈值进行Pearson相关性分析.结果 22例接受测试儿童中男14例,女8例,年龄3.3～6.5岁,平均年龄4.8岁.纳入研究的35耳中,正常听力6耳,听力损失轻度2耳、中度4耳、重度10耳、极重度13耳.行为测听0.5、1、2、4 kHz平均听阈与chirp ABR阈值,0.5 kHz听阈与L-chirp ABR阈值,1～4kHz平均听阈与U-chirp ABR阈值之间的相关系数分别为0.939,0.900及0.930,P值均<0.05.结论 chirp ABR作为一种客观测听技术,能够较好地反映儿童的听力水平,有希望应用到临床工作中.     

NICU患儿听力筛查结果分析

目的分析新生儿重症监护病房（NICU）患儿听力筛查结果。方法对2008年1月～2009年1月间3130例NICU患儿用TEOAE初筛、复筛,对复筛未通过患儿行ABR诊断性检查。结果未通过TEOAE初、复筛的513例（709耳）患儿中,以早产儿和肺部疾患阳性率最高,其中102例（156耳）患儿经诊断性ABR检查,确诊为听力损失130耳（83．33％,130／156）,其中轻度听力损失38耳,中度55耳,中重度15耳,重度16耳,极重度6耳,肺部疾患、高胆红素血症和早产儿阳性率最高。结论NICU患儿听力损失发生率高,肺部疾病、高胆红素血症和早产儿是引起听力损失最主要的高危因素。     

Tympanic ECochG and conventional ABR: a combined approach for the identification of wave I and the I-V interwave interval

Identification of wave I and measurement of the I-V interwave interval (IWI) are important parameters of the auditory brain stem response (ABR). However, at low stimulus sensation levels, wave I may be absent in the presence of wave V when the ABR is recorded conventionally with scalp electrodes. Several studies have shown that the amplitude and detectability of wave I (or N1) can be enhanced via extratympanic electrocochleography (ECochG), and even more so with tympanic ECochG. In the present study, tympanic ECochG was combined with conventional ABR to compare the amplitude and sensitivity of N1, wave I, and wave V in normally hearing subjects, and to identify the N1-V IWI in hearing impaired subjects whose conventional ABRs did not contain a reliable wave I. For the normally hearing subjects, the amplitude of the N1 was considerably larger than the amplitudes of waves I and V of the conventional ABR and there was no significant difference between N1 and wave V thresholds. For the hearing impaired group, the combined ECochG-ABR approach allowed for the identification of N1 and measurement of the N1-V IWI in all subjects. Our results support the use of tympanic ECochG in combination with conventional ABR for certain audiological and neurological applications.     

轻度感音神经性听力损失婴儿骨导ABR检测结果分析

目的探讨骨导听性脑干反应(ABR)检测在婴儿轻度感音神经性听力损失诊断中的价值。方法分别对30例(52耳)轻度感音神经性听力损失婴儿(患儿组)和30例(60耳)听力正常婴儿(正常组)行骨、气导ABR检测,并对两组结果进行分析比较。结果从40 dB nHL刺激强度开始,随着刺激强度下降,患儿组骨导ABR波V引出率逐渐下降;在40 dB nHL刺激强度下,患儿组骨导ABR波Ⅰ、Ⅲ、Ⅴ潜伏期较正常组稍延长,但差异无显著统计学意义(P>0.05)。患儿组骨、气导ABR反应阈均较正常组显著升高(P<0.05),但两组骨气导反应阈差值无明显差异(P>0.05)。结论骨导ABR检测对轻度感音神经性听力损失婴幼儿听力损失性质的鉴别诊断和评估具有重要的临床参考价值。     

听力筛查未通过婴幼儿相关高危因素及听力评估结果转归分析

目的：探讨不同高危因素下听力筛查未通过婴幼儿听力特点及其转归情况。方法：对2次听力筛查未通过而转诊我科的婴幼儿采用ABR、畸变产物耳声发射（DPOAE）、鼓室声导抗和镫骨肌反射等客观听力测试。首次听力评估异常者依照听力损失情况,建议复诊时间一般1～3个月,以不超过6个月龄为限。分析未通过听力筛查的婴幼儿在不同年龄、不同筛查结果、不同高危因素下的听力测试的特点及转归情况。结果：听力筛查不通过的802例（1179耳）中,单耳不通过组初次听力评估正常的比例为53．2％,高于双耳不通过组（39．5％）,P％0．05。而初评为重度听力异常的比例在两组问无明显差异（P〉0．05）;高胆红素血症导致的听力筛查不通过占25．8％,远高于其他已知的高危因素（P％0．05）;先兆流产组未发现有重度听力异常患儿;有耳聋家族史的婴幼儿导致重度听力损失的比例（40．9％）远高于其他高危因素,其次为同时有2种以上高危因素者（10．8％）;听力筛查不通过者中,56．9％未发现有高危因素,其中有54．7％初次评估听力异常;而有高危因素的婴幼儿中,42．3％初次评估听力为正常;所有2次评估的96例（138耳）中,轻度异常好转比例为40．9％,中度为74．3％,重度为33．3％,P％0．05。有7耳出现听力损失加重现象。各种不同高危因素导致的听力异常中,中度异常好转的比例均较轻度异常高;802例（1179耳）中,有10例（12耳）诊断为听神经病。结论：未通过听力筛查的婴幼儿围产期病史及听力损失程度和年龄等均是决定追踪随诊次数的重要因素,仍存在许多未知的听力损害高危因素,实现新生儿聋病易感基因的普遍筛查应该是今后努力的方向。     

A study of the effects of cochlear loss on the auditory brainstem response (ABR) specificity and false positive rate in retrocochlear assessment.

The auditory brainstem response (ABR) test is widely used as a screen for retrocochlear dysfunction in individuals suffering idiopathic auditory and vestibular disturbance. Although its sensitivity for lesions of the lower brainstem is well established, hearing loss is known to have significant effects upon the test's specificity and false positive rate. This study analysed the effects of aspects of cochlear hearing loss including level, slope and general audiogram shape on these properties of the ABR test in a large clinical group. The study comprised 306 patients (153 male, 153 female) referred for ABR screening to exclude retrocochlear dysfunction. Of 566 ears meeting the inclusion criteria, 85 (15 per cent) failed the test. On follow-up eight ears (3 per cent) were confirmed to have some form of retrocochlear abnormality, seven of which were pathological. All had abnormal ABR results. No cases of retrocochlear abnormality were found in the ABR pass group. In those patients diagnosed as free of retrocochlear problems, the importance of the I-V interval as a primary index of function was confirmed. It displayed a high specificity (>90 per cent) which was largely independent of the level or slope of high-frequency hearing loss. In contrast wave V specificity decreased with increasing loss and increasing slope. Its value as a functional index was limited with losses greater than 70 dB HL in whom specificity fell below 70 per cent. The study concluded that, despite reducing interval availability above 60 dB HL, wave V latency cannot be used as an alternative index because it displays weakening specificity over this range of loss. With the problems inherent in applying latency corrections, the author advocates the use of improved procedures for wave I identification in these cases.