阻塞性睡眠呼吸暂停低通气综合征患者的高刺激率ABR的临床分析

目的探讨阻塞性睡眠呼吸暂停低通气综合征患者高刺激率ABR和常规刺激率ABR的临床价值及其与间歇性低氧的关系。方法对58例(116耳)OSAHS患者及正常成年人分别进行11次/秒及51次∕秒刺激率的听性脑干反应(ABR)测试,比较组间结果。结果 11次∕秒刺激率ABR,OSAHS组双耳的波I潜伏期(1.51±0.13ms)较对照组(1.33±0.07ms)延长;波V潜伏期(5.65±0.23ms)较对照组(5.53±0.23ms)延长;在51次/s刺激率下,患者组双耳的Ⅰ波潜伏期、Ⅴ波潜伏期均比正常人延长,(1.64±0.12ms)较对照组(1.44±0.06ms)延长;波V潜伏期(5.92±0.26ms)较对照组(5.80±0.18ms)延长;有统计学意义(P<0.05)。而在两种刺激率下,两组人群双耳的Ⅰ~Ⅴ波间期、波间期差值之间的差异均无统计学意义(P>0.05)。结论高刺激率ABR可发现中度及重度OSAHS患者耳蜗功能的损伤。     

非镇静听性脑干反应检测的有效性研究

目的探讨非镇静听性脑干反应(ABR)检测的有效性,为其临床应用提供参考。方法以30例(60耳)听力正常人(0.5~2 kHz气导平均听阈15.7±4.1 dB HL)为正常组,10例(20耳)感音神经性聋患者(0.5~2 kHz气导平均听阈35.7±8.4 dB HL)为病例组,均进行非镇静ABR测试和镇静ABR测试,比较两种ABR的潜伏期、波间期及反应阈。结果①正常组非镇静ABR波Ⅰ、Ⅲ、Ⅴ潜伏期分别为1.78±0.25、3.96±0.18、6.10±0.33 ms,镇静ABR波Ⅰ、Ⅲ、Ⅴ潜伏期分别为1.62±0.18、3.76±0.20、5.78±0.45 ms,二者比较差异无统计学意义(P>0.05);非镇静ABR各波波间期(Ⅰ-Ⅲ1.98±0.32 ms,Ⅲ-Ⅴ2.13±0.37 ms,Ⅰ-Ⅴ4.05±0.08 ms)与镇静ABR各波波间期(Ⅰ-Ⅲ2.10±0.02 ms,Ⅲ-Ⅴ1.98±0.25 ms,Ⅰ-Ⅴ4.02±0.18 ms)比较,差异无统计学意义(P>0.05)。②病例组非镇静ABR波Ⅰ、Ⅲ、Ⅴ波潜伏期分别为1.71±0.29、4.06±0.08、5.90±0.18 ms,镇静ABR波Ⅰ、Ⅲ、Ⅴ潜伏期分别为1.72±0.14 ms、3.76±0.25 ms、5.77±0.59 ms,二者比较差异无统计学意义(P>0.05);非镇静ABR各波波间期(Ⅰ-Ⅲ2.18±0.47 ms,Ⅲ-Ⅴ2.03±0.27 ms,Ⅰ-Ⅴ4.15±0.58 ms)与镇静ABR各波波间期(Ⅰ-Ⅲ2.00±0.10 ms,Ⅲ-Ⅴ1.98±0.39 ms,Ⅰ-Ⅴ4.12±0.38 ms)比较,差异无统计学意义(P>0.05)。③两组非镇静ABR与镇静ABR反应阈差异无统计学意义(P>0.05)。结论非镇静ABR测试结果与镇静ABR无差异,且波形分化好,易辨别,可方便、有效的应用于临床。     

不同月龄婴儿的ABR正常值分析

目的 获取6月龄内婴儿的听性脑干反应(auditory brainstem response,ABR)正常值范围并分析其特点.方法 2006年5月至2008年5月对听力正常、出生40天～7月龄的60例婴儿进行ABR检测,根据平均年龄分为A(6周龄)、B(3月龄)、C(6月龄)组,每组20例(40耳);对照组为听力正常的成人20例(40耳),平均年龄25.2岁.对各组的ABR结果进行统计分析.结果 各组100 dB nHL ABR的波Ⅰ、Ⅲ、Ⅴ潜伏期的正常值范围分别为:A组:1.49±0.08、4.42±0.16、6.61±0.25 ms;B组:1.47±0.07、4.35±0.20、6.50±0.25 ms;C组:1.45±0.07、4.17±0.15、6.32±0.22 ms;对照组:1.45±0.07、3.79±0.11、5.49±0.20 ms;三组婴儿80 dB nHL ABR的波Ⅰ、Ⅲ、Ⅴ潜伏期的正常值范围分别为:A组:1.63±0.08、4.52±0.17、6.74±0.26 ms;B组:1.64±0.11、4.44±0.20、6.67±0.26 ms;C组:1.60±0.11、4.27±0.16、6.43±0.24 ms.随刺激声强度降低,ABR各波潜伏期延长.各月龄组婴儿的波Ⅲ、Ⅴ潜伏期、Ⅰ-Ⅲ、Ⅰ-Ⅴ波间期均比成人延长,且随婴儿月龄增加逐渐缩短,但6月龄时仍未达到成人水平.各月龄组ABR反应阈差异无统计学意义.结论 不同月龄婴儿的波Ⅰ潜伏期与成人相近;各月龄婴儿的ABR反应阈无明显差异,且与成人相近.     

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。     

儿童OSAHS不同刺激重复率听性脑干反应的临床研究

目的 探讨儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep Apnea-hypopnea syndrome,OSAHS)的脑干听觉诱发电位反应(Brain Auditory Evoked Potention,BAEP)的特征。方法 对经多导睡眠检测确诊的儿童OSAHS患者87例,经声阻抗检查呈A型曲线,4～7岁,分别以11.1、33.1?Hz的不同刺激重复率进行BAEP测试,比较不同病变程度对两种刺激重复率听觉阈值、潜伏期及波间期差的影响。结果 与对照组比较,OSAHS轻度组：两种刺激重复率的 BAEPⅠ、Ⅲ、Ⅴ波的潜伏期及波间期差均在正常范围,Ⅴ波听阈为25dBnHL;中度组：刺激重复率33.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期及波间期差无异常,Ⅴ波听阈25dBnHL;刺激重复率11.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期延长,差异具有统计学意义（P＜0.05）,Ⅰ～Ⅲ、Ⅰ～Ⅴ波间期延长,Ⅲ～Ⅴ间期在正常范围,Ⅴ波听阈28dBnHL;重度组：刺激重复率33.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期及各波间期差均延长,Ⅴ波听阈35dBnHL;刺激重复率11.1Hz,Ⅰ、Ⅲ、Ⅴ波的潜伏期及波间期差均延长,Ⅴ波听阈40dBnHL。重度OSAHS患者两种刺激重复率各波潜伏期、波间期差听阈改变均具有统计学意义。结论 低频短声刺激能较早反映OSAHS患儿脑干功能的改变;重度OSAHS患儿的BAEP测试结果异常,提示OSAHS对听阈及听觉脑干传导功能都存在影响。     

经鼻持续正压通气对OSAHS患者ABR的影响

目的　研究经鼻持续正压通气(continuouspositiveairwaypressurethroughthenares,nCPAP)治疗前后阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapnea/hypopneasyndrom ,OSAHS)患者听性脑干反应(ABR)各波潜伏期及波间期的变化,探讨OSAHS患者脑干电生理变化的解剖学及病理生理学基础。方法　对4 5例( 90耳)OSAHS患者及16例( 32耳)正常对照者行ABR测试及多导睡眠监测(polysomnography ,PSG) ,对其中34例( 6 8耳)OSAHS患者行nCPAP治疗前后ABR测试对比。结果　OSAHS患者的波Ⅲ、Ⅴ潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期比正常对照组明显延长(P <0 .0 5 )。nCPAP治疗后波Ⅲ潜伏期较治疗前缩短,Ⅰ-Ⅲ波间期较治疗前缩短,Ⅲ-Ⅴ波间期较治疗前延长;nCPAP治疗后OSAHS患者呼吸紊乱指数及减血氧次数较治疗前明显下降(P <0 .0 5 )。结论　OS AHS患者的脑干听觉传导通路受损,与其高碳酸-低氧血症有密切关系。nCPAP治疗可以改善脑干听觉传导功能。     

中耳功能异常婴儿听性脑干反应特点及应用

目的探讨中耳功能异常婴儿的听性脑干反应(ABR)特点及临床应用价值。方法分析比较85例(170耳)中耳功能异常、ABR反应阈≤60dB nHL的婴儿(A组)和83例(166耳)中耳功能正常、ABR反应阈40～60dB HL的婴儿(B组)以及41例(82耳)正常婴儿(C组)的ABR波Ⅰ、Ⅲ、Ⅴ潜伏期、波间期和波Ⅴ反应阈值。结果 A组中24耳(14.11%)为ABR反应阈≤30dB nHL、73耳(42.94%)为40dB nHL、54耳(31.76%)为50dBnHL、19耳(11.18%)为60dB nHL;B组中83耳(50%)ABR反应阈为40dB nHL、52耳(31.33%)为50dB nHL、31耳(18.67%)为60dB nHL;C组婴儿ABR反应阈均≤30dB nHL。刺激声为80dB nHL时三组间波Ⅰ、Ⅲ、Ⅴ潜伏期的关系分别为:A组波Ⅰ、Ⅲ、Ⅴ潜伏期明显长于B组和C组(P<0.01),而Ⅰ-Ⅲ、Ⅰ-Ⅴ波间期则较B组和C组短(P<0.01),Ⅲ-Ⅴ波间期则与B组和C组差异无统计学意义(P>0.05);B组各波潜伏期、波间期与C组比较差异均无统计学意义(P>0.05)。三组中反应阈相同者波潜伏期比较:A组波Ⅰ、Ⅲ、Ⅴ潜伏期仍明显长于B组和C组(P<0.05)。结论婴儿中耳功能异常时大部分ABR反应阈升高,以轻中度异常为主,均有波Ⅰ潜伏期延长;波Ⅰ潜伏期明显延长对判断婴儿中耳功能异常有意义。     

听力正常孤独症谱系障碍儿童的听性脑干反应波形特征分析

目的 探究听力正常孤独症谱系障碍(autism spectrum disorder, ASD)儿童的听性脑干反应(ABR)特征及各波潜伏期和波间期与ASD严重程度分级的关系。方法 (1)将55例(110耳)听力正常ASD儿童和月龄、性别相匹配的55例(110耳)典型发育(typical development, TD)儿童,按月龄分为≤24月龄(22耳)、25～36月龄(40耳)、37～48月龄(28耳)及>48月龄(20耳)四个亚组。比较听力正常ASD儿童与TD儿童的ABR潜伏期和波间期是否存在差异。(2)根据第五版精神障碍诊断与统计手册(DSM-V)将ASD儿童按照严重程度分级,探究听力正常ASD儿童ABR各波潜伏期和波间期与其严重程度分级是否相关。结果 (1)≤24月龄时,ASD与TD儿童ABR各波潜伏期及波间期差异均无统计学意义(P>0.05);(2)25～36月龄时,与TD儿童相比,听力正常ASD儿童波Ⅲ潜伏期及Ⅰ-Ⅲ、Ⅰ-Ⅴ波间期显著延长;37～48月龄时波Ⅲ、Ⅴ潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期显著延长;>48月龄时波Ⅴ潜伏期及Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期显著...     

小型猪与人类听性脑干电位的特性比较

目的分析听力正常的小型猪听性脑干诱发电位(auditory brainstem response,ABR)波形图,并与人类的ABR波形图进行比较;方法选取15只听力正常的小型猪,分别在10日龄、30日龄、60日龄的时候给予短声(click)和短纯音(toneburst)刺激,并记录相应ABR波形图;结果 1小型猪可记录到分化出7个波的ABR波形图,以Ⅴ波的出现作为判断阈值的标志,阈值在25-30dB SPL水平,敏感频率为2kHz,可测定阈值的频率范围在1-48kHz;2小型猪ABRⅠ、Ⅱ、Ⅳ、Ⅴ波的潜伏期及Ⅱ-Ⅴ间期10日龄是分别为1.53±0.18、2.60±0.16、3.36±0.22、4.76±0.21、2.16±0.14(ms),30日龄时分别为1.68±0.23、2.79±0.33、3.47±0.32、4.97±0.32、2.17±0.30(ms),60日龄的潜伏期分别为1.71±0.22、2.74±0.23、3.45±0.25、4.82±0.22、2.08±0.23(ms);随年龄增大潜伏期先延长后缩短,10日龄的潜伏期与30日龄之间存在统计学差异,但与60日龄之间并无统计学差异;3小型猪左右两侧ABR的潜伏期、幅值等均略有差异,但并无显著性统计学差异;结论小型猪的ABR波形图与人类极为相似,并且可能具有相似的来源,因此可以选择小型猪作为研究人类听力特点的模型动物。     

90岁以上老年性聋患者的听性脑干反应

目的分析90岁以上老年性聋患者听性脑干反应(ABR)的特征。方法对14例90岁以上老年性聋患者(平均年龄91.1.4±1.3岁,26耳)进行交替短声ABR测试。听力正常人9例(平均年龄22.7±1.2岁,18耳)作为对照组。观测Ⅰ、Ⅲ、Ⅴ波的峰潜伏期(PeakLatency,PL)和Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期(Inter-PeakLatency,IPL),并分别与对照组总体均数进行比较。结果总体的I波引出率和III波引出率均为76.9%(20/26),V波引出率为84.6%(22/26)。高龄老年性聋组各波PL较对照组延长。Ⅰ-Ⅲ波IPL、Ⅲ-Ⅴ波IPL、Ⅰ-Ⅴ波IPL无组间统计学差异。结论 90岁以上高龄老年性聋患者ABR波形分化较差。     

Obstructive Sleep Apnea–Hypopnea Ssyndrome and Hearing in Children

ObjectiveTo explore the relationship between hypoxemia and hearing in children with obstructive sleep apnea–hypopnea syndrome. Methods Auditory brainstem responses (ABRs) were recorded in 68 ears and distortion product otoacoustic emissions (DPOAEs) in 60 ears in children with OSAHS and type “A” tympanograms, and in 30 ears in normal children.ResultsABR latencies of waves I, III and V, and I–III, III–V and I–V intervals were not statistically different between OSAHS and normal children. Wave I latency was delayed in children with OSAHS compared to normal children3 (P < 0.05). DPOAE amplitudes in children with mild OSAHS were lower than normal children at 8 kHz (P < 0.05). DPOAEs were lower at 6 kHz and 8 kHz in children with moderate/severe OSAHS than normal children (P < 0.05).ConclusionCochlear function was affected when AHI was at or greater than 10/hour. ABR and DPOAE can be used to detect early changes in auditory function in children with OSAHS.     

Auditory brainstem evoked responses in insulin-dependent (ID) and non-insulin-dependent (NID) diabetic subjects with normal hearing

Hearing impairment has been reported to be one of the late complications of diabetes mellitus (DM), and the frequency varies. Previous data suggest that auditory brainstem potentials deteriorate long before the hearing impairment appears in patients with DM. Delay in neural conductance along the auditory pathway due to DM was assessed by means of auditory brainstem response (ABR) in 43 patients with normal hearing in a controlled study. Patients were classified according to age, presence of neuropathy, metabolic control, and duration and type of DM. ABR recordings revealed that absolute latencies of waves I, III and V were prolonged significantly in the diabetic group when compared to the control group ( p < 0.05). When two diabetic groups (insulin-dependent and non-insulin-dependent) were compared with each other, the difference between the latency of wave I and the inter-peak latencies of I–III, III–V and I–V was not significant ( p > 0.05). However, the difference between the latencies of waves III and V in the two diabetic groups was statistically significant. The duration of diabetes, blood glucose level and age were not associated with prolonged ABR latencies ( p > 0.05). Prolongation of latency of ABR in patients with DM should alert us to possible damage to the auditory nerve, and close follow-up is needed in these patients.     

阻塞性睡眠呼吸暂停低通气综合征患者不同刺激率ABR结果分析

目的：探讨高刺激率ABR对阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea－hypopnea syndrome,OSAHS）患者听力评估的价值及其与低氧血症的相关性。方法对39例（78耳）OSAHS患者（中度5例、重度34例）和34例（68耳）正常成年人分别进行11．1、31．1、51．1次/秒刺激率的听性脑干反应（ABR）测试,比较组间结果,并与多导睡眠监测呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSaO2）、平均血氧饱和度（MSaO2）、氧饱和度≤90％的时间占总监测时间的百分比（SIT90）、氧饱和度≤80％的时间占总监测时间的百分比（SIT80）进行相关性分析。结果在11．1次/秒刺激率时OSAHS组ABR波Ⅴ潜伏期（5．79±0．22 ms）较对照组（5．67±0．24 ms）延长;31．1次/秒刺激率时OSAHS组ABR 波Ⅰ潜伏期（1．85±0．18 ms）、波Ⅴ潜伏期（5．98±0．19 ms）均较对照组（分别为1．76±0．16 ms、5．82±0．24 ms）延长;在51．1次/秒刺激率时OSAHS组ABR波Ⅰ潜伏期（1．94±0．26 ms）、波Ⅴ潜伏期（6．09±0．25 ms）较对照组（分别为1．83±0．15 ms、5．99±0．24 ms）延长。刺激率由11．1次/秒升高至31．1次/秒时,OSAHS 组波Ⅰ潜伏期延长,ΔⅠ31．1－11．1（0．12±0．17ms）较对照组（0．07±0．11 ms）长,刺激率由11．1次/秒升高至51．1次/秒时,OSAHS组波Ⅰ潜伏期延长,ΔⅠ51．1－11．1（0．21±0．25 ms）较对照组（0．15±0．10 ms）长。ΔⅠ31．1－11．1与LSaO2负相关（r＝－0．24）,与SIT90（r＝0．23）、SIT80（r＝0．27）正相关;ΔⅠ51．1－11．1与LSaO2（r＝－0．33）、MSaO2（r＝－0．35）负相关,与SIT90（r＝0．37）、SIT80（r＝0．29）正相关;以上差异及相关性均有统计学意义（p＜0．05）。结论高刺激率ABR可发现中度及重度OSAHS患者耳蜗及听神经近耳蜗段的损伤。     

Auditory brainstem evoked responses in insulin-dependent (ID) and non-insulin-dependent (NID) diabetic subjects with normal hearing

Hearing impairment has been reported to be one of the late complications of diabetes mellitus (DM), and the frequency varies. Previous data suggest that auditory brainstem potentials deteriorate long before the hearing impairment appears in patients with DM. Delay in neural conductance along the auditory pathway due to DM was assessed by means of auditory brainstem response (ABR) in 43 patients with normal hearing in a controlled study. Patients were classified according to age, presence of neuropathy. metabolic control, and duration and type of DM. ABR recordings revealed that absolute latencies of waves I, III and V were prolonged significantly in the diabetic group when compared to the control group (p < 0.05). When two diabetic groups (insulin-dependent and non-insulin-dependent) were compared with each other, the difference between the latency of wave I and the inter-peak latencies of I-III, III-V and I-V was not significant (p > 0.05). However, the difference between the latencies of waves III and V in the two diabetic groups was statistically significant. The duration of diabetes, blood glucose level and age were not associated with prolonged ABR latencies (p > 0.05). Prolongation of latency of ABR in patients with DM should alert us to possible damage to the auditory nerve, and close follow-up is needed in these patients.     

听性稳态诱发反应在听力异常婴儿的诊断意义

目的听性稳态诱发反应（auditory steady—statere sponse，ASSR）新技术与视觉强化测听（vision reinforcement audiometry，VRA）阈值的相关性分析研究，探讨听神经病症侯群及其鉴别诊断。方法10例（20耳）对照组，年龄6～12个月，测得ASSR和VRA的正常阈值。16例（26耳）异常听力组患儿（年龄在3～6个月），根据其所患疾病分为3个亚组：Ⅰ组为早孕感染组5例（8耳），Ⅱ组为窒息缺氧组5例（10耳），Ⅲ组为高胆红素血症组6例（8耳），检测畸变产物耳声发射（DPOAE）、听性脑干反应（ABR）潜伏期、肌反射值与ASSR和VRA及其相关性结果对照。结果Ⅰ组中2例次（2耳次）为单纯疱疹病毒感染。5例次（8耳次）DPOAE消失，4例次（6耳次）ABR波Ⅰ潜伏期延长、Ⅰ—Ⅴ波间潜伏期缩短，3例次（6耳次）500Hz和1000Hz的镫骨肌反射正常，2例次（2耳次）镫骨肌反射阈偏高，初步推测单纯耳蜗性病变，排除听神经病可能，测得ASSR平均估计阈值与VRA平均阈值具有很好的相关性（r=0．95～0．98）。Ⅱ组中4例次（8耳次）畸变产物耳声发射消失，其中1例次（2耳次）ABR波Ⅰ、波Ⅲ、波Ⅴ消失和肌反射消失，3例次（5耳次）ABR波Ⅰ消失和波Ⅲ及波Ⅴ潜伏期延长，以及肌反射消失。2例次（3耳次）Ⅰ-Ⅲ波间潜伏期延长，肌反射也消失。推测可能为听神经病症侯群（耳蜗至脑干下听觉传导通路受损）伴有耳蜗功能障碍，测得ASSR平均估计阈值与VRA平均阈值具有较好的相关性（r=0．72～0．84）。Ⅲ组中6例次（8耳次）DPOAE存在，4例次（5耳次）ABR波Ⅰ、Ⅲ、Ⅴ和肌反射消失，2例次（3耳次）Ⅰ—Ⅴ波间潜伏期延长，镫骨肌反射阈正常偏高，初步分析推测为听神经病症侯群病损在脑干以上，测得ASSR平均估计阈值与VRA平均阈值具有很弱的相关性（r=0．43～0．64），ASSR阈值和VRA阈值不一致，进一步说明这组的病损应该在脑干或皮层。3个亚组的每个频率（0．25、0．5、1、2,4kHz）平均ASSR和VRA阈值差值比较，差异都具有统计学意义（F检验，P〈0．05、P〈0．01、P〈0．01、P〈0．05、P〈0．05）。结论通过ASSR阈值和VRA阈值相关性技术研究或许可提供诊断及鉴别诊断在各种频率听力障碍婴儿的听神经病症侯群（病变高位）、听神经病症侯群伴有耳蜗功能障碍（病变低位）以及单纯耳蜗性病（非听神经病）。     

阻塞性睡眠呼吸暂停低通气综合征的听性脑干反应特征

目的:分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的听性脑干反应(ABR)特征,探讨OSAHS对听觉通路的影响及其机制。方法:应用PSG对72例具有打鼾症状的患者进行检测并分为单纯鼾症组与OSAHS组,另选无打鼾症状的正常人为对照组,对3组的ABR进行分析。结果:OSAHS组波Ⅰ、Ⅴ潜伏期延长及波Ⅴ反应阈增高,与单纯鼾症组和对照组比较,差异均有统计学意义(均P<0.01)。结论:OSAHS的ABR主要表现为波Ⅰ、Ⅴ潜伏期延长及波Ⅴ反应阈增高,说明OSAHS对听觉通路的影响主要在耳蜗,而对脑干部位的影响尚不明确。     

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.     

高刺激速率听性脑干反应实验室正常参考值研究*

目的获得正常青年的高刺激速率(high stimulus rate)听性脑干反应(ABR)实验室正常参考值范围并分析其特点,为诊断后循环缺血提供参考依据.方法对20例听力正常青年(男女各10例,共40耳)分别进行刺激速率为11.1次/s和51.1次/s的ABR检测,比较两种不同刺激速率下I、III、V波的潜伏期(peak latency,PL),I~III、III~V、I~V波间期(inter-peak latency,IPL)和波间期的差值(ΔIPL),并对测试的结果进行统计分析.结果刺激速率为11.1次/s时波I、III、V的PL分别为1.33±0.07、3.57±0.18、5.51±0.23 ms;I~III、III~V、I~V的IPL分别为2.25±0.19、1.93±0.16、4.18±0.21 ms.刺激速率为51.1次/s时波I、III、V的PL分别为1.44±0.06、3.74±0.16、5.80±0.18 ms;I~III、III~V、I~V的IPL分别为2.31±0.14、2.06±0.12、4.36±0.17 ms.高低刺激速率下I~III、III~V、I~V的ΔIPL分别为0.06±0.08、0.13±0.10、0.18±0.09 ms.不同刺激速率下I~V的ΔIPL实验室正常参考值范围为△I~V<0.328 ms.结论随刺激声速率升高,ABR各波PL、IPL、ΔIPL均会延长.本文提出了听力正常的青年人不同刺激速率下ABR各波潜伏期、波间期和I~V波间期差值的实验室正常参考值范围,为后循环缺血患者的早期诊断提供参考依据.     

唇腭裂患儿的听觉脑干反应检测

目的：研究唇腭裂患儿听力损失的特点。方法：对68例（136耳）腭裂、70例（140耳）唇腭裂患儿进行ABR测试,均按年龄分为3组（〈6个月,6～12个月,13～24个月）,并与80例（160耳）同样分为3组的正常对照组儿童进行比较。结果：91．9％腭裂及89．3％唇腭裂患儿存在听力障碍,且大部分为中重度听力障碍,其各波潜伏期及反应阈值均较正常儿童明显延长和增加,12个月以下腭裂、唇腭裂患儿其Ⅰ～Ⅴ波波间期与正常儿童比较差异无统计学意义,13～24个月腭裂、唇腭裂患儿其Ⅰ～Ⅴ波波间期与正常儿童比较差异有统计学意义。腭裂与唇腭裂患儿比较差异无统计学意义,两组患儿听觉阈值均随年龄的增长而降低。腭裂患儿Ⅴ波引出率及唇腭裂患儿Ⅰ、Ⅲ、Ⅴ波引出率均随年龄增大而提高。结论：大部分唇腭裂患儿存在听力障碍,因此要早期发现,及时治疗和干预,但由于婴幼儿的中枢神经系统还处于一个不断发育成熟的阶段,所以需要动态的听力客观评估。