听性脑干反应与40Hz听觉相关电位综合评估听觉阈值

目的 探索应用听性脑干反应(auditory brain stem response,ABR)和40Hz听觉相关电位(40Hz auditory event related potential,40Hz AERP)来客观评估听阈的最佳方法.方法 对120例受试者分别测出其平均听阈和ABR阈值、40Hz AERP阈值,共获得资料可靠完整的86耳用于实验分析.将86耳根据听力曲线的类型分为下降型29耳、上升型20耳和水平型37耳三种.用SPSS软件分别对3组数据进行统计学处理,并进行多元回归分析,建立三种数学模型,并进行简化和检验.最后另选10例新的受试者对得到的公式进行均方差可靠性检验.结果 3组平均听阈与ABR阈值和40Hz AERP阈值具有显著线性相关性(r2=0.932,0.944,0.934).建立的三种模型分别为:水平型,平均听阈=ABR阈值;下降型,平均听阈=1/3(40HzAERP) 2/3ABR;上升型,平均听阈=2/3(40HzAERP) 1/3ABR.均方差检验显示公式法优于ABR法.结论 利用ABR阈值和40Hz AERP阈值通过三种回归方程较单纯应用ABR阈值能够更准确的估计受试者的平均听阈,可以尝试用于评估婴幼儿及不能主动配合的受试者的听阈.

Synthetic evaluation of hearing threshold with auditory brainstem response and 40Hz auditory event related potential

OBJECTIVE To find the best way to evaluate the hearing threshold with the objectivethresholds of auditory brainstem response(ABR) and 40Hz auditory event related potential(40Hz AERP) . METHODS Pure tone audiometry,ABR and 40Hz AERP detection were performed in 120 recipients from whom 86 ears were available to be analyzed. According to the styles of configuration of hearing,we divided the 86 ears into 3 groups. There were 37 ears in flat style group,29 ears in descent style group,20 ears in ascent style group. The values were statistically analyzed with SPSS software. Correlations and multiple linear regression analysis were used in each group separately and three kind of mathematic models were established to estimate the subjective auditory thresholds. Then the models were simplified and tested. At last the models were checked out in 10 new recipients separately. RESULTS The pure tone audiometric threshold had good liner correlations with ABR and 40Hz AERP in three groups(R2=0.932,0.944,0.934) . In the flat style group,the subjective average auditory threshold can be estimated by ABR threshold. The predict mathematic model of the descent style group was 1/3(40HzAERP) +2/3ABR and the model of the ascent style group was 2/3(40HzAERP) +1/3ABR. Mean square deviation test showed equation manners were better than ABR means. CONCLUSION We can predict the subjective average auditory threshold more accurately than ABR only from ABR threshold and 40Hz AERP values with the predict mathematic models in young child and patients difficult to be test with subjective audiometry.