多频稳态诱发反应应用于中度以上聋儿听力评估的临床分析

目的 探讨多频稳态诱发反应(auditory steady-state response,ASSR)在中度以上聋儿残余听力检测中应用的可能性.方法 检测64例(128耳)听性脑干反应(auditory brainstem response,ABR)阈值＞60 dBnHL的中度以上聋儿在睡眠状态下的ASSR阈值.按ABR阈值将聋儿分为2组:第1组84耳,ABR阈值为61～100 dB nHL;第2组44耳,ABR阚值＞100 dB nHL.将第1组中ASSR在0.5,1.0,2.0,4.0 kHz频度处的阈值分别与ABR阈值作比较,统计分析两者的相关性;计算第2组中ASSR在各个频率的引出率.结果 第1组中,ASSR在O.5,1.0,2.0,4.0 kHz频率处阈值分别与ABR阈值比较,经各相关系数的t检验,P均＜0.01,ASSR阈值与纯音听阈呈线性相关.第2组中,ASSR在0.5,1.0,2.0,4.0 kHz频率处的引出率分别为25.0%,43.1%,34.1%和31.8%,且差异无统计学意义(x2=3.33,P＞0.05).结论 ASSR具有刺激强度大、频率特异性好、测试不受睡眠影响等特点,作为一种客观的测试方法,能够早期快速检测中度以上聋儿的听力水平.

Application of auditory steady-state response in assessing hearing level of children with moderate deafness

Objective To investigate the application of auditory steady-state response （ASSR） in assessing the residual hearing in children with moderate hearing loss. Methods Sixty-four pediatric moderate hearing loss patients （128 ears） with auditory brainstem response （ABR） 〉 60 dB nHL were divided into two groups, group 1 （61 - 100 dB nHL, 84 ears） and group 2 （ 〉 100 dB nHL, 44 ears）. ASSR thresholds at 500, 1 000, 2 000 and 4 000 Hz were all measured under sleep conditions. The correlation between ABR and ASSR threshold in group 1 and the present rates of ASSR at 500, 1 000, 2 000 and 4 000 Hz in group 2 were analyzed statistically. Results In group 1, the ASSR threshold was found to be correlated with ABR threshold（ P 〈0.01 ）. The present rates of ASSR threshold at 500, 1 000, 2 000, and 4 000 Hz were 25.0%, 43.1%, 34. 1% and 31.8% respectively in group 2, but the difference was not significant among them （χ^2 = 3.33 ,P 〉 0.05 ）. Conclusions ASSR is characterized by high intensity stimulus ,frequency specificity and being independent on sleep conditions and thus may serve as a valuable objective measurement in detecting early moderate hearing loss in children.