生殖激素对正常青年人言语听性脑干反应特性的影响

目的 分析正常青年人生殖激素浓度与言语诱发听性脑干反应(speech-ABR)幅值及潜伏期的相关性,探讨生殖激素对青年人言语听性脑干反应特性的影响.方法 选择纯音听阈、声导抗、短声诱发听性脑干反应(click-ABR)测试均正常的青年35例为研究对象,其中女性17例(27.29±1.83岁),男性18例(28.17±2.50岁),分别行speech-ABR测试,刺激声为/da/音,采用插入式耳机,右耳给声,记录并分析各波潜伏期及波幅,同时检测血清中雌二醇、总睾酮的浓度,分析雌二醇、总睾酮的浓度与speech-ABR各波幅值及潜伏期的相关性.结果 ①女性speech-ABR各波(V、A、D、E、F、O波)潜伏期均比男性短(P<0.05),V/A复合波斜度大于男性,除O波外,女青年speech-ABR其余各波幅值均显著大于男性(P<0.05).②女青年雌二醇水平(118.77±102.66 pg/ml)显著高于男青年(52.91±14.77 pg/ml)(P<0.05),而总睾酮浓度(457.65±140.82 pg/ml)显著低于男青年(3 677.37±1 155.80 pg/ml)(P<0.05).③speech-ABR各波潜伏期与雌二醇浓度呈负相关(P<0.05),相关系数在0.2~0.4之间,与总睾酮浓度呈正相关关系(P<0.05),相关系数在0.4~0.7之间.④speech-ABR各波幅值随雌二醇浓度增加而增大,正向波V波与雌二醇浓度呈正相关,而负向波A、D、E、F及O波呈负相关,相关系数在0.2~0.7之间;speech-ABR各波幅值随总睾酮浓度增加而降低,起始复合波V波、A波及V/A斜率与睾酮的相关系数在0.4~0.6之间,为中度相关(P<0.05);而周期性成分与睾酮浓度的相关性不强,其中D波幅值与总睾酮浓度的相关性无统计学意义(P>0.05),而E波和F波的相关性也只是弱相关(P<0.05);此外,结束波O波幅值与睾酮水平无关(r=0.133, P>0.05).结论 生殖激素水平与speech-ABR的幅值及潜伏期存在一定相关性,可能是导致正常青年人言语诱发听性脑干反应特性性别差异的原因之一.

The Effects of Reproductive Hormones on Speech-evoked Auditory Brainstem Response in Young Adults

Objective To investigate the correlation between reproductive hormone concentration and the amplitude and latency of speech-evoked auditory brainstem response (speech-ABR) in young adults, and to explore the effects of reproductive hormone on the speech processing ability of young people.Methods Speech-ABR of thirty five normal hearing young adults, including seventeen females (27.29±1.83 years old) and eighteen males (28.17±2.50 years old) were recorded.The speech syllable /da/ was transmitted as a stimulus sound to the right ears through insert earphones in speech-ABR test.All participants had air conduction hearing thresholds of 20 dB HL or better across the standard audiometric frequencies (250~8 000 Hz) in both ears, and click-ABRs were also within normal limits.At the same time, the concentrations of estradiol and testosterone in the serum were examined.Results ① Females had a shorter latency than males in transient responses (waves V, A and O) and sustained responses (waves D, E and F) of speech-ABR (P<0.05, respectively).The amplitude of transient response (waves V and A) and sustained response (waves D, E and F) in females was also significantly larger than that in males (P<0.05, respectively), except for amplitude of peak O (P>0.05).The V/A slope in females was significantly steeper than that in males (P<0.05).② Estradiol levels in females (118.77±102.66 pg/ml) were significantly higher than that in males (52.91±14.77 pg/ml) (P<0.05), and the total testosterone concentration in females (457.65±140.82 pg/ml) was significantly lower than that in males (3 677.37±1 155.80 pg/ml) (P<0.05).③ A correlation analysis between speech-ABR and estradiol or total testosterone showed that all peak latencies of speech-ABR in transient responses (waves V, A and O) and sustained responses (waves D, E and F) were negatively correlated with the estradiol concentration (P<0.05 respectively), in which the correlation coefficient was between 0.2~0.4.All peak latencies of speech-ABR were positively correlated with the total testosterone concentration (P<0.05 respectively), in which the correlation coefficient was between 0.4~0.7.④ The amplitudes of speech-ABR increased with estradiol concentration growing, the wave V and estradiol concentrations were positively correlated (P<0.05).The estradiol concentrations showed a significant negative correlation with wave A, D, E, F and O wave (P<0.05 respectively), with a correlation coefficient between 0.2~0.7.On the contrary, the amplitudes of speech-ABR decreased with the increasing of total testosterone concentration, and the wave V, wave A, V/A slope and total testosterone concentration were moderately correlated (P<0.05),with a correlation coefficient between 0.4-0.6.The correlation between the amplitudes of D wave and total testosterone concentration was not statistically significant (P>0.05), and the correlation between wave E and wave F and total testosterone concentration was weakly correlated (P<0.05).In addition, the amplitudes of the wave O were also independent with testosterone levels (r=0.133, P>0.05).Conclusion There are correlations between the level of reproductive hormone and the amplitude and latency of speech-ABR.It is one of the reasons for the gender difference in the brainstem speech coding ability of normal young adult.