阻塞性睡眠呼吸暂停低通气综合征患者的早期听觉损害评估手段探讨

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的早期听觉损害评估方法。方法对31例(62耳)OSAHS患者和20例(40耳)对照组,分别检测常频(0.125～8 kHz)纯音气骨导和扩展高频(8～16 kHz)气导听阈、瞬态诱发性耳声发射(TEOAE)及畸变产物耳声发射(DPOAE)。结果①常频纯音听阈两组间无显著差异,而扩展高频听阈OSAHS组明显高于对照组(t=3.045～3.779,P=0.000～0.003);②TEOAE检出率OSAHS组为37.1%,而对照组为92.5%,组间差异显著,χ2=30.82,P=0.000;③在各个频率点DPOAE检出率和振幅,OSAHS组明显低于对照组(检出率χ2=22.94～34.31,P=0.000～0.000;振幅t=-2.740～-9.980,P=0.000～0.008)。结论对于OSAHS患者建议用耳声发射、扩展高频测听进行早期听觉损害评估。

Assessment of early hearing loss in patients with obstructive sleep apnea-hypopnea syndrome

OBJECTIVE To investigate the assessment methods of early hearing loss in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）. METHODS 31 patients（62 ears）with OSAHS and 20 persons（40 ears）without OSAHS were tested with conventional audiometry（0.125～8 kHz）, extended high frequency audiometry（8～16 kHz）, transiently evoked otoacoustic emissions（TEOAE）and distortion-product otoacoustic emissions（DPOAE）. RESULTS ①There were no differences in conventional threshold between the two groups. The extended high frequency thresholds increased obviously in OSAHS group（t =3.045～3.779, P=0.000～0.003）; ②The prevalence of TEOAEs in the patients was 37.1%, and 92.5% in the control group. The difference was significant statistically, χ 2=30.82, P=0.000;③The prevalence and amplitudes of DPOAEs were reduced significantly in each frequency point （χ2=22.94～34.31, P=0.000～0.000; t=-2.740～-9.980, P =0.000～0.008）. CONCLUSION Extended high frequency audiometry and otoacoustic emissions can offer the assessment of early hearing loss in patients with OSAHS.