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。

Brain auditory evoked potention in children with severe obstructive sleep apnea hypopnea syndrome

Objective To explore the characteristics of brain auditory evoked potention (BAEP) in children with obstructive sleep apnea hypopnea syndrome with different stimulation frequencies. Method BAEP was determined in 87 OSAHS patients (the OSAHS group) and 20 controls (the control group) with different stimulation frequencies. Results(1) In children with mild and moderate OSAHS, the response threshold of wave Ⅴ and the latency values of waves Ⅰ, Ⅲand Ⅴ were normal at a stimulation of 33.1Hz; the threshold of wave Ⅴ was normal, but the latency values of waves Ⅴ and the transmission time among wavesⅠ, Ⅲ and Ⅴwas found to be prolonged in the moderate OSAHS group with a stimulation of 11.1Hz. (2) A statistically significant elevation was found when compared with the control group, the latency values of waves Ⅴ and the transmission time between waves were found to be prolonged in the severe OSAHS group with stimulations of 33.1Hz and 11.1?Hz. Conclusion Low stimulation frequency can reflect changes of brain stem functions. Pathological sleepiness in OSAHS patients may induce BAEP abnormalities, suggesting that OSAHS effect the latency values of waves and the hearing threshold.