同步多频听觉稳态诱发反应与听性脑干诱发电位相关性研究

目的探讨同步多频听觉稳态诱发反应(auditory steady-state responses to multiple simultaneous stimuli,MSS-ASSR)与听性脑干诱发电位(auditory brainstem response audiometry，ABR)的关系。方法受试者为不同程度听力损失的儿童70名(140耳)，年龄范围为3月龄～6岁。测试状态为水合氯醛镇静睡眠。仪器采用美国INTELLEGENT HEARING的诱发电位仪，MSS-ASSR及ABR测试的软件分别为SMART ASSR和SMART EP，刺激声信号的载波频率为0．5kHz、1kHz、2kHz及4kHz。左耳上述各个载波频率的调制频率分别为77Hz、85Hz、93Hz、101Hz，右耳为79Hz、87Hz、95Hz、103Hz。测试时，双耳八个调幅调制声信号经ER-3A标准插入式耳机同时给出。ABR的刺激声为短声，极性为交替波，刺激速率为19．3次／分，耳机也是ER-3A插入式耳机。受试儿先进行ABR测试、然后进行MSS-ASSR的测试，分别以降10升5法得出二者的反应阈。将MSS-ASSR 0．5kHz、1kHz、2kHz和4kHz的反应阈与ABR反应阈比较，以SPSS 10．0软件进行相关性分析。结果除去58耳ABR无反应外，剩余82耳ABR反应阈与MSS-ASSR 0．5kHz、1kHz、2kHz、4kHz的反应阈相关性具有显著性意义(P=0．000)。Pearson相关系数分别为0．757，0．854，0．906，0．912。结论MSS-ASSR作为儿童听力定量诊断的客观方法有很大的临床应用价值。

The correlation between auditory steady-state response to multiple simultaneous stimuli and ABR

OBJECTIVE To explore the correlation between the reponse thresholds of ABR and auditory steady-state reponse(ASSR) to multiple simultaneous stimuli.METHODS The subjects were 70 children(140 ears) with variant degree of hearing loss coming to our clinic or being referred from the neonate hearing screening program.Their age ranged from 3 months to 6 years old.AII the subjects were sedated by Hydrate Chloride during testing. The equipment and software were SMART EP and SMART ASSR from INTELLIGENT HEARING.Simultaneous carrier tones(0.5 kHz,1 kHz,2 kHz.and 4 kHz),modulated at different frequencies of 77 Hz,85 Hz,93 Hz,101 Hz in left ear and 79 Hz,87 Hz,95 Hz, 103 Hz in right ear,were presented bin-aurally by the standard ER-3A insert phones the same time.Stimuli of ABR.also presented by insert phones.were clicks with alternating polarity and stimulation rate of 19.3 pulses per second.Down 10 up 5 method was adopted for threshold searching both for ABR and ASSR of each subject. Reponse thresholds of 0.5 kHz,1 kHz,2 kHz,4 kHz of ASSR were compared with that of ABR respectively to get the correlation factors.The statistical analysis was made by SPSS 10.0. RESULTS There were 58 ears without reponse. The correlation coefficient between the thresholds of ABR and 0.5 kHz,1 kHz,2 kHz,4 kHz of ASSR in the remaining 82 ears were as follows:0.757,0.854, 0.906,0.912.CONCLUSION ASSR is proved to be a good tool for hearing assessment in children.