正常儿童多频稳态诱发电位与纯音测听测试的相关性

正常儿童多频稳态诱发电位与纯音测听测试

的相关性

【摘要】目的：测定正常儿童多频稳态听觉诱发反应（multiple auditory steady state responses，ASSR）阈值及纯音听阈，探讨两者的相关性。方法：对30例（60耳）正常5 10岁儿童分别行ASSR 与纯音测听测试。结果：不同频率ASSR测试值均数与纯音听阈均数差值为11 16.50?dB HL；各频率ASSR测试值与纯音听阈均数间差异均有统计学意义（P＜0.05），在0.25?kHz及0.5?kHz组差异尤为明显（P ＜0.01）。除0.25?kHz及0.5?kHz外，其他频率ASSR测试值与纯音听阈相关系数均有统计学意义（P＜0.05），且随着测试频率的增加，两者的相关关系有增强趋势。结论：正常5 10岁儿童中、高频率ASSR 测试值与纯音听阈有良好的相关性，可应用ASSR预测被检查者纯音听阈。

【关键词】多频稳态诱发电位纯音听阈相关性儿童

［ABSTRACT］ Objective: To determine the threshhold of multiple auditory steady state responses (ASSR) and pure tone audiometry in children aged five to ten with normal hearing, and to explore the correlation between them. Methods: Thirty children with normal hearing had the ASSR and pure tone audiometry determined at 0.25, 0.5, 1, 2, 4 and 8 kHz. The

coherence and correlation between the two groups were determined by the t test and the correlated modulus t test. Results: The different average threshholds of ASSR and pure tone audiometry at all tested frequencies ranged from 11 to 16.50 dBHL. There was a statistical difference between the result obtained by ASSR and pure tone audiometry at all tested frequencies (P＜0.05), especially at 0.25?kHz and 0.5?kHz (P＜0.01). The correlation was significant between the results by ASSR and pure tone audiometry at all tested frequencies (P＜0.05) by using the correlated modulus t test, Conclusion: In the middle or high frequencies, there are good correlations between ASSR and pure tone audiometry. However, there is a numerical value between them. It is feasible to confer the pure tone hearing threshhold of children aged from five to ten by determining the threshhold of ASSR and by using the numerical value.

［KEY WORDS］ Multiple auditory steady state responses；Pure tone audiometry； Correlation； Children

多频稳态听觉诱发反应（multiple auditory steady state evoked responses, ASSR）又称多频稳态听觉诱发电位（auditory steady state evoked potential），是由调制声信号引起的反应相

位与刺激信号的相位具有稳定关系的听觉诱发电位，它具有频率特异性好、刺激强度较大、客观分析结果等优点，已逐步应用于临床，并展现出广阔的应用前景［13］。但在5 10岁正常儿童中，ASSR与纯音测听联合应用及两者间相关性的分析鲜有报道。我们检测了30例正常儿童的ASSR阈值和纯音听阈，并探讨两者的相关性，以期为ASSR的临床应用提供客观依据。

1 资料与方法

1.1 临床资料正常儿童30例（60耳），男17例，女13例；5 10岁，平均（7.5±

2.1）岁。均无耳疾病史、耳毒性药物史、噪声接触史等。鼓室曲线图为A型，声反射阈正常。

1.2 测试方法利用经校准的美国Grason Standler 公司GSI

68型纯音听力计，采用上升法测试气导听阈，测试频率为0.25 8.0?kHz，环境噪声为17.5?dB（A）；ASSR阈值测试采用GSI Audera

ASSR测试系统，测试环境为听力门诊隔声室，背景噪声＜30?dB（A）。ASSR刺激声信号的载波频率为0.25、0.5、1、2、4、8?kHz。左右耳上述各个载波频率的调制频率分别为67、74、81、88、95、102?Hz。双耳单通道分别进行测试。测试时，儿童均处于安静睡眠状态，每耳6个调幅调制声信号经Tip50插入式耳机分别给出。记录电极置于前额正中发际处，双侧乳突为参考电极，鼻根部为地极。电极阻抗＜