0～6岁正常儿童骨导听性脑干反应的特征分析

摘要

目的 研究0～6岁听力正常儿童骨导听性脑干反应(bone conduction auditory brainstem responses,BC-ABR)的特征,探讨BC-ABR在儿童听力损失评估中的作用.方法 对30例0～6岁听力正常儿童(0～岁、1～岁、3～6岁各10例20耳)进行短声气、骨导ABR检测,对检测结果进行统计分析.结果 ①在阈值及阈上强度下,BC-ABR波形与气导波形相似,刺激声强度为30 dB nHL时波Ⅰ、Ⅲ、Ⅴ引出率分别为28.3%、48.3%和100%.BC-ABR波V反应阈为5.95±4.80 dB nHL,潜伏期为6.94±0.45 ms.不同性别间BC-ABR波V阈值和潜伏期差异均无统计学意义(P>0.05).②0～岁、1～岁和3～6岁儿童BC-ABR波V阈值分别为10.36±4.34,6.03±2.99和5.83±3.03 dB nHL;波V潜伏期分别为7.14±0.41、6.79±0.44和6.86±0.40 m5,0～岁组波V阈值较1～岁和3～6岁组高,潜伏期较1～岁和3～6岁组延长,差异有统计学意义(P<0.05);1～岁和3～6岁组间波V阈值和潜伏期差异均无统计学意义(P>0.05).结论 短声刺激时可记录到清晰稳定的BC-ABR波形,在阈值及阈上强度下,其波形与气导ABR波形相似;对婴幼儿听力筛查,儿童听力损失性质的判断有重要参考价值.%Objective To study the characteristic of bone —conduction click —evoked auditory brain stem responses in 0～6 years old children with normal hearing and to evaluate the clinical value of its application. Methods Air— and bone—conduction click—evoked ABRs in 30 normal children(0～ years, 1 ～ years, 3～ 6 years every 10 cases )were recorded using MCU—90 auditory evoked potential system and compared sex and age differences in BC —ABR. The ABR data were statistically analyzed with SPSS 13.0. Results The wave forms of bone—conduction ABR were almost the same as those of air—conduct at the threshold or above. The detection rates of Wave Ⅰ ,Ⅲ and V were 28.3％、48.3％and 100％,respectively at 30 dB nHL. The thresholds to bone —conducted click—e voked ABR were 5. 95±4.80 dB nHL and the wave V latencies were 6. 94±0.45 ms. There were no significant differences between male and female for the threshold( male/female: 5.97±4.73 / 6. 15±5. 10 dB nHL) and the wave V latencies (male/female:6. 93±0. 41/6. 98±0. 46 ms). For aged 0～ years, 1～ years and 3～6 years children, the thresholds to bone —conducted click—evoked ABR were 10. 36±4.34, 6. 03±2.99, 5. 83±3.03 dB nHL and the wave V latencies were 7. 14±0.41, 6. 79±0.44, 6. 86±0.40 ms. There were no statistically significant differences between the threshold and latencies of bone —conducted click—evoked ABR to 1～3 years old group and 3～6 years old group . When comparing other age groups, the wave V latency were prolonged and the threshold higher to bone — conducted click— evoked ABR in 0～ 1 years old children. Conclusion The bone— conduction ABR is a valuable and effective method in children＇s hearing test with special values in newborn hearing screening, assessment and identification of hearing loss.