畸变产物耳声发射在重度阻塞性睡眠呼吸暂停综合征中的特点及其临床意义

摘要

目的 观察并评估畸变产物耳声发射(DPOAE)检查在重度阻塞性睡眠呼吸暂停综合征(OSAS)患者中的特点并分析其临床意义.方法 选择60例经睡眠呼吸监测确诊为重度OSAS的患者为实验组,年龄、性别与实验组相匹配的正常人群15例作为对照组.应用耳声发射检测仪对两组进行DPOAE检查、纯音测听检查,对睡眠监测及DPOAE检测结果进行分析、比较.结果 重度OSAS患者主观听力无下降,但DPOAE在0.75～8kHz各频率反应幅值较正常对照组明显降低,与正常组比较,其结果有显著性差异;DPOAE反应幅值与血氧饱和度降低及呼吸紊乱指数具有显著的相关性.结论 大部分重度OSAS病人存在不同程度的耳蜗损害,主要表现为畸变产物耳声发射反应幅值的降低,该指标敏感性高,可以作为评估重度OSAS患者早期耳蜗损害的一项指标.%Objective To study the characteristic of distortion-product otoacoustic emissions (DPOAE) in patients with serious OSAHS and anlysis the clinical significance Methods Sixty patients diagnosised as serious OSAHS by PSG in experimental group were compared with fifteen common persons age- and sex- matched subjects in control group. Both groups receiced distortion-product otoacoustic emission and pure tone audiometry testing,The statistical analysis was carried out on the data obtained from the two groups.Results There were no hearing loss among experimental group by using pure tone audiometry ,but the amplitudes of DPOAEs were reduced obviously in the group. There were significant differences between experimental and control groups. Correlation analysis of the results from all subjects revealed significant covariance with oxygen saturation and AHI for amplitude of DPOAE. Conclusion Most patients with serious OSAHS have cochlear damage in some extent, the main change is the ampltitudes of DPOAE reduced, and it is-very sensitive for detecting injured changes in cochlear of the patients with OSAHS.