单侧突聋患者对侧耳高刺激率ABR结果分析

摘要

目的：研究单侧突聋患者对侧耳高刺激率ABR的特点及临床应用价值。方法对40例（40耳）17～45岁单侧突聋患者（病例组）的健耳及同龄听力正常人20例（40耳，对照组）双耳分别进行纯音测听和高（55．1次/秒）、低（11．1次/秒）刺激率听性脑干反应（ABR）检测，以两种刺激率下ABR I -V波间期（interpeak latency ， IPL ）差值（△IPL ）＞0．28为异常，比较两组检测结果及I-V△IPL异常率。结果①病例组健耳和对照组各频率纯音听阈无统计学差异；②病例组健耳高刺激率 ABR波 I潜伏期比对照组明显延长（ P＜0．001），其余各波潜伏期、波间期及波Ⅴ反应阈均无统计学差异；③病例组健耳Ⅰ-Ⅴ波间期差值异常率为62．5％（25/40），对照组为5％（2/40），病例组高于对照组（χ2＝29．574，P＜0．001）。结论单侧突聋患者健耳高刺激率 ABR波I潜伏期明显延长，高、低刺激率ABRⅠ-Ⅴ波间期差异常率明显增加，提示单侧突聋患者对侧耳可能同时存在内耳血供异常。%Objective To analyze the characteristic and the clinical application of high -frequency stimulation ABR for the patients with unilateral sudden deafness .Methods 40 patients aged 17~45 with unilateral sudden deaf-ness(40 health ears ,subject group)and 20 normal volunteers (40 ears ,control group)were selected to receive high and low frequency stimulation ABRs and pure tone audiometry .Results There were no statistical differences be-tween subject group and control group in pure tone audiometry .The wave Ⅰlatency of high -frequency ABR was longer in the subject group than that in the control group(P<0 .001) .The abnormal rate of Ⅰ - Ⅴ interval between high and low frequency stimulation ABRs was 62 .5% (25/40) in the subject group ,and 5% (2/40) in the control group .There were statistical differences between the two groups (χ2 =29 .574 ,P<0 .001) .Conclusion The waveⅠlatency of high-frequency ABR was longer and the abnormal rate of Ⅰ - Ⅴ interval markedly increased in the health ear of patients with unilateral sudden deafness .This may suggest that the contralateral ear may have an ab-normal blood supply of the inner ear when single side sudden deafness happened .High frequency stimulation ABR can be used to detect the potential changes of contralateral ear before the hearing loss occurred .