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目的探讨噪声性听力损失的听性脑干反应特点,为职业性噪声聋的诊断提供依据。方法对130名存在听力损失的噪声作业工人(噪声组)和35名非接触噪声的行政人员(对照组)分别进行听性脑干反应(ABR)及纯音听阈测试,然后对结果进行比较分析。结果噪声组波Ⅰ、波Ⅲ的出现率(85.77%、85.77%)均明显低于对照组(100.00%,P<0.05);噪声组左、右耳的各波潜伏期及峰间潜伏期比较,差异均无统计学意义(P>0.05);但与对照组比较,波Ⅲ、波Ⅴ潜伏期明显延长(P<0.001);噪声组工龄<10年和工龄≥10年的ABR各波潜伏期及峰间潜伏期组间比较,差异均无统计学意义(P>0.05);噪声组语频听阈异常者的波Ⅰ潜伏期缩短、波Ⅲ潜伏期延长,与语频听阈正常者比较,差异有统计学意义(P<0.05)。结论噪声性听力损失的ABR具有以下特点:①双耳ABR各波潜伏期和峰间潜伏期基本对称;②噪声可引起ABR波Ⅰ、波Ⅲ的单一缺失或联合缺失;③噪声可引起ABR波Ⅲ、波Ⅴ潜伏期的明显延长,这种改变与工龄无关;④随着听力损失由高频向语频的发展,可出现ABR波Ⅰ潜伏期的缩短和波Ⅲ潜伏期的延长。
Objective To investigate the characteristics of auditory brainstem response to noise-induced hearing loss and provide the basis for the diagnosis of occupational noise-induced hearing loss. Methods A total of 130 noise-exposed workers (noise group) and 35 non-contact noise workers (control group) underwent auditory brainstem response (ABR) and pure tone threshold test. The results were compared and analyzed. Results The incidences of wave Ⅰ and wave Ⅲ in the noise group (85.77%, 85.77%) were significantly lower than those in the control group (100.00%, P <0.05). The differences in latency and peak latency between the left and right ears in noise group were (P> 0.05). However, compared with the control group, wave latency of wave Ⅲ and wave Ⅴ significantly prolonged (P <0.001) (P> 0.05). In the noise group, the latency of wave Ⅰ was shortened and the latency of wave Ⅲ was prolonged, and the difference was statistically significant compared with normal hearing threshold (P <0.05). Conclusion ABR of noise-induced hearing loss has the following characteristics: (1) The latency and peak latency of each wave in ABR are basically symmetrical; (2) Noise can cause single deletion or combined deletion of ABR wave Ⅰ and wave Ⅲ; (3) Wave Ⅴ latency significantly prolonged, this change has nothing to do with the length of service; â ’£ with hearing loss from high frequency to the development of language, there may be shortening of ABR Ⅰ wave latency and wave Ⅲ latency extension.