Analysis on the correlation of auditory brain/stem response and 40 Hz auditory event related potential by pure tone audiometry in adult patients with sudden deafness
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摘要: 目的 研究听性脑干反应(ABR)及40 Hz听觉诱发电位(40 Hz AERP)在成人突发性聋患者中的价值。方法 治疗前对成人突发性聋患者132例(184耳)进行纯音测听、ABR及40 Hz AERP测试。根据纯音测听听力损失累及的频率和程度, 分为低频下降型(86耳)、高频下降型(60耳)、平坦型(32耳)和全聋型(6耳, 因ABR及40 Hz AERP反应阈引出不全未做统计), 共收集178耳做出统计结果。治疗后再进行纯音测听、ABR及40 Hz AERP测试。结果 治疗前各型听力损失ABR阈值与主观纯音测听500 Hz阈值相关性差(r=0.233, P=0.706), 与1000 Hz阈值相关性较差(r=0.472, P=0.345), 与2000 Hz阈值相关性较好(r=0.878, P=0.021), 与4000 Hz阈值相关性好(r=0.800, P=0.010)。各型听力损失40 Hz AERP阈值与主观纯音测听500 Hz阈值相关性好(r=0.992, P=0), 与1000 Hz阈值相关性较好(r=0.912, P=0.110), 与2000 Hz阈值相关性较差(r=0.210, P=0.690), 与4000 Hz阈值相关性差(r=0.370, P=0.945)。ABR与主观纯音测听在高频相关性高, 40 Hz AERP与主观纯音测听在低频相关性高。结论 ABR及40 Hz AERP共同评估, 能更全面反映成人突发性聋患者的听力损失程度。Abstract: Objective To study the value of auditory brainstem response (ABR) and 40 Hz auditory evoked potential (40Hz AERP) in adult patients with sudden deafness.Methods Pure tone audiometry, ABR and 40 Hz AERP were performed in 184 adult patients with sudden deafness before treatment.According to the frequency and severity of hearing loss revealed by pure tone audiometry, the patients were divided into low-frequency decline type (86 cases), high-frequency decline type (60 cases), flat type (32 cases) and total deafness type (6 cases, statistical analysis were not conducted in this group due to the incomplete elicitation of reaction threshold).Data from 178 ears were collected for statistical results.After treatment, pure tone audiometry, ABR and 40 Hz AERP were performed.Results As for ABR threshold, its correlation with 500 Hz threshold of subjective pure tone test was poor (r=0.233, P=0.706), and was worse with 1000 Hz threshold (r=0.472, P=0.345).ABR threshold was closely correlated with 2000 Hz threshold (r=0.878, P=0.021) and 4000 Hz threshold (r=0.800, P=0.010) of subjective pure tone test.As for 40 Hz AERP threshold, its correlation with 500 Hz threshold of subjective pure tone audiometry was good (r=0.992, P=0), and was better with 1000 Hz threshold (r=0.912, P=0.110).40 Hz AERP threshold was poorly correlated with 2000 Hz threshold (r=0.210, P=0.690) and 4000 Hz threshold (r=0.370, P=0.945) of subjective pure tone audiometry.ABR and subjective pure tone audiometry have high correlation at high frequency, while 40 Hz AERP and subjective pure tone audiometry have high correlation at low frequency.Conclusion ABR and 40 Hz AERP can comprehensively reflect the severity of hearing loss in adult patients with sudden deafness.
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表 1 听力曲线类型及各型PTA值
dB HL 听力曲线类型 PTA 500 Hz 1000 Hz 2000 Hz 4000 Hz 低频下降型 44.18±13.87 33.25±12.04 14.89±4.18 13.43±2.74 高频下降型 21.73±4.18 20.07±6.12 23.27±15.65 56.18±12.94 平坦型 56.67±9.62 58.92±11.51 62.36±10.95 64.27±9.62 全聋型 88.57±7.48 93.57±5.56 94.17±6.90 95.71±6.07 
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