0~6岁听力正常儿童听性脑干反应演化规律及声传导功能异常儿童的特征

李颖; 王雪瑶; 周怡; 金欣; 郑之芃; 史吉峰; 刘海红

doi:10.13201/j.issn.2096-7993.2023.03.014

0~6岁听力正常儿童听性脑干反应演化规律及声传导功能异常儿童的特征

- 国家儿童医学中心(北京)首都医科大学附属北京儿童医院耳鼻咽喉头颈外科儿童耳鼻咽喉头颈外科疾病北京市重点实验室(北京，100045)
基金项目:
北京市百千万人才工程(No：2019A34)、首都卫生发展科研专项项目重点攻关研究项目(首发 2022-1-2023)和高层次公共卫生技术人才培养计划(No：2022-3-016)联合资助

详细信息

通讯作者: 刘海红，E-mail：haihongliu6@aliyun.com

中图分类号: R764.43

收稿日期: 2022-12-08

刊出日期: 2023-03-03

Evolution of auditory brainstem response in 0-6 years old normal hearing children and characteristics of children with abnormal acoustic conduction

- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, Beijing, 100045, China

More Information

Corresponding author: LIU Haihong, E-mail: haihongliu6@aliyun.com

Received Date: 08 December 2022

Publish Date: 03 March 2023

摘要

摘要: 目的探索0~6岁儿童短声诱发听性脑干反应(Click-ABR)潜伏期及波间期的正常参考范围，分析声传导功能异常儿童Click-ABR的临床特征。方法分别对1791例(3582耳)0~6岁听力正常儿童及176例(258耳)声传导功能异常儿童进行Click-ABR。分析不同月龄听力正常儿童Click-ABR各项参数的差异，同时比较声传导功能异常儿童Click-ABR波Ⅴ反应阈与潜伏期及波间期的相关性。结果波Ⅰ潜伏期与月龄不相关，波Ⅲ潜伏期、波Ⅴ潜伏期、波Ⅰ-Ⅲ间期和波Ⅰ-Ⅴ间期均与月龄呈明显负相关; 波Ⅲ潜伏期自25个月起不随年龄增长而缩短，波Ⅴ潜伏期自37个月起不随年龄增长而缩短。声传导功能异常儿童在80 dB nHL刺激声下波Ⅰ潜伏期与听阈呈正相关，波Ⅰ-Ⅲ、Ⅰ-Ⅴ间期与听力正常儿童标准值无差异。结论 0~6岁儿童Click-ABR波Ⅲ、Ⅴ潜伏期及波Ⅰ-Ⅲ、Ⅰ-Ⅴ间期随年龄增长而缩短，本研究建立了本实验室0~6岁不同年龄段儿童Click-ABR潜伏期及波间期的正常参考范围; 结合Click-ABR听阈以及80 dB nHL刺激声下波Ⅰ潜伏期，可初步筛选出声传导功能异常儿童，同时应进一步补充其他听力诊断组合。
- 儿童 /
- 听性脑干反应 /
- 传导性听力损失
Abstract: Objective To explore the normal reference range of Click-ABR latency and interwave period in 0-6 years old children, and to analyze the clinical characteristics of Click-ABR in children with sound transmission function is abnormal.Methods A total of 1791(3582 ears) normal hearing children aged 0-6 years and 176(258 ears) conductive hearing loss children were selected for Click-ABR. The differences of Click-ABR parameters in children of different months were analyzed, and the correlation between the degree of conductive hearing loss and Click-ABR parameters was explored.Results The incubation period of wave Ⅰ was not correlated with the age of month, while the incubation period of wave Ⅲ, wave Ⅴ, waveⅠ-Ⅲ and wave Ⅰ-Ⅴ were highly correlated with the age of month. There was a positive correlation between the latency of wave Ⅰ and hearing threshold in the children with sound transmission function is abnormal under 80 dB nHL stimulation, and there was no difference between the standard values of wave Ⅰ-Ⅲ and Ⅰ-Ⅴ in the children with sound transmission function is abnormal and normal children.Conclusion The latency of ABR wave Ⅲ and Ⅴ, and the interval between wave Ⅰ-Ⅲ and Ⅰ-Ⅴ shorten with the increase of age in children aged 0-6 years. The normal ABR values of children of different ages should be established in each hearing clinic for children as a reference. Combined with Click-ABR threshold and 80 dB nHL acoustic subwave Ⅰlatency, the abnormal conduction function can be preliminatively screened out, which should be further supplemented with other combinations of hearing diagnosis.
- child /
- auditory brainstem response /
- conductive hearing loss

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图 1 不同月龄儿童波Ⅰ潜伏期差异性比较的P值

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图 2 不同月龄儿童波Ⅲ潜伏期差异性比较的P值

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图 3 不同月龄儿童波Ⅴ潜伏期差异性比较的P值

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图 4 不同月龄儿童波Ⅰ-Ⅲ间期差异性比较的P值

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图 5 不同月龄儿童波Ⅰ-Ⅴ间期差异性比较的P值

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图 6 0~6岁声传导功能异常儿童ABR波Ⅴ反应阈与ABR波Ⅰ的对应关系

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图 7 不同听阈的声传导功能异常儿童在刺激强度为80 dB nHL下的典型波形

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表 1 听力正常组和声传导功能异常组儿童年龄分布例

月龄	听力正常组	声传导功能异常组
0	3	0
1	24	0
2	47	1
3	263	16
4	157	12
5	70	7
6	75	13
7	71	9
8	41	5
9	45	7
10	41	6
11	42	9
12	40	9
13~15	103	15
16~18	64	11
19~21	76	8
22~24	94	7
25~30	193	10
31~36	132	12
37~48	140	14
49~60	37	3
61~72	20	2
73~83	13	0

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表 2 0~6岁听力正常儿童ABR波Ⅰ、Ⅲ、Ⅴ潜伏期及波Ⅰ-Ⅲ间期和波Ⅰ-Ⅴ间期的正常参考范围

测试月龄	耳数	波Ⅰ潜伏期	波Ⅲ潜伏期	波Ⅴ潜伏期	波Ⅰ-Ⅲ间期	波Ⅰ-Ⅴ间期
0	6	1.34±0.05	4.02±0.09	6.24±0.07	2.68±0.06	4.90±0.08
1	48	1.36±0.10	4.10±0.24	6.35±0.39	2.75±0.25	4.99±0.40
2	94	1.35±0.11	4.07±0.22	6.25±0.29	2.73±0.20	4.90±0.29
3	526	1.33±0.13	4.00±0.21	6.17±0.26	2.67±0.18	4.84±0.25
4	314	1.34±0.13	3.97±0.20	6.13±0.27	2.63±0.17	4.78±0.26
5	140	1.35±0.14	3.91±0.21	6.05±0.26	2.56±0.18	4.70±0.27
6	150	1.34±0.13	3.87±0.21	5.99±0.27	2.53±0.18	4.65±0.25
7	142	1.32±0.10	3.82±0.24	5.91±0.32	2.51±0.23	4.60±0.32
8	82	1.35±0.14	3.78±0.21	5.83±0.28	2.43±0.16	4.48±0.28
9	90	1.35±0.16	3.74±0.18	5.76±0.25	2.40±0.19	4.41±0.27
10	82	1.32±0.13	3.71±0.18	5.74±0.24	2.39±0.18	4.42±0.26
11	84	1.32±0.12	3.69±0.19	5.73±0.23	2.38±0.15	4.42±0.22
12	80	1.31±0.11	3.66±0.19	5.64±0.25	2.34±0.17	4.32±0.24
13~15	206	1.34±0.16	3.66±0.24	5.65±0.32	2.32±0.21	4.30±0.29
16~18	128	1.35±0.15	3.63±0.20	5.57±0.23	2.29±0.16	4.23±0.21
19~21	152	1.33±0.12	3.60±0.16	5.54±0.21	2.28±0.14	4.21±0.19
22~24	188	1.33±0.12	3.59±0.19	5.52±0.30	2.26±0.19	4.20±0.30
25~30	386	1.33±0.11	3.55±0.16	5.45±0.22	2.22±0.15	4.12±0.21
31~36	264	1.34±0.13	3.56±0.17	5.44±0.23	2.22±0.15	4.09±0.24
37~48	280	1.35±0.13	3.56±0.18	5.39±0.28	2.21±0.15	4.04±0.26
49~60	74	1.36±0.11	3.55±0.15	5.37±0.21	2.20±0.15	4.02±0.21
61~72	40	1.37±0.12	3.60±0.24	5.45±0.44	2.23±0.24	4.08±0.43
73~83	26	1.34±0.13	3.57±0.16	5.33±0.18	2.24±0.14	3.99±0.18

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表 3 声传导功能异常组儿童波Ⅰ-Ⅲ间期与听力正常组标准值间的差异

月龄	听力正常组	声传导功能异常组	P值
2	2.73	2.53	0.51
3	2.67	2.57	0.06
4	2.63	2.66	0.98
5	2.56	2.46	0.58
6	2.53	2.43	0.10
7	2.51	2.43	0.31
8	2.43	2.35	0.63
9	2.40	2.30	0.21
10	2.39	2.26	0.20
11	2.38	2.36	0.80
12	2.34	2.51	0.15
13~15	2.32	2.23	0.14
16~18	2.29	2.17	0.07
19~21	2.28	2.29	0.90
22~24	2.26	2.31	0.68
25~30	2.22	2.24	0.74
31~36	2.22	2.28	0.22
37~48	2.21	2.17	0.31
49~60	2.20	2.06	0.13
61~72	2.23	2.04	0.11

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表 4 声传导功能异常组儿童波Ⅰ-Ⅴ间期与听力正常组标准值间的差异

月龄	听力正常组	声传导功能异常组	P值
2	4.90	4.70	0.11
3	4.84	4.66	0.07
4	4.78	4.78	0.98
5	4.70	4.47	0.54
6	4.65	4.58	0.43
7	4.60	4.48	0.12
8	4.48	4.17	0.16
9	4.41	4.27	0.17
10	4.42	4.23	0.13
11	4.42	4.32	0.39
12	4.32	4.50	0.30
13~15	4.30	4.20	0.21
16~18	4.23	4.07	0.05
19~21	4.21	4.13	0.35
22~24	4.20	4.12	0.43
25~30	4.12	4.08	0.63
31~36	4.09	4.10	0.91
37~48	4.04	3.96	0.10
49~60	4.02	3.89	0.28
61~72	4.08	4.25	0.63

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