青中年无眩晕、心脑血管疾病病史的突发性聋患者高刺激率听性脑干反应特征分析

doi:10.6040/j.issn.1673-3770.0.2017.521

摘要/Abstract

摘要： 目的探讨青中年无眩晕、脑血管疾病病史的突发性聋患者高刺激速率听性脑干反应(ABR)的特征。方法将2016年1月至2017年5月就诊的46例青中年突发性聋患者及同期体检的30例听力正常者纳入研究对象。患者均无眩晕、心脑血管疾病病史,单侧发病。对患者患侧、健侧、体检对象双侧进行纯音测听和高(51.1次/s)、低(11.1次/s)刺激速率ABR检测,结果分别纳为患侧组、健侧组、对照组,观察2种刺激速率的ABR Ⅰ~Ⅴ波间期差值(△IPL)水平,比较3组检测结果及异常率。根据患侧△IPL水平,将患者分为患侧正常组、异常组与未引出组,对比3组疗效。根据检测△IPL水平,将患者划分为健侧正常组、异常组与未引出组,对比3组疗效。结果健侧组与对照组纯音听阈检测结果比较,差异无统计学意义(P>0.05)。健侧组、患侧组高刺激速率ABR未引出率及△IPL异常率均高于对照组,差异有统计学意义(P均<0.05)。健侧组中,高刺激速率ABR未引出或△IPL异常者,其患侧亦表现出高刺激速率ABR未引出或△IPL异常。患侧正常组临床疗效明显好于异常组和未引出组,健侧正常组临床疗效明显好于异常组和未引出组,差异均有统计学意义(P均<0.05)。结论青中年无眩晕、心脑血管疾病病史的突发性聋患者,其高、低刺激速率ABR Ⅰ~Ⅴ波△IPL异常或无法引出高刺激速率ABR者较多,且患侧出现上述表现,对侧亦可能存在同样表现。患侧及健侧存在上述表现可能导致患者不良预后。

关键词: 刺激率, 青中年, 突发性聋, 听性脑干反应

Abstract: Objective To investigate the characteristics of auditory brainstem response(ABR)to high-frequency stimulus in young and middle-aged patients with sudden deafness and no history of vertigo or cardiocerebrovascular disease. Methods A total of 46 young and middle-aged patients with sudden deafness and 30 volunteers with normal hearing were enrolled from January 2016 to May 2017. All patients had no history of vertigo or cardiocerebrovascular disease, and all exhibited unilateral onset of sudden deafness. Pure tone audiometry, high-(51.1 times per second)and low-(11.1 times per second)frequency stimulation ABRs were tested for the affected side of patients, the normal side of patients, and both sides of volunteers; the results were categorized as the affected side, normal side, and control groups, respectively. The difference in I-V interpeak latency between high- and low-frequency stimulation ABRs(△IPL)and the rate of ears with abnormalities among the 3 groups were compared. Based on the △IPL of their affected side, patients were subdivided into affected side abnormal, normal, and no △IPL groups; the clinical curative effect was compared among the 3 groups. Based on the △IPL of their healthy side, patients were again subdivided into healthy side abnormal, normal, and no △IPL groups; the clinical curative effect was compared among the 3 groups. Results The test results of pure-tone audiometry were similar in the normal side and control groups(differences between these groups were not statistically significant(P>0.05)). The rate of ears that could not elicit ABRs to high-frequency stimuli and ears with abnormal △IPL in affected side and normal side groups was much greater than the corresponding rate in the control group; these differences were statistically significant(all P<0.05). Patients who could not elicit ABRs to high-frequency stimuli from the normal side exhibited a similar lack of ABRs from the affected side. Patients with abnormal △IPL from the normal side also showed abnormal △IPL from the affected side. The clinical curative effect in the affected side normal group was much better than in the abnormal group and the no △IPL group; these differences were statistically significant(all P<0.05). The clinical curative effect in the healthy side normal group was much better than in the abnormal and no △IPL groups; these differences were statistically significant(all P<0.05). Conclusion For young and middle-aged patients with sudden deafness and no history of vertigo or cardiocerebrovascular disease, it is common to observe abnormal △IPL between high- and low-frequency stimulation ABRs, as well as ears that could not elicit ABRs to high-frequency stimuli. If these characteristics are present on the affected side, they may be present on the healthy side; these characteristics in either side may be associated with a poor prognosis.

Key words: Sudden deafness, Auditory brainstem response, Stimulation rate, Young and middle-aged

中图分类号:

R764.43

陈伟,胡中南,童钊君,李湘宇,刘文君. 青中年无眩晕、心脑血管疾病病史的突发性聋患者高刺激率听性脑干反应特征分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 45-49.

CHEN Wei, HU Zhongnan, TONG Zhaojun, LI Xiangyu, LIU Wenjun. Characteristics of auditory brainstem response to high-frequency stimulus in young and middle-aged patients with sudden deafness and no history of vertigo or cardiocerebrovascular disease[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(5): 45-49.

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