山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (1): 43-47.doi: 10.6040/j.issn.1673-3770.0.2021.378

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1 000 Hz声导抗在高危新生儿听力筛查中的应用

倪坤,孙世冰,李晓艳   

  1. 上海市儿童医院 耳鼻咽喉头颈外科, 上海 200062
  • 出版日期:2022-01-10 发布日期:2022-02-22
  • 通讯作者: 李晓艳. E-mail:chhshent@163.com

Application of 1 000 Hz acoustic immittance in hearing screenings of high-risk newborns

NI Kun, SUN Shibing, LI Xiaoyan   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Shanghai Children's Hospital, Shanghai 200062, China
  • Online:2022-01-10 Published:2022-02-22

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摘要： 目的 探讨1 000 Hz声导抗检查联合自动听性脑干反应(AABR),畸变产物耳声发射(DPOAE)检查用于高危新生儿听力筛查的意义。 方法 纳入高危新生儿318例(636耳)作为研究对象,采用AABR+DPOAE+1 000 Hz声导抗三联的听力筛查方案,筛查未通过的新生儿在3个月进行诊断性听力检查,计算三联筛查结果的灵敏度、特异度、漏诊率、误诊率和正确率。其中本研究中三联筛查结果正常包括AABR(-)DPOAE(+)声导抗(+),AABR(-)DPOAE(-)声导抗(+),AABR(-)DPOAE(-)声导抗(-)三种情况,三联筛查异常包括AABR(+)DPOAE(+)声导抗(+),AABR(+)DPOAE(+)声导抗(-),AABR(+)DPOAE(-)声导抗(+),AABR(-)DPOAE(+)声导抗(-),AABR(+)DPOAE(-)声导抗(-)。 结果 共纳入318例高危新生儿(636耳),使用三联筛查的灵敏度(96.77%)高于单一AABR筛查方法(80.64%)和单一DPOAE筛查方法(83.87%),与AABR+DPOAE两联筛查方法(96.77%)灵敏度一致。使用三联筛查的特异度(91.24%)高于AABR+DPOAE两联筛查方法(87.44%),三联筛查方法可进一步降低二联筛查假阳性率,适用于高危新生儿筛查。 结论 1 000 Hz声导抗联合AABR和DPOAE进行高危新生儿听力筛查,筛查灵敏度高,漏诊率低,三联听力检查可应用于高危新生儿听力筛查,早期即可筛出部分单纯中耳功能异常的假阳性婴儿,可一定程度缓解家长焦虑。

关键词: 高危儿, 听力筛查, 自动听性脑干反应, 畸变产物耳声发射, 1 000 Hz声导抗, 联合筛查

Abstract: Objective To explore the significance of the 1 000 Hz acoustic immittance test combined with automatic auditory brainstem response(AABR)and distortion product otoacoustic emission(DPOAE)in hearing screenings of high-risk newborns. Methods A total of 318 high-risk newborns(636 ears)were included as the research subjects. The triple hearing screening scheme of AABR + DPOAE + 1 000 Hz acoustic immittance was adopted. The newborns who failed the screening test were examined for diagnostic hearing at 3 months of age, and the sensitivity, specificity, missed diagnosis rate, false diagnosis rate, and accuracy of the triple screening results were calculated. In this study, the normal triple screening results included AABR(-)DPOAE(+)acoustic immittance(+), AABR(-)DPOAE(-)acoustic immittance(+), and AABR(-)DPOAE(-)acoustic immittance(-). The abnormal triple screening results include AABR(+)DPOAE(+)acoustic immittance(+), AABR(+)DPOAE(+)acoustic immittance(-), AABR(+)DPOAE(-), AABR(-)DPOAE(+)acoustic immittance(-), and AABR(+)DPOAE(-)acoustic immittance(-). Results A total of 318 high-risk newborns(636 ears)were included. The sensitivity of triple screening(96.77%)was higher than that of the AABR-only screening method(80.64%)and DPOAE-only screening method(83.87%), which was consistent with that of the double AABR + OAE screening method(96.77%). The specificity of triple screening(91.24%)was higher than that of AABR + OAE double screening(87.44%). Triple screening can further reduce the false-positive rate of double screening and is suitable for high-risk neonatal screening. Conclusion Triple screening has high sensitivity and a low missed diagnosis rate for hearing screening of high-risk newborns. Triple hearing examinations can be applied to hearing screening of high-risk newborns. Some false-positive infants with simple middle-ear dysfunction can be screened out in the early stage, which can alleviate parental anxiety.

Key words: High-risk infants, Hearing screening, Automated auditory brainstem response, Distortion product otoacoustic emission, 1 000 Hz acoustic immittance, Combined screening

中图分类号: 

  • R764
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