山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (5): 6-10.doi: 10.6040/j.issn.1673-3770.0.2021.404

• 论著 • 上一篇    下一篇

DPOAE与高刺激率ABR在听力正常耳鸣患者中的应用价值

段新艳1,2,宋忠义2,王宁2,訾希存3, 潘新良1,2   

  1. 青岛)耳鼻咽喉头颈外科, 山东 青岛 266035;
    3.山东大学齐鲁医院(青岛)门诊单元, 山东 青岛 266035
  • 发布日期:2022-09-20
  • 通讯作者: 潘新良. E-mail:Panxinlent@126.com
  • 基金资助:
    山东大学齐鲁医院(青岛)科研启动基金(QDKY2018ZD03)

Application value of distortion product otoacoustic emission and high stimulation rate auditory brainstem response in patients with normal hearing tinnitus

DUAN Xinyan1,2, SONG Zhongyi2, WANG Ning2, ZI Xicun3, PAN Xinliang1,2   

  1. 1. Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
    2. Department of Otorhinolaryngology Head and Neck Surgery, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, Shandong, China;
    3. Outpatient Unit, Qilu Hospital of Shandong University(Qingdao), Qingdao 266035, Shandong, China
  • Published:2022-09-20

PDF (PC)

554

摘要： 目的 观察分析听力正常的耳鸣患者畸变产物耳声发射(DPOAE)与高刺激率听性脑干反应(ABR)检测的特征,探讨其在耳鸣评估中的应用价值。 方法 选取耳鼻咽喉科门诊听力正常的青年耳鸣患者31例(46耳)为耳鸣组,另外选取听力结果正常的青年无耳鸣者25例(50耳)为正常对照组,分别进行纯音听阈测定、声导抗测听、DPOAE和高低刺激率ABR的检测,对比两组受试者DPOAE各频检出率和信噪比以及高低刺激率ABR各波潜伏期(PL)、波间期(IPL)、波幅以及两种刺激速率下的潜伏期和波间期差值(△PL和△IPL)。 结果 DPOAE各频检出率两组无显著性差异;信噪比在8 kHz,耳鸣组较对照组降低,差异有统计学意义(P<0.05);高低刺激率ABR结果中,不同刺激速率下两组Ⅰ、Ⅲ、Ⅴ波波幅差异均无统计学意义;高刺激速率下,耳鸣组Ⅰ~Ⅴ IPL较对照组延长,差异有统计学意义(P<0.05),两种刺激速率下,耳鸣组Ⅰ△PL较对照组缩短,差异有统计学意义(P<0.05),耳鸣组Ⅴ△PL、Ⅰ~Ⅴ△IPL较对照组延长,差异有统计学意义(P<0.05)。 结论 DPOAE与高刺激率ABR可作为诊断耳鸣的一种客观检查方法,其对耳鸣的早期评估有重要的应用价值;增加ABR刺激速率,可提高耳鸣检测的敏感性。

关键词: 耳鸣, 高低刺激率, 听性脑干反应, 畸变产物耳声发射

Abstract: Objective This study aimed to observe and analyze the characteristics of distortion product otoacoustic emission(DPOAE)and high stimulation rate auditory brainstem response(ABR)in tinnitus patients with normal hearing and to explore their application value in tinnitus assessment. Methods Thirty-one(46 ears)young tinnitus patients with normal hearing were selected as the tinnitus group, and 25(50 ears)young people without tinnitus with normal hearing results were selected as the normal control group. Pure tone audiometry, acoustic conductance audiometry, DPOAE, and high and low stimulus rate ABR were detected, and the results in the tinnitus and healthy controls were compared. Results We found no significant difference in the detection rate of DPOAE and ABR wave Ⅰ, Ⅲ, and Ⅴ amplitudes with different stimulation rates between the two groups. The signal-to-noise ratio at 8 kHz in the tinnitus group was significantly lower than that in control group. Further, under a high stimulation rate, the Ⅰ~Ⅴ wave interval of tinnitus group was longer than that of the control group, and the difference was statistically significant(P<0.05). At two stimulus rates,the the wave Ⅰ latency difference was shorter and the wave Ⅴ latency difference was longer in the tinnitus group, indicating that the wave Ⅰ~Ⅴ interval difference was longer in the tinnitus group than in the control group(P<0.05). Conclusion DPOAE and high stimulation rate ABR can be used as an objective method to diagnose tinnitus and evaluate early tinnitus. Increasing the stimulation rate of ABR could improve the sensitivity of tinnitus detection.

Key words: Tinnitus, High and low stimulation rate, Auditory brainstem response, Distortion product otoacoustic emission

中图分类号: 

  • R764.45
[1] 刘蓬.如何接诊耳鸣患者[J].中医耳鼻喉科学研究杂志,2011,10(1):23.
[2] 郭焕萍, 杨海弟, 郑亿庆, 等. 2 171例耳鸣患者的临床特征分析[J]. 听力学及言语疾病杂志, 2017, 25(4): 378-381. doi:10.3969/j.issn.1006-7299.2017.04.010. GUO Huanping, YANG Haidi, ZHENG Yiqing, et al. Clinical characteristics of tinnitus: an analysis of 2 171 patients[J]. Journal of Audiology and Speech Pathology, 2017, 25(4): 378-381. doi:10.3969/j.issn.1006-7299.2017.04.010.
[3] 周腊梅, 蒋雯, 刘稳, 等. 持续性特发性耳鸣严重程度的相关因素分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 70-76. doi:10.6040/j.issn.1673-3770.0.2021.009. ZHOU Lamei, JIANG Wen, LIU Wen, et al. Analysis of factors related to the severity of persistent idiopathic tinnitus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 70-76. doi:10.6040/j.issn.1673-3770.0.2021.009.
[4] 杨霞, 高下. 畸变产物耳声发射在听力正常的单侧耳鸣患者中的应用价值[J]. 现代医学, 2015, 43(11): 1399-1402. doi: 10.3969/j.issn.1671-7562.2015.11.019. YANG Xia, GAO Xia. Application of distortion product otoacoustic emission in unilateral tinnitus patients with normal hearing capability[J]. Modern Medical Journal, 2015, 43(11): 1399-1402. doi: 10.3969/j.issn.1671-7562.2015.11.019.
[5] 李国庆, 吕萍, 王秋菊. 隐性听力损失的发病机制及听力学表现[J]. 中华耳科学杂志, 2017, 15(2): 185-190. doi:10.3969/j.issn.1672-2922.2017.02.009. LI Guoqing, LÜ Ping, WANG Qiuju. Pathogenesis and audiologic performances in hidden hearing loss[J]. Chinese Journal of Otology, 2017, 15(2): 185-190. doi:10.3969/j.issn.1672-2922.2017.02.009.
[6] Kemp DT. Otoacoustic emissions, their origin in cochlear function, and use[J]. Br Med Bull, 2002, 63: 223-241. doi:10.1093/bmb/63.1.223.
[7] 李兴启, 王秋菊. 听觉诱发反应及应用[M]. 2版. 北京: 人民军医出版社, 2015: 115.
[8] 邵渊, 安燕, 张少强. 畸变产物耳声发射在听力正常的耳鸣患者中的应用[J]. 山西医科大学学报, 2013, 44(1): 66-68. doi:10.3969/J.ISSN.1007-6611.2013.01.021. SHAO Yuan, AN Yan, ZHANG Shaoqiang. Application of distort product otoacoustic emission(DPOAE)in the tinnitus patients with normal hearing capability[J]. Basic Medical Education, 2013, 44(1): 66-68. doi:10.3969/J.ISSN.1007-6611.2013.01.021.
[9] 陈向红, 李佳, 张驰, 等. 不同病程听力正常耳鸣患者畸变产物耳声发射结果分析[J]. 中华耳科学杂志, 2019, 17(4): 532-535. doi:10.3969/j.issn.1672-2922.2019.04.017. CHEN Xianghong, LI Jia, ZHANG Chi, et al. Distortion product otoacoustic emissions in tinnitus patients with normal hearing[J]. Chinese Journal of Otology, 2019, 17(4): 532-535. doi:10.3969/j.issn.1672-2922.2019.04.017.
[10] Singh S, Munjal SK, Panda NK. Comparison of auditory electrophysiological responses in normal-hearing patients with and without tinnitus[J]. J Laryngol Otol, 2011, 125(7): 668-672. doi:10.1017/S0022215111000569.
[11] Terao K, Cureoglu S, Schachern PA, et al. Cochlear changes in presbycusis with tinnitus[J]. Am J Otolaryngol, 2011, 32(3): 215-220. doi:10.1016/j.amjoto.2010.02.001.
[12] 王铮, 田颖, 姜学钧. 客观听力学测试在纯音听阈正常双侧耳鸣患者中的应用价值[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(23): 1846-1849. doi:10.13201/j.issn.1001-1781.2016.23.003. WANG Zheng, TIAN Ying, JIANG Xuejun. Application of objective audiological tests in bilateral tinnitus patients with normal hearing capability[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(23): 1846-1849. doi:10.13201/j.issn.1001-1781.2016.23.003.
[13] 刘永新, 谷京城. DPOAE异常而听力正常耳鸣患者的临床分析[J]. 听力学及言语疾病杂志, 2010, 18(2): 106-107. doi:10.3969/j.issn.1006-7299.2010.02.005.
[14] Zuccotti A, Kuhn S, Johnson SL, et al. Lack of brain-derived neurotrophic factor hampers inner hair cell synapse physiology, but protects against noise-induced hearing loss[J]. J Neurosci, 2012, 32(25): 8545-8553. doi:10.1523/JNEUROSCI.1247-12.2012.
[15] Polyakov A, Pratt H. The cumulative effect of high click rate on monaural and binaural processing in the human auditory brainstem[J]. Clin Neurophysiol, 2003, 114(2): 366-375. doi:10.1016/s1388-2457(02)00372-3.
[16] 钟乃川, 宋江顺, 金晶, 等. 高刺激率听性脑干反应诊断椎基底动脉短暂缺血性眩晕的临床应用[J]. 耳鼻咽喉头颈外科, 1994, 1(2): 71-74. doi:10.16066/j.1672-7002.1994.02.002. ZHONG Naichuan, SONG Jiangshun, JIN Jing, et al. Study on the clinical application of auditory brainstem response with high stimulus rates in patients suffering from vertebro-basilar transient ischemic Vertigo[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 1994, 1(2): 71-74. doi:10.16066/j.1672-7002.1994.02.002.
[17] 钟乃川. 椎基底动脉短暂缺血性眩晕的听性脑干反应与经颅多普勒检查[J]. 中华耳鼻咽喉科杂志, 1996, 31(2): 86-88. doi:10.13201/ji.sn. 2096-7993.2020.07.023. ZHONG Naichuan. The correlation of auditory brain stem response and transcranial doppler on the vertebrobasilar transientischemic vertigo[J]. Chinese Journal of Otorhinolaryngology, 1996, 31(2): 86-88. doi:10.13201/ji.sn. 2096-7993.2020.07.023.
[18] 黄丽辉. 隐性听力损失及早期识别[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(7): 668-671. doi:10.13201/j.issn.2096-7993.2020.07.023. HUANG Lihui. Hidden hearing loss and early identification[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(7): 668-671. doi:10.13201/j.issn.2096-7993.2020.07.023.
[19] 胡鸿, 史波宁. Ⅴ波潜伏期差值与Ⅰ-Ⅴ波间期差值的关系研究[J]. 中华耳科学杂志, 2016, 14(3): 370-373. doi:10.3969/j.issn.1672-2922.2016.03.011. HU Hong, SHI Boning. Relationship between high/low stimulation rate ABR wave Ⅴ latency differential and Ⅰ-Ⅴ inter-peak latency differential[J]. Chinese Journal of Otology, 2016, 14(3): 370-373. doi:10.3969/j.issn.1672-2922.2016.03.011.
[20] 邱泽恒, 梁象逢, 王培, 等. 青年急性耳鸣高刺激率ABR的检测及临床意义[J]. 中华耳科学杂志, 2009, 7(3): 191-193. doi:10.3969/j.issn.1672-2922.2009.03.004. QIU Zeheng, LIANG Xiangfeng, WANG Pei, et al. High stimulus rate auditory brainstem responses in young patients with acute tinnitus[J]. Chinese Journal of Otology, 2009, 7(3): 191-193. doi:10.3969/j.issn.1672-2922.2009.03.004.
[21] 张静,郭英,许轶,等.高刺激率听性脑干反应评估前庭性偏头痛患者听觉脑干传导通路的意义[J].听力学及言语疾病杂志, 2022, 30(2):164-167. doi:10.3969/j.issn.1006-7299.2022.02.013. ZHANG Jing, GUO Ying, XU Yi, et al. The Use of ABRs with High Stimulation Frequency Rates in Patients with Vestibular Migraine[J]. Journal of Audiology and Speech Pathology, 2022, 30(2):164-167. doi:10.3969/j.issn.1006-7299.2022.02.013.
[1] 高奇歌,张华. 搏动性耳鸣的治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 95-101.
[2] 凌雯琛,陈佳旭,徐智辉,郑伟,刘广宇,赵鑫宇,黄平. 基于R语言数据挖掘技术对黄平教授治疗耳鸣用药规律及诊疗特色[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 8-19.
[3] 王莹,蔡燕文. 以听力减退为主要表现的中枢神经系统表面铁沉积症1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 89-96.
[4] 董雪林,张治军. 掩蔽声治疗慢性主观性耳鸣的焦虑抑郁状态分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 18-24.
[5] 郭振平,李雪冰. 慢性主观性耳鸣患者心理特征、睡眠质量调查及与临床效果相关性[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 1-7.
[6] 陈丹萍,何子键,虞幼军,周晓娓. 儿童突发性聋10年住院病例的疗效及预后相关因素分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 16-22.
[7] 卜苓南,李茂才,宫丽丽. 以搏动性耳鸣就诊的外伤性颞浅动静脉瘘1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 101-104.
[8] 陈倬诣,郑亿庆,杨海弟. 慢性主观性耳鸣分类、发生发展机制及治疗新进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 1-12.
[9] 罗伊雯,肖永涛,高敏倩,杨嘉仪,杨海弟. 慢性主观性耳鸣的声治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 13-23.
[10] 张红,李欣. 中枢神经系统活动异常在耳鸣发生中的作用与机制[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 24-29.
[11] 董洪松,王春丽,俞艳萍,陈涛,聂国辉. 声音疗法联合药物治疗慢性主观性耳鸣的临床随机对照研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 30-37.
[12] 许海艳,曹卫,范大川. 多元复合声治疗对突聋患者耳鸣的疗效分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 38-45.
[13] 吴波,黄天德,闫斌,陈伊,汤勇. 焦虑抑郁状态与特发性耳鸣预后的相关性研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 46-52.
[14] 刘广宇,谭君颖,霍岩,张剑宁,李明. “治鸣六穴”治疗脾胃虚弱型耳鸣患者的临床疗效观察及脑效应机制研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 53-61.
[15] 熊彬彬,卢子昂,杨晶,徐文强,周潞茹,孙平原,袁丁,朱佳浩. 纯音听阈值正常的中青年耳鸣群体耳蜗功能分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(4): 62-67.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发