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目的 寻找早期发现噪声性听觉损害的敏感参数 ,明确可引起暂时性阈移的最敏感暴露诸因素及其交互作用。方法 正交方法观察 0 5、 1、 4kHz窄带噪声及 1kHz纯音 ,85、 10 0、 115dBSPL暴露强度 ,2 5、 4 5、6 5min暴露时程耳声发射变化 ,并与 0 2 5～ 8kHz各倍频纯音听阈、 0 5～ 4kHz各倍频及BBN镫骨肌反射阈相对照。结果 三因素中强度最为主要 ,85dBSPL时多数观察对象出现各项听功能指标出现改变并随强度加强而更明显 ;频率和暴露时间作用次之。 1kHz的纯音暴露后 ,各项听功能指标的改变相对较大 ,4 5分钟的暴露时间 ,听功能改变相对较大。结论 引起暂时性阈移的最佳因素组合是 1kHz、 115dBSPL、 6 5分钟 ;引起较为稳定的暂时性阈移的最佳因素组合是 1kHz、 10 0dBSPL、 4 5分钟 ;测量暂时性阈移最敏感的测试方法是DPOAE幅值
OBJECTIVE: To find the sensitive parameters of early detection of noise-induced hearing impairment and to identify the most sensitive exposure factors and their interactions that may cause temporary threshold shift. Methods Orthogonal methods were used to observe the narrowband noise at 0, 1, 4 kHz and pure tone at 1 kHz, exposure intensity at 85, 10 0 and 115 dBSPL, and the changes of the duration of otoacoustic emissions at 25, 45, Frequency pure tone threshold, 0 5 ~ 4kHz frequency and BBN stapedius reflex threshold contrast. The results of the three factors the most important, 85dBSPL when most of the observed objects appeared to change the various hearing indicators and with the intensity to strengthen and more obvious; frequency and exposure time second. 1kHz pure tone exposure, the various changes in hearing function indicators relatively large, 4 5 minutes of exposure time, hearing changes relatively large. Conclusion The best combination of factors that cause temporary threshold shift is 1kHz, 115dBSPL, 65 minutes. The best combination of factors causing transient transient threshold shift is 1kHz, 100dBSPL, 45 minutes, and the most sensitive The test method is DPOAE amplitude