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目的探讨听性脑干反应(auditory brain stem response,ABR)和多频稳态诱发电位(auditory steady state response,ASSR)在听力筛查阳性婴幼儿听力诊断中的应用价值。方法2005年8月至2007年10月期间宁波市新生儿畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)听力筛查阳性者70例转诊至宁波市儿童听力诊断治疗中心进行听性脑干反应及多频稳态诱发电位测试,综合分析ABR及ASSR的测试结果。结果70例婴幼儿(140耳)中ABR正常37耳,轻度聋18耳,中度聋21耳,重度聋31耳和极重度聋33耳;非极重度聋ASSR的2kHz和4kHz反应阈与ABR反应阈之间呈直线正相关关系(P<0.05),而ASSR的0.5kHz和1kHz反应阈与ABR反应阈之间无直线关系(P>0.05)。极重度聋0.5kHz、1kHz、2kHz和4kHzASSR引出率分别为42.4%、57.6%、45.5%和48.5%,高于ABR的引出率21.2%(χ2=9.7408,P=0.0450)。结论听力筛查阳性婴幼儿的高载波频率ASSR与ABR存在良好的相关性,且ASSR具有频率特性及较高反应引出率而更适用于极重度聋婴幼儿残余听力的评估。
Objective To investigate the value of auditory brain stem response (ABR) and auditory steady state response (ASSR) in the audiological diagnosis of hearing-positive infants. Methods From August 2005 to October 2007, 70 patients with positive product hearing loss (otoacoustic emission) of distortion product otoacoustic emission (DPOAE) in Ningbo were referred to Ningbo Children’s Hearing Diagnostic Center for auditory brainstem Response and multi-frequency steady-state evoked potential test, a comprehensive analysis of ABR and ASSR test results. Results 70 cases of infants (140 ears) had normal ABR of 37 ears, mild deafness of 18 ears, moderate deafness of 21 ears, severe deafness of 31 ears and extremely severe deafness of 33 ears. The thresholds of 2 kHz and 4 kHz for ASSR with non-maximal deafness were There was a linear positive correlation between ABR thresholds (P <0.05), but there was no linear relationship between ASSR thresholds and ABR thresholds at 0.5kHz and 1kHz (P> 0.05). The lead rates of ASSR for severe deafness were 42.4%, 57.6%, 45.5% and 48.5% at 0.5kHz, 1kHz, 2kHz and 4kHz respectively, which was 21.2% higher than that of ABR (χ2 = 9.7408, P = 0.0450). Conclusion There is a good correlation between high carrier frequency ASSR and ABR in hearing-positive infants. And ASSR has better frequency response and response rate, and is more suitable for assessment of residual hearing loss in very deaf infants.