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目的探讨多频稳态诱发电位(multiple auditory steady-state evoked responses,ASSR)鉴别诊断职业性噪声聋的可行性及临床应用价值。方法33例客观聋组、47例夸大聋组和30例正常听力组人员均行0.5kHz、1kHz、2kHz、4kHz共四个频率处的ASSR和纯音测试(pure tone threshold audiometry,PTA),进行相关性分析和一元回归分析。结果各频率的ASSR-PTA差值在正常听力组依次为(7.63±5.62)dBHL、(11.58±2.80)dBHL、(10.54±3.24)dBHL、(9.20±3.32)dBHL,在客观聋组依次为(-0.63±8.22)dBHL、(8.99±8.75)dBHL、(12.50±8.50)dBHL、(10.03±10.13)dBHL,在夸大聋组依次为(-18.02±18.15)dBHL、(-11.05±16.63)dBHL、(-6.06±19.17)dBHL、(-5.81±20.17)dBHL。各频率ASSR反应阈与PTA听阈的相关系数在正常听力组依次为0.668、0.839、0.791、0.716,在客观聋组依次为0.817、0.826、0.892、0.768,而在夸大聋组依次为0.280、0.352、0.396、0.468。以客观聋组的ASSR反应阈为自变量、PTA听阈为因变量,进行一元回归分析。经回顾性考核和前瞻性考核,证实应用ASSR评估真实听力效果较好。结论应用ASSR鉴别诊断职业性噪声聋是可行的,有临床应用价值。
Objective To investigate the feasibility and clinical value of multiple auditory steady-state evoked responses (ASSR) in differential diagnosis of occupational noise-induced deafness. Methods The ASSR and pure tone threshold audiometry (PTA) at three frequencies of 0.5kHz, 1kHz, 2kHz and 4kHz were performed in 33 deaf patients, 47 exaggerated deaf patients and 30 normal hearing patients. Sex analysis and one-way regression analysis. Results The differences of ASSR-PTA in each group were (7.63 ± 5.62) dBHL, (11.58 ± 2.80) dBHL, (10.54 ± 3.24) dBHL and (9.20 ± 3.32) dBHL in the normal hearing group, (-18.02 ± 18.15) dBHL, (-11.05 ± 16.63) dBHL, (-12.02 ± 18.65) dBHL, (12.50 ± 8.75) dBHL, (-6.06 ± 19.17) dBHL, (-5.81 ± 20.17) dBHL. The correlation coefficients of ASSR thresholds and PTA thresholds were 0.668,0.839,0.791,0.716 in the normal hearing group, 0.817,0.826,0.892,0.768 in the objective deaf group, followed by 0.280,0.352 in the exaggerated deaf group, 0.396, 0.468. ASSR response threshold of the objective deaf group as the independent variable, PTA threshold as the dependent variable, the one-way regression analysis. After a retrospective assessment and prospective assessment confirmed the application of ASSR assessment of the actual hearing better. Conclusion ASSR differential diagnosis of occupational noise deaf is feasible and has clinical value.