中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2004年
7期
1372-1374
,共3页
薛希均%钟乃川%钟玲%全永安%王红
薛希均%鐘迺川%鐘玲%全永安%王紅
설희균%종내천%종령%전영안%왕홍
耳声发射,自发性%听觉丧失,噪声%听力
耳聲髮射,自髮性%聽覺喪失,譟聲%聽力
이성발사,자발성%은각상실,조성%은력
背景:耳声发射是了解听觉功能受损情况的敏感测量方法,而对侧抑制可改变耳蜗的功能状态. 目的:了解对侧抑制效应对噪声暴露后畸变产物耳声发射( DPOAE) 听力图幅值的影响. 设计:自身对照的前瞻性研究. 地点和对象:在同济医科大学协和医院完成,耳科正常人 20例 40 耳,男 9例,女 11例. 干预:对受试者以宽带噪声为对侧抑制声 (60 dB SPL), 105 dB SPL 2 kHz窄带噪声暴露 10 min,以 L1=70 dB SPL,L2=60 dB SPL,f2/f1=1.21的初始音进行 DPOAE听力图测试观察. 主要观察指标: DPOAE幅值. 结果:噪声暴露可引起暴露声以上各频率测量点的 DPOAE 2f1-f2反应幅值显著性降低 (t=5.468,4.984,4.796,5.966,3.546,P均 < 0.05),以暴露声半倍频 f2频率处 (f2=3kHz)降低最为显著 (t=4.984,P=0.000 02). 而对侧抑制效应主要表现在 2 kHz 测量点,使此处幅值显著降低 (t=3.148,P=0.003).暴露后存在对侧抑制与否对 2～ 6 kHz f2频率处的 2f1-f2幅值改变具有明显影响( t=5.452,4.037,4.798,5.964,3.564,P 均 < 0.001). 结论: DPOAE听力图测试具有较好的频率特异性和高度敏感性,能特异而敏感地反映出对侧抑制和噪声暴露的效应.对侧抑制效应明显增加了 DPOAE测量对强声所引起的耳蜗功能降低的敏感性.
揹景:耳聲髮射是瞭解聽覺功能受損情況的敏感測量方法,而對側抑製可改變耳蝸的功能狀態. 目的:瞭解對側抑製效應對譟聲暴露後畸變產物耳聲髮射( DPOAE) 聽力圖幅值的影響. 設計:自身對照的前瞻性研究. 地點和對象:在同濟醫科大學協和醫院完成,耳科正常人 20例 40 耳,男 9例,女 11例. 榦預:對受試者以寬帶譟聲為對側抑製聲 (60 dB SPL), 105 dB SPL 2 kHz窄帶譟聲暴露 10 min,以 L1=70 dB SPL,L2=60 dB SPL,f2/f1=1.21的初始音進行 DPOAE聽力圖測試觀察. 主要觀察指標: DPOAE幅值. 結果:譟聲暴露可引起暴露聲以上各頻率測量點的 DPOAE 2f1-f2反應幅值顯著性降低 (t=5.468,4.984,4.796,5.966,3.546,P均 < 0.05),以暴露聲半倍頻 f2頻率處 (f2=3kHz)降低最為顯著 (t=4.984,P=0.000 02). 而對側抑製效應主要錶現在 2 kHz 測量點,使此處幅值顯著降低 (t=3.148,P=0.003).暴露後存在對側抑製與否對 2～ 6 kHz f2頻率處的 2f1-f2幅值改變具有明顯影響( t=5.452,4.037,4.798,5.964,3.564,P 均 < 0.001). 結論: DPOAE聽力圖測試具有較好的頻率特異性和高度敏感性,能特異而敏感地反映齣對側抑製和譟聲暴露的效應.對側抑製效應明顯增加瞭 DPOAE測量對彊聲所引起的耳蝸功能降低的敏感性.
배경:이성발사시료해은각공능수손정황적민감측량방법,이대측억제가개변이와적공능상태. 목적:료해대측억제효응대조성폭로후기변산물이성발사( DPOAE) 은력도폭치적영향. 설계:자신대조적전첨성연구. 지점화대상:재동제의과대학협화의원완성,이과정상인 20례 40 이,남 9례,녀 11례. 간예:대수시자이관대조성위대측억제성 (60 dB SPL), 105 dB SPL 2 kHz착대조성폭로 10 min,이 L1=70 dB SPL,L2=60 dB SPL,f2/f1=1.21적초시음진행 DPOAE은력도측시관찰. 주요관찰지표: DPOAE폭치. 결과:조성폭로가인기폭로성이상각빈솔측량점적 DPOAE 2f1-f2반응폭치현저성강저 (t=5.468,4.984,4.796,5.966,3.546,P균 < 0.05),이폭로성반배빈 f2빈솔처 (f2=3kHz)강저최위현저 (t=4.984,P=0.000 02). 이대측억제효응주요표현재 2 kHz 측량점,사차처폭치현저강저 (t=3.148,P=0.003).폭로후존재대측억제여부대 2～ 6 kHz f2빈솔처적 2f1-f2폭치개변구유명현영향( t=5.452,4.037,4.798,5.964,3.564,P 균 < 0.001). 결론: DPOAE은력도측시구유교호적빈솔특이성화고도민감성,능특이이민감지반영출대측억제화조성폭로적효응.대측억제효응명현증가료 DPOAE측량대강성소인기적이와공능강저적민감성.
BACKGROUND:Otoacoustic emissions is a sensitive measurement method for understanding auditory,however,the contralateral acoustic suppression the functional status of cochlea. OBJECTIVE:To investigate the effect of intensive noise exposure and contralateral acoustic suppression(CAS) on distortion otoacoustic emisson(DPOAE) gram amplitude and its sensitivity. DESIGN:The design is self-controlled and prospective. SETTING and PARTICIPANTS:The experiment was completed in Union Hospital of Tongji University.Forty ears of 20 normal volunteers(9 males and 11 females) were selected. INTERVENTION:Forty ears of 20 normal acouesthesia volunteers were exposed under narrow band noise(NBN)(105 dB SPL,2 kHz central frequency) and investigated by using DP-gram measurement with primates of L1=70 dB SPL,L2=60 dB SPL,f2/f1=1.21 with or without CAS of 60 dB SPL WN.The main outcome measure was DPOAE amplitude. RESULTS:The DPOAE 2f1-f2 amplitude of every f2 frequency measured decreased significantly(t=5.468,4.984,4.796,5.966,3.546,P=0.000 003,0.000 02,0.000 03,0.000 000 6,0.001) with a most significant decrease on the half octave frequency(f2=3 kHz)(t=4.984,P=0.000 02). CAS showed most significant effect on 2 kHz of f2 frequency and deceased amplitude significantly(t=3.148,P=0.003).After noise exposure, the changes of 2f1-f2 amplitude on 2-6 kHz f2 frequency sites showed significant difference between groups with and without CAS(t=5.452,4.037,4.798,5.964,3.564,P=0.000 001,0.000 7,0.000 04,0.000 5,0.001). CONCLUSION:DP-gram measurement has better frequency specificity and high sensitivity and can specifically and sensitively reflect the effects of CAS and noise exposure.CAS can increase sensitivity of DPOAE-gram measurement to the cochlear function induced by noise exposure.
