CAJ | 학술논문

目的寻找感音神经性耳聋的发病与耳蜗毛细胞损伤的联系,探讨早期发现、早期干预本病的听力测试方法.方法从进行高压氧(HBO)治疗的感音神经性耳聋患者中随机选出253人,对HBO治疗前、治疗1、2个疗程后的治疗效果进行比较;行听性脑干反应(ABR)、畸变产物耳声发射(DPOAE)听力测试,并对结果进行比较.结果 HBO治疗2个疗程后轻度耳聋治愈率与总有效率显著高于中度耳聋;HBO治疗1、2个疗程后与治疗前、治疗1个疗程后与2个疗程后ABR异常的发生率相比,差异有统计学意义(P＜0.05).HBO治疗前与治疗2个疗程后比较,治疗1个疗程后与治疗2个疗程后比较,DPOAE幅值中、高频率段下移明显;治疗1个疗程后较治疗前在1.4～6.0 kHz频率段略有上移.结论 HBO可能是通过恢复耳蜗凋亡过程中毛细胞的活性而达到对感音神经性聋的治疗效果;DPOAE较ABR在对感音性耳聋检测中有敏感性和前瞻性;可以通过ABR、DPOAE组合检测来判断感音神经性耳聋的听力损伤和恢复的程度.
목적 심조감음신경성이롱적발병여이와모세포손상적련계,탐토조기발현、조기간예본병적은력측시방법.방법 종진행고압양(HBO)치료적감음신경성이롱환자중수궤선출253인,대HBO치료전、치료1、2개료정후적치료효과진행비교;행은성뇌간반응(ABR)、기변산물이성발사(DPOAE)은력측시,병대결과진행비교.결과 HBO치료2개료정후경도이롱치유솔여총유효솔현저고우중도이롱;HBO치료1、2개료정후여치료전、치료1개료정후여2개료정후ABR이상적발생솔상비,차이유통계학의의(P＜0.05).HBO치료전여치료2개료정후비교,치료1개료정후여치료2개료정후비교,DPOAE폭치중、고빈솔단하이명현;치료1개료정후교치료전재1.4～6.0 kHz빈솔단략유상이.결론 HBO가능시통과회복이와조망과정중모세포적활성이체도대감음신경성롱적치료효과;DPOAE교ABR재대감음성이롱검측중유민감성화전첨성;가이통과ABR、DPOAE조합검측래판단감음신경성이롱적은력손상화회복적정도.
Objective To study the relationship between the cochlear hair cell and sensorineural deafness,so as to explore hearing test method for early intervention and discovery.Methods Two hundred and fifty-three patients suffered from sensorineural deafness with hyperbaric oxygen(HBO)treatment were randomly seleceted,curative effect before and after HBO treantment were recorded and compared,respectively.Examinations of acoustic brainstem evoked respone(ABR)and distortion product otoacoustic emission(DPOAE)were conducted for the evaluation of hearing test result.Results It Was revealed that total effective rate of mild hearing loss after two courses of HBO treatment was significantly higher than that of moderate deafness.There Was significant difference in the incidence of abnormal ratio of ABR between pretherapy and aftertherapy of HBO(P＜0.05).DPOAE amplitude obviously decreased after one and two courses of HBO treatment.At 1.4-6.0 kHz frequency before and one course of HBO treatment.there was a slight upward.Conclusions HBO may have therapeutic efficacy on sensorineural deafness by revive the activity of cochlear hair apoptosis cell.DPOAE is more sensitive and prospective than ABR.The combination of ABR and DPOAE Can be used to judge the degree of hearing impairment and recovery.