CAJ | 학술논문

目的：分析0~24月龄婴幼儿鼓室声导抗测试的结果，将其与听性脑干反应（auditory brainstem response，ABR）、畸变产物耳声发射（distortion product otoacoustic emission，DPOAE）结果比较，以评价高频和低频鼓室声导抗测试对于诊断该年龄段婴幼儿中耳功能障碍的作用。方法对98例（196耳）0～24月龄婴幼儿（0～6月龄、7～12月龄、13～24月龄组分别有63、22、13例）进行1000 Hz鼓室声导抗测试、ABR测试和DPOAE测试，对其中25例（50耳）7～24月龄婴幼儿同时进行了226 Hz鼓室声导抗测试。结果在0～6月龄、7～12月龄、13～24月龄婴幼儿中，1000 Hz鼓室声导抗测试无峰组ABR波Ⅰ潜伏期延长率分别为85.2%、89.3%、89.5%，有峰组分别为32.6%、43.8%、40.0%；DPOAE正常率无峰组分别为3.4%、3.6%、0，有峰组分别为47.4%、50.0%、33.3%；且0～12月龄段各参数无峰组与有峰组间的差异均有统计学意义（P均＜0.05）。7～12月龄、13～24个月龄婴幼儿中，226 Hz鼓室声导抗测试异常组ABR波Ⅰ潜伏期延长率分别为78.6%、86.7%，正常组分别为100%、57.1%；DPOAE正常率异常组分别为14.3%、0%，正常组分别为16.7%、25%。在7～12月龄、13～24月龄婴幼儿中，226 Hz与1000 Hz鼓室声导抗测试的一致率分别为57.7%、73.1%。结论在0～24月龄婴幼儿中1000 Hz鼓室声导抗测试对于诊断婴幼儿中耳功能障碍有意义。在7～24月龄婴幼儿中，226 Hz 鼓室声导抗测试诊断中耳功能障碍的准确性较1000 Hz鼓室声导抗测试差，在13～24月龄婴幼儿中的准确性较7～12月龄中好。因此，建议7～24月龄婴幼儿声导抗测试同时用226 Hz和1000 Hz探测音。
목적：분석0~24월령영유인고실성도항측시적결과，장기여은성뇌간반응（auditory brainstem response，ABR）、기변산물이성발사（distortion product otoacoustic emission，DPOAE）결과비교，이평개고빈화저빈고실성도항측시대우진단해년령단영유인중이공능장애적작용。방법대98례（196이）0～24월령영유인（0～6월령、7～12월령、13～24월령조분별유63、22、13례）진행1000 Hz고실성도항측시、ABR측시화DPOAE측시，대기중25례（50이）7～24월령영유인동시진행료226 Hz고실성도항측시。결과재0～6월령、7～12월령、13～24월령영유인중，1000 Hz고실성도항측시무봉조ABR파Ⅰ잠복기연장솔분별위85.2%、89.3%、89.5%，유봉조분별위32.6%、43.8%、40.0%；DPOAE정상솔무봉조분별위3.4%、3.6%、0，유봉조분별위47.4%、50.0%、33.3%；차0～12월령단각삼수무봉조여유봉조간적차이균유통계학의의（P균＜0.05）。7～12월령、13～24개월령영유인중，226 Hz고실성도항측시이상조ABR파Ⅰ잠복기연장솔분별위78.6%、86.7%，정상조분별위100%、57.1%；DPOAE정상솔이상조분별위14.3%、0%，정상조분별위16.7%、25%。재7～12월령、13～24월령영유인중，226 Hz여1000 Hz고실성도항측시적일치솔분별위57.7%、73.1%。결론재0～24월령영유인중1000 Hz고실성도항측시대우진단영유인중이공능장애유의의。재7～24월령영유인중，226 Hz 고실성도항측시진단중이공능장애적준학성교1000 Hz고실성도항측시차，재13～24월령영유인중적준학성교7～12월령중호。인차，건의7～24월령영유인성도항측시동시용226 Hz화1000 Hz탐측음。
Objective To analysis the result of tympanometries in children of 0-24 months who do diagnostic test in the auditory diagnosis center of children, and compare their result with auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE), to evaluate the diagnostic value of high and low frequency probe tone tympanometries in children of the corresponding age. Methods 1000 Hz probe tone tympanometries, ABRs and DPOAEs were tested in 98 children 196 ears. Among these children, 226 Hz probe tone tympanometries were also tested in 25 children 50 ears, whose age were 7-24 months. Results In the group whose 1000 Hz tympanogram were without positive peak, ABR wave I latency delay rates were 85.2%, 89.3%, 89.5%;DPOAE pass rates were 3.4%, 3.6%, 0 for children of 0-6, 7-12, 13-24 months respectively. In the group whose 1000 Hz tympanogram had positive peaks, ABR wave I latency delay rates were 32.6%, 43.8%, 40.0%;DPOAE pass rates were 47.4%, 50.0%, 33.3%for children of 0-6, 7-12, 13-24 months respectively. The differences between 1000 Hz tympanometry normal and abnormal groups were of statistic significance in 0-12 months children. In the 226 Hz tympanometry abnormal group, the ABR wave I latency delay rates were 78.6%, 86.7%; DPOAE pass rates were 14.3%, 0% for children of 7-12, 13-24 months. In the 226 Hz tympanometry normal group, the ABR wave I latency delay rates were 100%, 57.1%; DPOAE pass rates were 16.7%,25% for children of 7-12, 13-24 months. For children of 7-12, 13-24 months, the agreements of 226 Hz and 1000 Hz tympanometries were 57.7%and 73.1%. Conclusions In children of 0-24 months, 1000 Hz tympanomtries are of great value in the diagnosis of middle ear dysfunction. For 7-24 months children, the value of 226 Hz tympanometries in diagnosis of middle ear dysfunction were less than 1000 Hz tympanometries and 226 Hz tympanometries works better in children of 13-24 months than 7-12 months. It is recommended to use 226 Hz and 1000 Hz probe tone at the same time while doing the tympanometries in children of 7-24 months.