CAJ | 학술논문

目的：观察刺激声频率差异变化对正常人失匹配负波（mismatch negativity, MMN）的影响，探讨MMN产生机制，及其对声音辨别能力检测的应用价值。方法对12例青年健康男性行MMN检查，所有受试者均行听性脑干反应（ABR）阈值检查，确定ABR阈值，MMN检查在受试者在阅读状态检测，采用odd?ball刺激方式，给予短纯音刺激，偏差刺激概率为20%，标准刺激概率为80%，刺激频率为1.1次/s，刺激声强度为ABR阈上50dB；偏差刺激声频率分别为750Hz；1000Hz；2000Hz；3000Hz，对应的标准刺激声频率分别为500Hz；500Hz；1000Hz；1000Hz，每个受试者均行4次MMN检查，每次标准刺激和偏差刺激的频率差异幅值分别为250Hz；500 Hz；1000 Hz；2000 Hz。观察各组MMN潜伏期及波幅的特点。结果所有受试者ABR阈值均≤25 dB nHL。每例受试者均可引出MMN波形，当频率差异幅度分别为250Hz，500 Hz，1000 Hz，2000 Hz时，各组MMN潜伏期分别为167.61±14.93ms,148.48±12.03ms,139.17±10.93ms,121.37±19.51ms，经方差分析，总体各组潜伏期有显著差异（F=18.81, p=0.000）；波幅分别为5.62±2.68 uV,7.35±2.97 uV,6.13±1.83 uV,6.36±2.26uV，经方差分析，总体各组波幅无显著差异（F=0.956，p=0.423）。结论MMN在正常青年人可以稳定引出，而且随着刺激声频率差异的增大，其潜伏期呈现稳定而且有规律的减小，重复性良好，作为对声音辨别能力检测的有效手段，有较为广阔的临床应用价值。
목적：관찰자격성빈솔차이변화대정상인실필배부파（mismatch negativity, MMN）적영향，탐토MMN산생궤제，급기대성음변별능력검측적응용개치。방법대12례청년건강남성행MMN검사，소유수시자균행은성뇌간반응（ABR）역치검사，학정ABR역치，MMN검사재수시자재열독상태검측，채용odd?ball자격방식，급여단순음자격，편차자격개솔위20%，표준자격개솔위80%，자격빈솔위1.1차/s，자격성강도위ABR역상50dB；편차자격성빈솔분별위750Hz；1000Hz；2000Hz；3000Hz，대응적표준자격성빈솔분별위500Hz；500Hz；1000Hz；1000Hz，매개수시자균행4차MMN검사，매차표준자격화편차자격적빈솔차이폭치분별위250Hz；500 Hz；1000 Hz；2000 Hz。관찰각조MMN잠복기급파폭적특점。결과소유수시자ABR역치균≤25 dB nHL。매례수시자균가인출MMN파형，당빈솔차이폭도분별위250Hz，500 Hz，1000 Hz，2000 Hz시，각조MMN잠복기분별위167.61±14.93ms,148.48±12.03ms,139.17±10.93ms,121.37±19.51ms，경방차분석，총체각조잠복기유현저차이（F=18.81, p=0.000）；파폭분별위5.62±2.68 uV,7.35±2.97 uV,6.13±1.83 uV,6.36±2.26uV，경방차분석，총체각조파폭무현저차이（F=0.956，p=0.423）。결론MMN재정상청년인가이은정인출，이차수착자격성빈솔차이적증대，기잠복기정현은정이차유규률적감소，중복성량호，작위대성음변별능력검측적유효수단，유교위엄활적림상응용개치。
Object To study the effects of changes in stimulus frequency difference on mismatch negativi-ty (MMN) in normal people, the mechanism of MMN generation, and the pragmatic value of MMN as a tool in evaluating sound discrimination capability. Methods MMN tests were performed on 9 young males. In all cas-es, acoustic brainstem responses (ABRs) were tested first to identify ABR thresholds. MMN was tested under the condition of reading. The odd-ball model was used, and a brief pure tone was used as the stimulus. Frequen-cy deviation was given at a rate of 20%, while the standard frequency at a rate of 80%. The stimulus was deliv-ered at 50 dB above the ABR threshold at a rate of 1.1/sec. Each subject received four MMN tests for the devi-ated frequency of 750, 1000, 2000 and 3000 Hz, with the corresponding standard frequency at 500, 500, 1000 and 1000 Hz, respectively, yielding a frequency difference magnitude (DM) of 250, 500, 1000 and 2000 Hz, in each test. The latency and amplitude of MMN were analyzed. Results In all cases, ABR thresholds were≤25 dB nHL and MMN was successfully induced and recorded. For the DM of 250, 500, 1000 and 2000 Hz, the la-tency was 167.61±14.93 ms, 148.48±12.03 ms, 139.17±10.93 ms and 121.37±19.51 ms, respectively (F=18.81, p=0.000), with corresponding amplitudes of 5.62±2.68 uV, 7.35±2.97 uV, 6.13±1.83 uV and 6.36±2.26uV (F=0.956, p=0.397). Conclusion MMN can be consistently induced in normal young people. With increasing DM, the MMN latency shows a systematic reduction with no obvious change in MMN amplitude. The phenomenon is highly reproducible. MMN, as an effective tool to test sound discrimination capability, has a prospective clin-ical pragmatic value.