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  本文關鍵詞： 法醫(yī)學 誘發(fā)電位 聽覺 測聽法 純音 聽閾　出處：《蘇州大學》2012年碩士論文　論文類型：學位論文

【摘要】：目的通過比較3種不同類型頻率特異性聽覺誘發(fā)電位（Auditory evokedpotential，AEP）的反應閾值與行為聽閾之間的關系，為不同類型頻率特異性AEP在客觀評估聽閾中的準確運用提供基礎數(shù)據(jù)。 方法分別對聽力正常組34例（68耳）及聽力障礙組89例進行0.5～4kHz頻率范圍內(nèi)的40Hz聽覺相關電位（40Hz auditory event related potential，40Hz AERP）、短純音聽覺腦干反應（tone burst auditory brainstem response，Tb-ABR）、聽性穩(wěn)態(tài)反應（auditory steady-state response，ASSR）這3種頻率特異性AEP及純音測聽（pure tone audiometry，PTA）測試，分析不同頻率之間、不同方法之間、不同組間這3種頻率特異性AEP反應閾值與PTA閾值的相關性，并對不同頻率3種AEP反應閾值之間以及與PTA閾值間的差異進行統(tǒng)計分析。 結(jié)果在聽力正常組和聽力障礙組，40Hz AERP、Tb-ABR、ASSR在0.5～4kHz頻率范圍的反應閾值與PTA閾值之間均具有較好的相關性，兩組比較，聽力障礙組的相關性優(yōu)于聽力正常組。在聽力正常組和聽力障礙組兩組相同的是，在0.5kHz及1kHz頻率，40Hz AERP反應閾值與PTA閾值相關性優(yōu)于Tb-ABR及ASSR，而在2kHz、4kHz頻率，Tb-ABR及ASSR反應閾值與PTA閾值相關性優(yōu)于40Hz AERP。 無論聽力正常組還是及聽力障礙組，40Hz AERP、Tb-ABR、ASSR反應閾值與PTA閾值之間均存在差值，反應閾值高于PTA閾值。不同頻率之間，40Hz AERP、Tb-ABR、ASSR反應閾值與PTA閾值之間差值有不同的統(tǒng)計學意義；不同組間，3種方法的反應閾值與PTA閾值的差異亦不同。聽力正常組：在0.5kHz頻率，40Hz AERP反應閾值與PTA閾值之間的差值最小，且差異與其他2種方法均具有統(tǒng)計學意義；在1kHz頻率，ASSR反應閾值、40Hz AERP反應閾值與PTA閾值之間的差值相近，，差異無統(tǒng)計學意義；而在2kHz、4kHz頻率，ASSR反應閾值與PTA閾值之間差值最小，且差異與其他2種方法均具有統(tǒng)計學意義。聽力障礙組：在0.5、1kHz頻率，40Hz AERP反應閾值與PTA閾值之間的差值最小，且與其他2種方法的差異有統(tǒng)計學意義；而在2、4kHz頻率，雖Tb-ABR反應閾值與PTA閾值的差值最小，但與其他2種方法的差異無統(tǒng)計學意義。 結(jié)論40Hz AERP、Tb-ABR、ASSR這3種頻率特異性AEP檢測技術所測得的反應閾值經(jīng)過校正，均可以用于言語頻率的客觀聽閾評估。從3種AEP反應閾值與PTA閾值之間的相關性及差值間的差異綜合考慮，在0.5kHz、1kHz頻率，建議選擇40HzAERP檢測方法，而在2kHz、4kHz頻率，建議選擇Tb-ABR或ASSR檢測方法，以提高客觀評估聽閾的準確性。
[Abstract]:Objective to compare the relationship between behavioral threshold and response threshold of three different types of frequency specific auditory evoked potentials (AEPs). To provide basic data for the accurate application of different types of frequency specific AEP in objective assessment of hearing threshold. Methods the 40 Hz auditory related potentials (40 Hz) in the frequency range of 0.5 kHz in the normal hearing group (34 cases, 68 ears) and the hearing impairment group (89 cases, respectively) were studied. 40Hz auditory event related potential. 40Hz AERP, short tone auditory brainstem response (burst auditory brainstem response Tb-ABR). Auditory steady-state response to auditory steady-state response. Three kinds of frequency specific AEP and pure tone audiometry were tested and analyzed between different frequencies and methods. The correlation between the three frequency specific AEP reaction thresholds and the PTA thresholds among different groups was analyzed. The differences between the three AEP response thresholds and the PTA thresholds at different frequencies were analyzed statistically. Results 40 Hz AERP Tb-ABR was found in normal hearing group and hearing impairment group. There was a good correlation between the response threshold and PTA threshold of ASSR in the frequency range of 0.5kHz. The two groups were compared. The correlation of hearing impairment group was better than that of normal hearing group. The frequencies of 0.5kHz and 1kHz were the same in the normal hearing group and the hearing impairment group. The correlation between 40 Hz AERP response threshold and PTA threshold was better than that of Tb-ABR and ASSRs, but at 2 kHz ~ 4 kHz. The correlation between the threshold of Tb-ABR and ASSR reaction and the threshold of PTA was better than that of 40 Hz AERP. There was a difference between PTA threshold and 40 Hz AERP Tb-ABRN ASSR response threshold in both normal hearing group and hearing impairment group. The response threshold was higher than the PTA threshold, and the difference between the PTA threshold and the 40 Hz AERPU Tb-ABRN threshold was statistically significant. The difference of response threshold and PTA threshold was also different among different groups. In normal hearing group, the difference between 40 Hz AERP response threshold and PTA threshold was the smallest at 0.5 kHz frequency. The difference was statistically significant with the other two methods. The difference between the 40Hz AERP threshold and the PTA threshold was similar at 1kHz frequency. The difference was not statistically significant. The difference between ASSR response threshold and PTA threshold was the smallest at 2kHz and 4kHz, and the difference was statistically significant compared with the other two methods. 1kHz frequency 40Hz AERP reaction threshold and PTA threshold were the smallest, and the difference was statistically significant compared with the other two methods. However, at 2kHz, the difference between the threshold of Tb-ABR reaction and that of PTA was the smallest, but there was no significant difference between the two methods. Conclusion the response threshold measured by 40 Hz AERP Tb-ABRN ASSR and three frequency specific AEP techniques has been corrected. All of them can be used to evaluate the objective hearing threshold of speech frequency. Considering the correlation and difference between the three AEP response thresholds and PTA thresholds, the frequency of 0.5 kHz is 1 kHz. In order to improve the accuracy of objective assessment of hearing threshold, it is suggested to choose 40 Hz AERP detection method and 4 kHz frequency at 2kHz. It is suggested that Tb-ABR or ASSR detection method should be selected to improve the accuracy of objective assessment of hearing threshold.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R764

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