【摘要】：目的探討重度OSAHS對患者聽覺系統(tǒng)造成的影響大小,提出相應(yīng)的治療措施,預(yù)防聽力進一步的損害。 方法我們隨機選取臨床資料完整的24例診斷為OSAHS的患者,根據(jù)OSAHS嚴重程度將其分為輕、中、重度OSAHS組,8例無打鼾的健康人作為對照組,在隔音屏蔽室中(噪音20dB SPL),分別檢測各組的常頻(125-6000Hz)純音氣導(dǎo)電測聽和擴展高頻(8000-16000Hz)氣導(dǎo)電測聽、聲導(dǎo)抗、畸變產(chǎn)物耳聲發(fā)射(DPOAE)、瞬態(tài)誘發(fā)性耳聲發(fā)射(TEOAE)、聽性腦干反應(yīng)(ABR)、40Hz聽覺事件相關(guān)電位(40Hz AERP)、聽覺穩(wěn)態(tài)反應(yīng)(ASSR),并記錄檢測結(jié)果。用SPSS 13.0統(tǒng)計軟件進行相關(guān)數(shù)據(jù)處理分析。 結(jié)果①輕中度OSAHS組常頻250Hz、1000Hz氣導(dǎo)聽閾較對照組差異顯著(P0.05),500 Hz氣導(dǎo)聽閾較對照組差異非常顯著(P0.01),重度OSAHS組常頻500 Hz氣導(dǎo)聽閾較對照組差異非常顯著(P0.01);輕中度OSAHS組擴展高頻16000 Hz氣導(dǎo)聽閾較對照組差異顯著(P0.05);重度OSAHS組擴展高頻10000 Hz氣導(dǎo)聽閾較對照組差異顯著(P0.05)。 ②對照組與輕中度OSAHS組間TEOAE檢出率差異無顯著性(P0.05),對照組與重度OSAHS組間TEOAE檢出率有顯著性差異(P0.05)。 ③輕中度OSAHS組DPOAE反應(yīng)幅值與對照組比較差異無顯著性(P0.05),重度OSAHS組DPOAE反應(yīng)幅值在750、3000、4000 Hz頻率點與對照組比較有非常顯著性差異(P0.01)。 ④750 Hz頻率點上,DPOAE檢出率OSAHS組明顯低于對照組,兩組之間有非常顯著性差異(P0.01);1000 Hz頻率點,DPOAE檢出率OSAHS組低于對照組,兩組之間有顯著性差異(P0.05)。 ⑤重度OSAHS組與對照組ABR I、II、III波潛伏期相比有非常顯著性差異(P0.01),重度OSAHS組與對照組ABR IV波潛伏期相比有顯著性差異(P0.05);波I-III間期、III-V間期、I-V間期及ABR閾值兩組之間比較無顯著性差異(P0.05)。 ⑥重度OSAHS、輕中度OSAHS與對照組40Hz AERP聽閾之間比較無顯著性差異(P0.05)。 ⑦輕中度OSAHS組在500 Hz、1000 Hz處ASSR聽閾較對照組有非常顯著性差異(P0.01),在2000 Hz處聽閾較對照組有顯著性差異(P0.05);重度OSAHS組在500 Hz、1000 Hz、4000 Hz處聽閾較對照組有非常顯著性差異(P0.01)。 結(jié)論重度OSAHS可以導(dǎo)致常頻和擴展高頻聽閾提高;可以使OAE檢出率下降,DPOAE反應(yīng)幅值下降;可以使ABR各波潛伏期延長;可導(dǎo)致ASSR聽閾提高。OSAHS可以導(dǎo)致耳蝸功能受損。
[Abstract]:Objective to investigate the effect of severe OSAHS on the auditory system of the patients, and to propose the corresponding treatment measures to prevent further hearing damage. Methods We randomly selected 24 patients diagnosed as OSAHS with complete clinical data and divided them into mild, moderate, severe OSAHS group according to the severity of OSAHS, and 8 healthy persons without snoring as the control group, in the sound insulation room (noise 20dB SPL),). Normal frequency (125-6000Hz) pure tone audiometry and extended high frequency (8000-16000Hz) audiometry, acoustic impedance, distortion product otoacoustic emission (DPOAE),) transient evoked otoacoustic emission (TEOAE),) auditory brainstem response (ABR),) were measured in each group. 40Hz auditory event-related potential (40Hz AERP),) auditory steady-state response (ASSR),) was recorded. SPSS 13.0 statistical software was used for data processing and analysis. Results (1) in mild and moderate OSAHS group, the air conduction threshold at 1000Hz was significantly higher than that in the control group (P0.05), and the difference was very significant at 500Hz compared with the control group (P0.01). In the severe OSAHS group, the air conduction threshold of 500 Hz was significantly different from that of the control group (P0.01). The hearing threshold of extended high frequency (16000 Hz) in mild to moderate OSAHS group was significantly higher than that in control group (P0.05), and that of 10000 Hz in severe OSAHS group was significantly higher than that in control group (P0.05). 2There was no significant difference in the detection rate of TEOAE between the control group and the mild to moderate OSAHS group (P0.05), but there was a significant difference between the control group and the severe OSAHS group in the detection rate of TEOAE (P0.05). 3There was no significant difference in the amplitude of DPOAE reaction between the mild and moderate OSAHS group and the control group (P0.05). The amplitude of DPOAE reaction in the severe OSAHS group was 750,3000,4 000 Hz higher than that in the control group (P0.01). At the frequency of 4750 Hz, the detection rate of DPOAE in OSAHS group was significantly lower than that in control group (P0.01), and the detection rate of DPOAE in OSAHS group was lower than that in control group at 1000 Hz frequency point (P0.05). 5There were significant differences in latency of ABR I, II and III between severe OSAHS group and control group (P0.01), and there was significant difference between severe OSAHS group and control group in ABR IV wave latency (P0.05). There was no significant difference in wave I-III interval, III-V interval, I / V interval and ABR threshold between the two groups (P0.05). (6) there was no significant difference in hearing threshold between severe OSAHS, mild and moderate OSAHS and control group 40Hz AERP (P0.05). (7) there was a significant difference in ASSR hearing threshold at 500 Hz,1000 Hz between mild and moderate OSAHS group compared with the control group (P0.01), and there was a significant difference in the hearing threshold at 2000 Hz compared with the control group (P0.05). There was a significant difference in hearing threshold at 500 Hz,1000 Hz,4000 Hz between the severe OSAHS group and the control group (P0.01). Conclusion severe OSAHS can increase the hearing threshold of constant frequency and extended high frequency, decrease the detection rate of OAE and decrease the amplitude of DPOAE response, prolong the latency of each wave of ABR, and increase the hearing threshold of ASSR. OSAHS can cause cochlear dysfunction.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R766

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