發(fā)布時間：2019-06-08 11:23

【摘要】： 目的:探索顱頂慢反應(yīng)(slow vertex response,SVR)在不同頻率、不同強度聲刺激條件下的變化規(guī)律;探討SVR閾值與純音測聽(pure tone audiometry,PTA)閾值之間的相互關(guān)系及其在法醫(yī)學(xué)聽力學(xué)評估中的應(yīng)用價值。 方法:對46名聽力正常人(92耳)分別進行PTA及SVR測試,標記不同聲刺激強度的SVR的N1波、P2波,得出三個分析指標(N1波潛伏期、P2波潛伏期、N1-P2波幅)的數(shù)值,分析分析指標隨聲刺激強度降低的變化規(guī)律;測得46名聽力正常人(92耳)的SVR閾值及PTA閾值,運用配對t檢驗對兩閾值進行比較,并確定各頻率的SVR閾值與PTA閾值差值;對25名感音神經(jīng)性耳聾患者(40耳)分別進行PTA及SVR測試,根據(jù)PTA閾值分成輕度、中度及重度聽力障礙組,然后對各組的SVR閾值及PTA閾值比較,并對SVR閾值與PTA閾值進行相關(guān)分析,擬出根據(jù)受試者SVR閾值推導(dǎo)受試者行為聽閾的線性回歸方程。 結(jié)果:①46名聽力正常人均能誘發(fā)清晰、穩(wěn)定的SVR波形。SVR的N1波潛伏期、P2波潛伏期隨聲刺激強度的降低逐漸延遲,N1-P2波幅隨著聲刺激強度的降低逐漸降低。②聽力正常人各頻率的SVR閾值高于PTA閾值,兩閾值平均差值約在5dB HL～10dB HL之間。此外,兩閾值間的差值隨著頻率的增高有增大趨勢,表明在低頻聲刺激時SVR閾值更接近于PTA閾值,更能準確反映受試者的低頻聽力。③在各個檢測頻率,SVR閾值與PTA閾值均高度相關(guān)。不同聽力水平受試者0.5kHz時SVR閾值與PTA閾值的r值=0.971(p0.05),一元線性回歸方程為Y=-3.582+1.020x;1kHz時SVR閾值與PTA閾值的r值=0.97(6p0.05),一元線性回歸方程為Y=-3.869+1.013x;2kHz時SVR閾值與PTA閾值的r值=0.957(p0.05),一元線性回歸方程為Y=-6.108+1.011x;4kHz時SVR閾值與PTA閾值的r值=0.928(p0.05),一元線性回歸方程為Y=-5.671+1.022x�；卮鷻z驗結(jié)果表明,應(yīng)用一元線性回歸方程評估聽力有望成為一個簡單可行的方法。 結(jié)論:①在適宜的條件下,SVR是一項穩(wěn)定的測聽技術(shù);顱頂慢反應(yīng)的分析指標隨聲刺激強度的變化規(guī)律在聽閾評估具有重要意義。②運用SVR閾值來推斷聽力正常人行為聽閾時,在各檢測頻率需要對SVR閾值進行校正。③根據(jù)建立的應(yīng)用SVR閾值推斷行為聽閾的線性回歸方程可以較準確的評估受試者的行為聽閾。
[Abstract]:Objective: to explore the changes of cranioparietal slow response (slow vertex response,SVR) under different frequencies and intensities of acoustic stimulation. To explore the relationship between SVR threshold and pure tone audiometric (pure tone audiometry,PTA threshold and its application value in forensic audiology evaluation. Methods: 46 normal hearing subjects (92 ears) were tested by PTA and SVR, respectively. The N1 wave and P2 wave of SVR with different acoustic stimulation intensity were marked, and the values of three analytical indexes (N1 wave latency, P2 wave latency, N1-P2 amplitude) were obtained. The variation of indexes with the decrease of acoustic stimulation intensity was analyzed. The SVR threshold and PTA threshold of 46 normal hearing subjects (92 ears) were measured. The two threshold values were compared by pairing t test, and the difference between SVR threshold and PTA threshold of each frequency was determined. 25 patients with sensorineural deafness (40 ears) were tested by PTA and SVR respectively. according to the PTA threshold, they were divided into mild, moderate and severe hearing impairment groups, and then the SVR threshold and PTA threshold of each group were compared. The correlation between SVR threshold and PTA threshold was analyzed, and the linear regression equation of behavioral hearing threshold was deduced according to the SVR threshold of the subjects. Results: 146 normal hearing subjects could induce clear and stable SVR waveforms. The N1 wave latency and P2 wave latency of SVR were gradually delayed with the decrease of acoustic stimulation intensity. The amplitude of N1-P2 decreased gradually with the decrease of acoustic stimulation intensity. 2 the SVR threshold of each frequency in normal hearing subjects was higher than the PTA threshold, and the average difference between the two threshold values was about between 5dB HL~10dB HL. In addition, the difference between the two threshold values tends to increase with the increase of frequency, which indicates that the SVR threshold is closer to the PTA threshold during low frequency acoustic stimulation, and can more accurately reflect the low frequency hearing of the subjects. 3 at each detection frequency, The SVR threshold is highly correlated with the PTA threshold. The r value of SVR threshold and PTA threshold was 0.971 (p0.05), and the univariate linear regression equation was Y 鈮，

本文編號：2495245