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目的:分析比较耳蜗电图和ABR测试在听神经病(AN)诊断中的作用。方法:AN组为AN患者16例(32耳),对照组为感音神经性听力损失患者20例(26耳)。对2组受试者行交替极性短声刺激耳蜗电图和ABR测试。分别观测AN组和对照组的波形,并进行以下对比:①比较AN组患者的ABR和耳蜗电图波形引出率;②比较AN组与对照组耳蜗电图的复合动作电位(CAP)潜伏期和绝对幅度,以及总和电位(SP)与CAP的幅度比值。结果:AN组32耳中有25耳引出-SP或CAP,耳蜗电图总体引出率为78.1%。AN组的CAP潜伏期短于对照组(P<0.05),CAP绝对幅度低于对照组(P<0.05),-SP/CAP幅度比值高于对照组(P<0.01)。AN组仅5耳引出不完整的ABR波形,引出率为15.6%,且波形分化较差。ABR引出率明显低于耳蜗电图(P<0.01)。对照组全部引出分化良好的耳蜗电图和ABR波形。结论:耳蜗电图和ABR在AN的诊断中各自发挥重要作用。AN患者听觉信息的时间整合作用受到损害而强度感受机制受影响较小。
OBJECTIVE: To analyze and compare the role of cochlear electrogram and ABR testing in the diagnosis of auditory neuropathy (AN). Methods: AN group was 16 cases (32 ears) in AN group and control group was 20 cases (26 ears) with sensorineural hearing loss. Alternate polar short sonic stimulation of the cochlear electrogram and ABR test was performed on the 2 subjects. The waveforms of AN group and control group were observed and compared as follows: ①The ABR and the leads of the electrochromic waveform in AN group were compared; ② The composite electrocorticography (CAP) latency and absolute Amplitude, and the magnitude ratio of the sum potential (SP) to CAP. Results: 25 ears of 32 ears of AN group led to -SP or CAP, and the total lead-out rate of ECG was 78.1%. The CAP latency of AN group was shorter than that of control group (P <0.05), and the absolute amplitude of CAP was lower than that of control group (P <0.05). The amplitude of SP / CAP was higher than that of control group (P <0.01). Only 5 ears of AN group lead to incomplete ABR waveform with a lead rate of 15.6% and poor waveform differentiation. ABR extraction rate was significantly lower than the cochlear electrogram (P <0.01). The control group all lead to well-differentiated cochlear electrogram and ABR waveform. Conclusion: Electrochrogram and ABR play an important role in the diagnosis of AN. The temporal integration of auditory information in AN patients was impaired and the mechanism of intensity perception was less affected.