摘要
目的探讨0～3岁正常婴幼儿听力年龄分段方法,并得出其不同年龄段听力正常值及变化规律。方法正常听力婴幼儿239人共575耳,年龄1～36月,其中男359耳,女216耳。均行声导抗、耳声发射、听性脑干反应(ABR)和听性稳态反应(ASSR)检查。分析ABR波I、III、V潜伏期及波间期和0.5、1、2、4kHz ASSR反应阈。以每月龄婴幼儿听力检查结果为基本单位进行聚类分析,聚类类别分别设为2、3、4、5类,聚类分析结果组内各指标进行性别和耳别t检验,组间各指标进行单因素方差分析,根据有无变化规律选定分类。结果聚类分析最终选定分为3类,分为1～4月龄(一组),5～24月龄(二组),25～36月龄(三组)3个年龄段。每年龄段内耳别间结果差异无统计学意义,性别间ABR波III、V潜伏期和I-III、I-V波间期差异有统计学意义(P<0.05)。一、二、三组ABR反应阈分别为25.62±4.99、22.92±4.52、23.90±4.79dB nHL;0.5、1、2、4kHzASSR反应阈一组分别为44.43±11.92、37.53±9.92、30.67±13.38和33.71±15.77dB nHL;二组分别为44.57±11.68、38.02±10.73、27.65±9.70和29.34±12.45dB nHL;三组分别为45.56±12.92、39.63±12.53、29.42±10.15和31.11±13.48dB nHL;ABR反应阈与2、4kHz ASSR反应阈在一、二组间差异有统计学意义(P<0.05),二、三组间差异无统计学意义。结论婴幼儿3岁之前听力发育水平可分为1～4月龄、5～24月龄和25～36月龄三个阶段;ABR波III、V潜伏期及I-III和I-V波间期随年龄增加而缩短,波I潜伏期不随年龄增加而缩短,ABR反应阈以及2、4kHzASSR反应阈在5～24月龄间开始降低;提示出生时耳蜗神经传导已发育完善,而大脑听觉通路到两岁时高频听敏度发育完善,但是神经传导三岁时仍未发育成熟。
Objective To study the hearing developmental stages of newborns and infant of 1～36 months in terms of normal values and developmental characteristies. Methods 239 normal hearing newborns and infants were 1 ～36 months with 359 males and 216 females ears. The criteria for normal hearing thresholds were defined as ABR ≤30 dB nHL. The ABR components consisted of wave latencies and interpeak lateneies. ASSR includes thresholds of 0.5 kHz, 1 kHz,2 kHz and 4 kHz. The cluster analysis was employed to studying ABR and ASSR responses as a function of age of 1 month interval, t test was used to analyzing genders and ears, respectively in the group. Results Cluster analysis results suggested three stages.. 1～4 months, 5 ～ 24 months and 25 ～36 months. Stage 1; ABR threshold was 25.62±4.99 nHL, ASSR 500 Hz was 44.43±11.92 nHL,1 000 Hz 37.53±9.92 nHL,2 000 Hz 30.67±13.38 nHL,4 000 Hz 33.71±15.77 nHL. Stage 2： threshold of ABR was 22.92±4.52 nHL,ASSR 500 Hz 44.57±11.68 nHL,1 000 Hz 38.02±10.73 nHL,2 000 Hz 27.65±9.70 nHL,4 000 Hz 29.34±12.45 nHL. Stage3 threshold of ABRwas 23. 90±4.79 nHL,ASSR 500 Hz 45. 56±12.92 nHL, 1 000 Hz 39. 63±12.53 nHL,2 000 Hz 29.42±10.15 nHL,4 000 Hz 31.11±13.48 nHL. There was no statistical difference between left and right ears in every stage. And there were statistical differences on latencies of Wave I, Ⅲ, and interpeak latenciesI-Ⅲ and I-V between male and female in every stage and were smaller in females. ANOVA results indicate that the indices of above decrease linearly with age. Thresholds of ABR and ASSR only decreased between stage 1 and two, the difference had statistical significance. Oonolusion 5 months and 25 months are the landmark month in hearing development in 1～36 months. Neural transmission to the cochlea was well developed after birth but neural trans mission to the central auditory pathway has not matured at three years old.
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2012年第6期555-557,共3页
Journal of Audiology and Speech Pathology
关键词
婴幼儿
听力
聚类分析
Newborn and infant Hearing Cluster analysis
