摘要
目的:探究听神经病(auditory neuropathy,AN)患者畸变产物耳声发射(DPOAE)的特征,分析影响DPOAE各频率引出率、各耳引出率以及自然病程中首末诊引出率变化的因素。方法:研究对象来自于听神经病临床诊断和干预多中心研究(注册号:ChiCTR2100050125),AN诊断标准依照2022年中国听神经病临床实践指南。筛选行2次及以上DPOAE测试的双侧AN患者,按照发现年龄分为婴幼儿组(≤3岁)和非婴幼儿组(>3岁),分析入组患者DPOAE各频率引出率、各耳引出率以及自然病程中引出率变化的趋势,并探索其相关影响因素。采用SPSS 26.0软件进行数据处理和分析。结果:共纳入165例(330耳)AN患者,总体DPOAE首诊各耳引出率为77.0%±29.4%,末诊各耳引出率为65.1%±35.2%,其中171耳(51.8%)引出率降低。婴幼儿组共49例(98耳),其中男28例、女性21例,发现年龄0~3岁,中位数0.7岁;DPOAE首诊各耳引出率为57.9%±35.5%,末诊各耳引出率为32.4%±32.1%,69耳(70.4%)引出率降低。非婴幼儿组共116例(232耳),其中男59例、女57例,发现年龄3.9~40岁,中位数14岁;DPOAE首诊各耳引出率为84.6%±23.4%,末诊各耳引出率为78.3%±27.1%,102耳(44.0%)引出率降低。经多分类无序logistic回归分析,发现年龄与DPOAE变化率具有相关性(B=-0.224,OR=0.799,P<0.001)。结论:AN患者DPOAE的引出率会随着病程的增加而降低甚至消失;婴幼儿AN患者DPOAE引出率低于非婴幼儿AN患者。随着病程进展,婴幼儿AN患者DPOAE引出率下降幅度高于非婴幼儿AN患者。故临床上应充分结合DPOAE和耳蜗微音器电位结果进行精准诊断,定期随访,了解其自然病程,给予个性化指导与帮助。
Objective The purpose of this study was to investigate the characteristics of distortion product otoacoustic emissions(DPOAE)in patients with auditory neuropathy(AN).The factors affecting DPOAE elicitation rate of each frequency,elicitation rate of each ear and change rate of first and last diagnosis in the natural course were analyzed.Methods The sample was obtained from the Multicenter Study on Clinical Diagnosis and Intervention of AN(registration number:ChiCTR2100050125),and the diagnostic criteria for AN were based on the Chinese Clinical Practice Guidelines of Auditory Neuropathy(version 2022).Patients with bilateral AN who underwent 2 or more DPOAE tests were screened and divided into infant groups(≤3 years old)and non-infant groups(>3 years old)according to the age of detection,and the trend of DPOAE elicitation rate of each frequency,elicitation rate of each ear and change rate in the natural course of disease were analyzed,in order to explore the relevant influencing factors.Results A total of 165 patients(330 ears)with AN were included in the study.The overall DPOAE elicitation rate per ear was 77.0%±29.4%at the initial diagnosis and 65.1%±35.2%at the final diagnosis,with a reduction observed in the elicitation rate of 171 ears(51.82%).In the infant group,there were 49 cases(98 ears),including 28 males and 21 females,whose found age ranged from 0 to 3 years old,with a median age of 0.7 years.DPOAE elicitation rate per ear was 57.9%±35.5%in the initial diagnosis,and 32.4%±32.1%in the final diagnosis,with a reduction observed in the elicitation rate of 69 ears(70.41%).In the non-infant group,there were 116 cases(232 ears),including 59 males and 57 females,ranging in found age from 3.9 to 40 years old,with a median age of 14 years old.DPOAE elicitation rate per ear was 84.6%±23.4%in the initial diagnosis,and 78.3%±27.1%in the final diagnosis,with a reduction observed in the elicitation rate of 102 ears(43.97%).Age was found to be correlated with DPOAE changes by multicategorical unordered logistic
作者
陈姿伊
王洪阳
兰兰
谢林怡
李进
李丹阳
武凯丽
施韬
王秋菊
Chen Ziyi;Wang Hongyang;Lan Lan;Xie Linyi;Li Jin;Li Danyang;Wu Kaili;Shi Tao;Wang Qiuju(School of Medical Technology and Information Engineering,Zhejiang Chinese Medical University,Hangzhou 310053,China;Department of Audio-Vestibular Medicine,Senior Department of Otolaryngology-Head and Neck Surgery,the Sixth Medical Center of Chinese PLA General Hospital,Beijing 100048,China;State Key Laboratory of Hearing and Balance Science,National Clinical Research Center for Otolaryngologic Diseases,Beijing 100853,China)
出处
《中华耳鼻咽喉头颈外科杂志》
CSCD
北大核心
2024年第5期423-431,共9页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
国家重点研发计划(2023YFC2508400,2023YFC2509800,2023YFF1203504)
国家自然科学基金优秀青年基金项目(82222016)。
关键词
听神经病
畸变产物耳声发射
发病年龄
Auditory neuropathy
Distortion product otoacoustic emissions
Age of onset
