感音神经性听力损失婴幼儿及儿童听性脑干反应与行为测听阈值之间相关性研究

doi:10.12372/jcp.2025.25e0828

临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (12): 940-946.doi: 10.12372/jcp.2025.25e0828

感音神经性听力损失婴幼儿及儿童听性脑干反应与行为测听阈值之间相关性研究

王璐¹^,², 马孝宝², 汪玮², 沈佳丽², 贺宽², 金玉莲², 杨军², 郑贵亮², 楼高忠³, 赵哲弘⁴, 陈建勇²()

1.浙江中医药大学（浙江杭州 310053）
2.上海交通大学医学院附属新华医院耳鼻咽喉头颈外科上海交通大学医学院耳科学研究所上海市耳鼻疾病转化医学重点实验室（上海 200092）
3.杭州市妇幼保健院（杭州市儿童医院）耳鼻咽喉科（浙江杭州 310000）
4.绍兴市中心医院医共体总院耳鼻咽喉科（浙江绍兴 312030）

收稿日期:2025-07-14 录用日期:2025-09-22 出版日期:2025-12-15 发布日期:2025-11-28
通讯作者: 陈建勇电子信箱：chenjianyong@xinhuamed.com.cn
作者简介:^* 具有同等贡献
基金资助:
国家重点研发计划(2024YFC251100);国家自然科学基金面上项目(82271160)

Research on the correlation between auditory brainstem response and behavioral hearing thresholds in infants and children with sensorineural hearing loss

WANG Lu¹^,², MA Xiaobao², WANG Wei², SHEN Jiali², HE Kuan², JIN Yulian², YANG Jun², ZHENG Guiliang², LOU Gaozhong³, ZHAO Zhehong⁴, CHEN Jianyong²()

1. Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China
2. Department of Otolaryngology, Head and Neck Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Translational Medicine of Ear and Nose Disease, Shanghai 200092, China
3. Department of Otolaryngology, Hangzhou Maternity and Child Health Care Hospital, Hangzhou Children’s Hospital, Hangzhou 310000, Zhejiang, China
4. Department of Otolaryngology, Shaoxing Central Hospital, Shaoxing 312030, Zhejiang, China

Received:2025-07-14 Accepted:2025-09-22 Published:2025-12-15 Online:2025-11-28

摘要/Abstract

摘要：

目的研究感音神经性听力损失婴幼儿及儿童听性脑干反应（ABR）阈值与行为测听阈值的相关性，并获得短纯音ABR（tb-ABR）与相应频率行为测听的校准因子，为预估行为测听阈值提供临床参考。方法选取2014年2月至2022年9月耳鼻咽喉头颈外科确诊为感音神经性听力损失的婴幼儿及儿童作为研究对象，对患儿行短声ABR（click-ABR）及500、1 000 、2 000和4 000 Hz频率的Tb-ABR测试，并在随访中获取其行为测听阈值。分析不同频率声刺激下ABR阈值与行为测听阈值的相关性，比较Tb-ABR阈值与行为测听阈值差异，并建立回归方程及获得校准因子。结果纳入感音神经性听力损失患儿61例（118耳），其中男40例（77耳）、女21例（41耳）。完成ABR中位年龄1.9（0.7~3.4）岁，完成行为测听中位年龄3.4（2.0~4.4）岁。click-ABR阈值与2 000 Hz、4 000 Hz行为测听阈值的相关系数分别为0.73和0.74。Tb-ABR阈值与500 Hz、1 000 Hz、2 000 Hz、4 000 Hz行为测听阈值间呈强相关性（r=0.82~0.87，P<0.01）。基于Tb-ABR阈值预估行为测听阈值的线性回归方程如下，500Hz：y=0.87x+2.55，1 000 Hz：y=0.89x+4.29，2 000 Hz：y=0.79x+14.70，4 000 Hz：y=0.99x+0.84。当500、1 000、2 000和4 000 Hz频率下Tb-ABR阈值在50、70和90 dB nHL时，校准因子分别为5、10、10 dB，5、5、10 dB，0、5、5 dB 以及0、0、0 dB。结论 Tb-ABR阈值与行为测听阈值具有高度相关性，获得的校准因子及回归方程可有效预估行为测听阈值，为感音神经性听力损失婴幼儿及儿童后期助听干预精准调试提供了重要参考。

关键词: 感音神经性听力损失, 短纯音听性脑干反应, 行为测听, 随访, 儿童

Abstract:

Objective To investigate the correlation between auditory brainstem response (ABR) thresholds and behavioral hearing thresholds in infants and children with sensorineural hearing loss (SNHL), and to establish calibration factors for tone burst ABR (Tb-ABR) and behavioral thresholds across frequencies, providing clinical reference for predicting behavioral hearing thresholds. Methods From February 2014 to September 2022, children diagnosed with SNHL in the Department of Otorhinolaryngology-Head and Neck Surgery were enrolled as subjects. Each participant underwent click-ABR and Tb-ABR testing at 500, 1000, 2000, and 4000 Hz. Behavioral hearing thresholds were obtained during follow-up visits. Correlation analyses between ABR thresholds and behavioral thresholds were conducted across frequencies. Differences between Tb-ABR and behavioral thresholds were compared, and regression equations along with calibration factors were derived. Results A total of 61 children (118 ears) with SNHL were included, comprising 40 boys (77 ears) and 21 girls (41 ears). The median age at ABR testing was 1.9 (0.7-3.4) years, and the median age at behavioral testing was 3.4 (2.0-4.4) years. Click-ABR thresholds showed correlations of 0.73 and 0.74 with behavioral hearing thresholds at 2000 Hz and 4 000 Hz, respectively. Strong correlations were observed between Tb-ABR thresholds and behavioral thresholds at all tested frequencies (r=0.82~0.87, P<0.01). The linear regression equations for predicting behavioral thresholds based on Tb-ABR thresholds were as follows, 500 Hz: y=0.87x+2.55, 1 000 Hz: y=0.89x+4.29, 2 000 Hz: y=0.79x+14.70, 4 000 Hz: y=0.99x+0.84. When the Tb-ABR threshold is 50, 70 and 90 dB nHL at frequencies of 500, 1 000, 2 000 and 4 000 Hz, the calibration factors are 5, 10, 10 dB, 5, 5, 10 dB, 0, 5, 5 dB and 0, 0, 0 dB, respectively. Conclusions Tb-ABR thresholds are strongly correlated with behavioral hearing thresholds in young children with SNHL. The derived calibration factors and regression equations can effectively predict behavioral hearing thresholds, offering valuable guidance for the accurate fitting of hearing aids in this population.

Key words: sensorineural hearing loss, tone-burst auditory brainstem response, behavioral audiometry, follow-up, child

中图分类号:

王璐, 马孝宝, 汪玮, 沈佳丽, 贺宽, 金玉莲, 杨军, 郑贵亮, 楼高忠, 赵哲弘, 陈建勇. 感音神经性听力损失婴幼儿及儿童听性脑干反应与行为测听阈值之间相关性研究[J]. 临床儿科杂志, 2025, 43(12): 940-946.

WANG Lu, MA Xiaobao, WANG Wei, SHEN Jiali, HE Kuan, JIN Yulian, YANG Jun, ZHENG Guiliang, LOU Gaozhong, ZHAO Zhehong, CHEN Jianyong. Research on the correlation between auditory brainstem response and behavioral hearing thresholds in infants and children with sensorineural hearing loss[J]. Journal of Clinical Pediatrics, 2025, 43(12): 940-946.

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频率/Hz	耳数	Tb-ABR阈值/dB nHL	行为测听阈值/dB HL	t值	P
500	117	72.63±18.18	65.61±19.17	6.74	<0.001
1 000	110	73.32±15.45	69.25±16.60	4.41	<0.001
2 000	91	72.79±16.90	72.13±16.19	0.52	0.605
4 000	89	74.75±17.83	74.92±20.40	0.13	0.901

感音神经性听力损失婴幼儿及儿童听性脑干反应与行为测听阈值之间相关性研究

Research on the correlation between auditory brainstem response and behavioral hearing thresholds in infants and children with sensorineural hearing loss

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项目	测试时间/月龄
项目	0~6	7~12	13~24	25~36	>36
ABR测试完成耳数	28	16	23	14	37
行为测听完成耳数	0	4	23	28	63

频率/Hz	回归方程	校准因子例举
频率/Hz	回归方程	50 dB nHL	70 dB nHL	90 dB nHL
500	y=0.87x+2.55	5	10	10
1 000	y=0.89x+4.29	5	5	10
2 000	y=0.79x+14.70	0	5	5
4 000	y=0.99x+0.84	0	0	0

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