分泌性中耳炎婴幼儿气导短纯音听性脑干反应阈分析

doi:10.12372/jcp.2025.25e0793

摘要/Abstract

摘要：

目的分析分泌性中耳炎（OME）婴幼儿气导短声（c-ABR）和短纯音听性脑干反应（Tb-ABR）阈结果，探讨气导Tb-ABR反应阈对OME婴幼儿分频听力评估的临床意义。方法回顾性分析2018年1月至2022年12月完成ABR反应阈测试的0~24月龄OME婴幼儿以及正常对照婴幼儿的测试结果。比较两组间气导c-ABR和Tb-ABR反应阈，分析OME组内气导c-ABR和Tb-ABR反应阈相关性。结果 OME组43例，男28例、女15例，中位年龄为8（3~14）月龄；气导c-ABR完成检测43例（60耳）、Tb-500 Hz ABR完成检测32例（45耳）、Tb-1000 Hz ABR完成检测27例（39耳）、Tb-2000 Hz ABR完成检测11例（17耳）、Tb-4000 Hz ABR完成检测11例（17耳）。对照组21例，男10例、女11例，中位年龄为6（4~8.25）月龄；气导c-ABR和4个频率Tb-ARB完成检测21例（42耳）。OME组气导c-ABR和Tb-500 Hz、Tb-1000 Hz、Tb-2000 Hz、Tb-4000 Hz ABR反应阈均高于正常对照组（P<0.01）。OME组内气导Tb-ABR 4个频率反应阈均高于气导c-ABR反应阈（P<0.05）。各频率反应阈间呈正相关性（P<0.05），Tb-2000 Hz与Tb-4000 Hz ABR反应阈间相关系数为0.925。结论 OME婴幼儿在低、中、高频均可能发生气导听力下降；与气导c-ABR相比，气导Tb-ABR反应阈可提供更多分频听力信息；测试时间有限时，Tb-2000 Hz和Tb-4000 Hz ABR或可选其一完成。

关键词: 分泌性中耳炎, 听性脑干反应阈, 婴幼儿

Abstract:

Objective To analyze the air-conduction click (c-ABR) and tone burst auditory brainstem response (Tb-ABR) thresholds in infants and young children with otitis media with effusion (OME) and explore the clinical significance of air-conduction Tb-ABR thresholds in frequency-specific hearing assessment for OME infants and young children. Methods A retrospective analysis was conducted on the ABR threshold test results of OME infants and young children aged 0~24 months and normal control infants from January 2018 to December 2022. The air-conduction click, Tb-500 Hz, Tb-1000 Hz, Tb-2000 Hz, and Tb-4000 Hz ABR thresholds were compared between the two groups. The correlation between c-ABR and Tb-ABR thresholds within the OME group was analyzed. Results The OME group consisted of 43 patients (28 boys and 15 girls), with a median age of 8 (3-14) months. The following testing was completed: air-conduction click for 43 cases (60 ears), Tb-500 Hz for 32 cases (45 ears), Tb-1000 Hz for 27 cases (39 ears), Tb-2000 Hz for 11 cases (17 ears), and Tb-4000 Hz for 11 cases (17 ears). The control group included 21 patients (10 boys and 11 girls), with a median age of 6 (4-8.25) months. The following tests were completed for the control group: air-conduction click, Tb-500 Hz, Tb-1000 Hz, Tb-2000 Hz, and Tb-4000 Hz for 21 cases (42 ears). The air-conduction click and Tb-ABR thresholds at Tb-500 Hz, Tb-1000 Hz, Tb-2000 Hz, and Tb-4000 Hz in the OME group were all significantly higher than those in the normal control group (P<0.01). In the OME group, the air-conduction c-ABR threshold was lower than the thresholds for Tb-ABR at all four frequencies (P<0.05). A positive correlation was found between the thresholds at different frequencies (P<0.05), and the correlation coefficient between Tb-2000 Hz and Tb-4000 Hz was 0.925. Conclusions Infants and young children with OME may experience hearing loss across a range of frequencies, from low to high. Compared to air-conduction c-ABR, Tb-ABR thresholds provide more information about frequency-specific hearing. In clinical settings with limited testing time, Tb-2000 Hz or Tb-4000 Hz might be selected for threshold testing, in addition to 500 Hz and 1000 Hz.

Key words: otitis media with effusion, auditory brainstem response threshold, infants and young children

中图分类号:

汪玮, 王璐, 沈佳丽, 马孝宝, 贺宽, 宋佳玥, 陈建勇, 杨军, 金玉莲. 分泌性中耳炎婴幼儿气导短纯音听性脑干反应阈分析[J]. 临床儿科杂志, 2025, 43(12): 902-907.

WANG Wei, WANG Lu, SHEN Jiali, MA Xiaobao, HE Kuan, SONG Jiayue, CHEN Jianyong, YANG Jun, JIN Yulian. Air-conduction tone burst auditory brainstem response thresholds in infants and young children with otitis media with effusion[J]. Journal of Clinical Pediatrics, 2025, 43(12): 902-907.

图/表 2

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测试项目	OME组		正常组		Z值	P
测试项目	耳数	ABR反应阈	耳数	ABR反应阈	Z值	P
c-ABR	60	35(25~45)	42	10(8.75~15)	8.09	<0.001
Tb-500 Hz	45	55(45~67.5)¹⁾	42	35(30~40)	6.68	<0.001
Tb-1000 Hz	39	45(40~60)¹⁾	42	25(20~30)	6.68	<0.001
Tb-2000 Hz	17	55(42.5~60)¹⁾	42	15(10~16.25)	6.06	<0.001
Tb-4000 Hz	17	50(40~60)¹⁾	42	10(5~20)	5.98	<0.001
H值	47.20		－
P	<0.001		－

项目	r_s
项目	c-ABR	Tb-500 Hz	Tb-1000 Hz	Tb-2000 Hz	Tb-4000 Hz
c-ABR	－	0.696	0.692	0.928	0.864
Tb-500 Hz	－	－	0.877	0.781	0.728
Tb-1000 Hz	－	－	－	0.684	0.666
Tb-2000 Hz	－	－	－	－	0.925
Tb-4000 Hz	－	－	－	－	－