健听婴幼儿骨导短声听性脑干反应波Ⅴ月龄-潜伏期函数模型构建

doi:10.12372/jcp.2025.25e0803

临床儿科杂志 ›› 2025, Vol. 43 ›› Issue (12): 933-939.doi: 10.12372/jcp.2025.25e0803

健听婴幼儿骨导短声听性脑干反应波Ⅴ月龄-潜伏期函数模型构建

马孝宝¹^,^*, 沈佳丽¹^,^*, 汪玮¹, 王璐¹, 楼高忠², 赵哲弘³, 金玉莲¹, 杨军¹, 陈建勇¹(), 秦欢¹()

1.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）
2.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）
3.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:2025-07-10 录用日期:2025-09-01 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，秦欢，电子信箱：qinhuan8269@xinhuamed.com.cn
作者简介:^* 具有同等贡献
基金资助:
国家自然科学基金重点项目(82230035);国家自然科学基金面上项目(82271179);国家自然科学基金面上项目(82271160);国家重点研发计划项目(2024YFC251100)

Establishment of an age-latency function model for wave Ⅴ of bone-conduction click-evoked auditory brainstem responses in normal-hearing infants and young children

MA Xiaobao¹^,^*, SHEN Jiali¹^,^*, WANG Wei¹, WANG Lu¹, LOU Gaozhong², ZHAO Zhehong³, JIN Yulian¹, YANG Jun¹, CHEN Jianyong¹(), QIN Huan¹()

1. 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
2. Department of Otolaryngology, Hangzhou Maternity and Child Health Care Hospital, Hangzhou Children’s Hospital, Hangzhou 310000, Zhejiang, China
3. Department of Otolaryngology, Shaoxing Central Hospital, Shaoxing 312030, Zhejiang, China

Received:2025-07-10 Accepted:2025-09-01 Published:2025-12-15 Online:2025-11-28

摘要/Abstract

摘要：

目的构建健听婴幼儿不同月龄骨导短声听性脑干反应（BC-ABR）波Ⅴ潜伏期函数曲线，为临床BC-ABR阈值的判断提供参考。方法选取2019年1月至2022年12月在听力障碍及眩晕诊治中心就诊的听力正常婴幼儿为研究对象。分别选取30 dB nHL及阈值强度2个不同刺激强度进行BC-ABR检测，使用短声（click）记录不同月龄的波Ⅴ潜伏期数值。建立听力正常婴幼儿月龄-潜伏期函数模型，并使用Bland-Altman法行月龄-潜伏期函数模型验证。结果研究期间共纳入婴幼儿210名（410耳），男113名（222耳）、女97名（188耳），中位月龄5（3~8）个月，其中0~3月龄组126耳、4~6月龄组168耳、7~12月龄组66耳、13~36月龄组50耳。30 dB nHL和阈值强度下不同月龄组间BC-ABR波Ⅴ潜伏期差异均有统计学意义（P<0.05)。30 dB nHL强度下，月龄-潜伏期函数模型为Y1=7.227+2.563×e^-0.1596×x，R²=0.44；阈值强度下，月龄-潜伏期函数模型为Y2=8.171+2.739×e^-0.1432×x，R²=0.33。Bland-Altman法显示30 dB nHL和阈值强度两组实测值与预测值差值落在95%一致性界限之外的比例为3.6%（4/110）和2.7%（3/110）。结论 BC-ABR的波Ⅴ潜伏期随月龄的增加而逐渐缩短。本研究建立的BC-ABR波Ⅴ月龄-潜伏期函数模型具有一定临床应用价值。

关键词: 骨导听性脑干反应, 月龄-潜伏期, 函数模型, 正常听力, 婴幼儿

Abstract:

Objective To construct latency-age function curves of waveⅤin bone-conducted auditory brainstem responses (BC-ABR) across different ages in normal-hearing infants and young children, thereby providing a reference for clinical assessment of BC-ABR thresholds. Methods Infants and young children with normal hearing who visited the Hearing Impairment and Vertigo Diagnosis and Treatment Center from January 2019 to December 2022 were selected as the research subjects. BC-ABRs were recorded at two stimulus intensities (30 dB nHL and threshold level) using click stimuli. The age-latency function model of infants and young children with normal hearing was established, and the Bland-Altman method was used to verify the model. Results A total of 210 infants and young children (410 ears) were included during the study period, including 113 boys (222 ears) and 97 girls (188 ears), with a median age of 5 (3-8) months. Among them, there were 126 ears in the 0-3 months age group, 168 ears in the 4-6 months age group, 66 ears in the 7-12 months age group, and 50 ears in the 13-36 months age group. Significant differences in wave Ⅴ latency were observed among different age groups under both 30 dB nHL and threshold stimulation (P<0.05). The latency-age function model at 30 dB nHL was: Y1=7.227+2.563×e^-0.1596×x, with R²=0.44, and at threshold intensity: Y2=8.171+2.739×e^-0.1432×x, with R²=0.33, where x is age in months. Bland-Altman analysis showed that the proportions of differences between measured and predicted values falling outside the 95% limits of agreement were 3.6% (4/110) and 2.7% (3/110), respectively. Conclusions Wave Ⅴ latency of BC-ABR shortens progressively with increasing age in infants and young children. The latency-age function models established in this study may serve as useful references for clinical applications.

Key words: bone-conduction auditory brainstem response, age-latency, function model, normal hearing, infants and young children

中图分类号:

马孝宝, 沈佳丽, 汪玮, 王璐, 楼高忠, 赵哲弘, 金玉莲, 杨军, 陈建勇, 秦欢. 健听婴幼儿骨导短声听性脑干反应波Ⅴ月龄-潜伏期函数模型构建[J]. 临床儿科杂志, 2025, 43(12): 933-939.

MA Xiaobao, SHEN Jiali, WANG Wei, WANG Lu, LOU Gaozhong, ZHAO Zhehong, JIN Yulian, YANG Jun, CHEN Jianyong, QIN Huan. Establishment of an age-latency function model for wave Ⅴ of bone-conduction click-evoked auditory brainstem responses in normal-hearing infants and young children[J]. Journal of Clinical Pediatrics, 2025, 43(12): 933-939.

图/表 4

表1

表2

图1

图2

参考文献 18

[1]	Norrix LW, Velenovsky D. Clinicians' guide to obtaining a valid auditory brainstem response to determine hearing status: signal, noise, and cross-checks[J]. Am J Audiol, 2018, 27(1): 25-36. doi: 10.1044/2017_AJA-17-0074 pmid: 29392291
[2]	Sharma M, Bist SS, Kumar S. Age-related maturation of wave V latency of auditory brainstem response in children[J]. J Audiol Otol, 2016, 20(2): 97-101. doi: 10.7874/jao.2016.20.2.97 pmid: 27626083
[3]	Farinetti A, Raji A, Wu H, et al. International consensus (ICON) on audiological assessment of hearing loss in children[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2018, 135(1S): S41-S48.
[4]	沈佳丽, 陈建勇, 汪玮, 等. 婴儿不同频率短纯音听性脑干反应正常值研究[J]. 听力学及言语疾病杂志, 2020, 28(6): 620-624.
	Shen JL, Chen JY, Wang W, et al. Study on normal value of different frequencies of tone burst auditory brainstem response in infants[J]. Tinglixue Ji Yanyu Jibing Zazhi, 2020, 28(6): 620-624.
[5]	汪玮, 陈向平, 马孝宝, 等. 骨导短声ABR在低龄分泌性中耳炎儿童合并感音神经性听力损失诊断中的应用[J]. 中国听力语言康复科学杂志, 2021, 19(5): 336-339.
	Wang W, Chen XP, Ma XB, et al. Identifying sensorineural hearing loss in young children with otitis media with effusion by applying bone-conducted click ABR[J]. Zhongguo Tingli Yuyan Kangfu Kexue Zazhi, 2021, 19(5): 336-339.
[6]	Jan SL, Shieh G. The Bland-Altman range of agreement: exact interval procedure and sample size determination[J]. Comput Biol Med, 2018, 100: 247-252. doi: 10.1016/j.compbiomed.2018.06.020
[7]	Bland JM, Altman DG. Measuring agreement in method comparison studies[J]. Stat Methods Med Res, 1999, 8(2): 135-160. doi: 10.1177/096228029900800204 pmid: 10501650
[8]	李隽, 王智楠, 黄芳, 等. 0-6岁正常儿童骨导听性脑干反应的特征分析[J]. 听力学及言语疾病杂志, 2011, 19(2): 123-125.
	Li J, Wang ZN, Huang F, et al. Bone conduction auditory brainstem responses in 0-6 years old children with normal hearing[J]. Tinglixue Ji Yanyu Jibing Zazhi, 2011, 19(2): 123-125.
[9]	Seo YJ, Kwak C, Kim S, et al. Update on bone-conduction auditory brainstem responses: a review[J]. J Audiol Otol, 2018, 22(2): 53-58. doi: 10.7874/jao.2017.00346 pmid: 29471611
[10]	Reynard P, Montero M, Alhamwi A, et al. Contribution of bone conduction click-evoked auditory brainstem responses to diagnosis of hearing loss in infants in France[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2021, 138(3): 159-162. doi: 10.1016/j.anorl.2020.09.007 pmid: 33046426
[11]	Durrant JD, Hyre R. Observations on temporal aspects of bone-conduction clicks: real head measurements[J]. J Am Acad Audiol, 1993, 4(3): 213-219. pmid: 8318712
[12]	Hooks RG, Weber BA. Auditory brain stem responses of premature infants to bone-conducted stimuli: a feasibility study[J]. Ear Hear, 1984, 5(1): 42-46. doi: 10.1097/00003446-198401000-00009
[13]	Johnson KL, Nicol T, Zecker SG, et al. Developmental plasticity in the human auditory brainstem[J]. J Neurosci, 2008, 28(15): 4000-4007. doi: 10.1523/JNEUROSCI.0012-08.2008 pmid: 18400899
[14]	茅学英, 陶峥, 顾宇, 等. 不同年龄正常听力新生儿和婴幼儿听性脑干反应波潜伏期分析[J]. 听力学及言语疾病杂志, 2014, 22(3): 239-241.
	Mao XY, Tao Z, Gu Y, et al. The analysis of auditory brainstem response latency for normal hearing newborn and infants[J]. Tinglixue Ji Yanyu Jibing Zazhi, 2014, 22(3): 239-241.
[15]	Stuart A, Yang EY, Green WB. Neonatal auditory brainstem response thresholds to air- and bone-conducted clicks: 0 to 96 hours postpartum[J]. J Am Acad Audiol, 1994, 5(3): 163-172. pmid: 8075412
[16]	Yang E, Stuart A. A method of auditory brainstem response testing of infants using bone-conducted clicks[J]. CJSLPA, 1990, 14: 69-76.
[17]	马孝宝, 沈佳丽, 汪玮, 等. 健听幼儿短纯音ABR波V强度-潜伏期函数模型构建[J]. 听力学及言语疾病杂志, 2023, 31(4): 299-304.
	Ma X, Shen J, Wang W, et al. Functional Model Construction of Wave V Intensity-latency Based on Tone Burst Auditory Brainstem Responses in Infants with Normal Hearing[J]. Tinglixue Ji Yanyu Jibing Zazhi, 2023, 31(4): 299-304.
[18]	马孝宝, 沈佳丽, 汪玮, 等. 婴幼儿短纯音听性脑干反应阈预测模型研究[J]. 中华耳科学杂志, 2024, 22(4): 562-566.
	Ma XB, Shen JL, Wang W, et al. A Predictive model for tone burst auditory brainstem response thresholds in infants[J]. Zhonghua Erkexue Zazhi, 2024, 22(4): 562-566.

组别	耳数	BC-ABR波Ⅴ潜伏期[M(P₂₅~P₇₅)]/ms	参考区间(P_2.5~P_97.5)/ms
0~3月龄	126	8.77(8.42~9.00)	8.08~10.20
4~6月龄	168	8.27(7.93~8.80)	7.34~9.88
7~12月龄	66	7.60(7.28~8.00)	6.93~9.26
13~36月龄	50	7.27(7.07~7.53)	6.85~8.45
H值		186.61
P		<0.001

组别	耳数	BC-ABR波Ⅴ潜伏期[M(P₂₅~P₇₅)]/ms	参考区间(P_2.5~P_97.5)/ms
0~3月龄	126	9.80(9.40~10.19)	8.80~11.51
4~6月龄	168	9.40(8.93~10.02)	8.20~11.39
7~12月龄	66	8.73(8.33~9.13)	7.84~10.53
13~36月龄	50	8.37(8.03~8.80)	7.38~9.33
H值		132.20
P		<0.001

健听婴幼儿骨导短声听性脑干反应波Ⅴ月龄-潜伏期函数模型构建

Establishment of an age-latency function model for wave Ⅴ of bone-conduction click-evoked auditory brainstem responses in normal-hearing infants and young children

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 18

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	许示沂, 杜敏, 白丽霞, 刘爱红. 婴幼儿重症百日咳研究进展[J]. 临床儿科杂志, 2025, 43(5): 383-388.
[2]	杨军, 陈建勇. 婴幼儿听力障碍：从精准诊断、个体化干预到系统性随访[J]. 临床儿科杂志, 2025, 43(12): 890-896.
[3]	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.
[4]	沈佳丽, 马孝宝, 汪玮, 王璐, 楼高忠, 赵哲弘, 金玉莲, 杨军, 陈建勇. 不同听力损失程度婴儿短声与短纯音听性脑干反应波Ⅴ潜伏期-强度函数构建[J]. 临床儿科杂志, 2025, 43(12): 908-914.
[5]	毛萌, 邵洁, 陈津津, 沈理笑. 《生长减缓婴幼儿的追赶生长：指导临床医师的专家建议》解读[J]. 临床儿科杂志, 2024, 42(5): 390-398.
[6]	谢垒, 王瑶, 马威, 范晓蕾, 孙娟, 陈晓昕, 王怀立. 宏基因组二代测序技术诊断骨髓涂片阴性婴幼儿黑热病3例报告[J]. 临床儿科杂志, 2023, 41(11): 859-862.
[7]	吴诗寅, 蔡美琴. 长双歧杆菌与婴幼儿肠道健康的研究进展[J]. 临床儿科杂志, 2022, 40(9): 715-720.
[8]	陈钰波, 李宇宁. 益生菌在婴幼儿消化道炎症性和功能性疾病中应用进展[J]. 临床儿科杂志, 2022, 40(11): 869-874.
[9]	朱婧. 人乳活性成分——骨桥蛋白研究进展[J]. 临床儿科杂志, 2021, 39(4): 313-.
[10]	谢丽春,游晶玉,李国栋,等. 婴幼儿肝血管瘤继发消耗性甲状腺功能减退症1例诊断及治疗[J]. 临床儿科杂志, 2021, 39(10): 761-.
[11]	吴小英，甘川. 婴幼儿重症百日咳死亡相关因素分析[J]. 临床儿科杂志, 2020, 38(6): 432-.
[12]	王智利，罗斯颖，易茜，等. CPAP 在先天性心脏病合并重症肺炎心功能不全患儿中的应用[J]. 临床儿科杂志, 2020, 38(1): 10-.
[13]	沈凌花，卫海燕，张英娴，等. 分型不明的婴幼儿糖尿病病因学探讨[J]. 临床儿科杂志, 2019, 37(8): 594-.
[14]	徐明玉，任芳，沈理笑，等. 屏幕暴露对0~3岁婴幼儿语言发育的影响[J]. 临床儿科杂志, 2019, 37(2): 97-.
[15]	徐萌,　王健怡,　肖婷婷,　谢利剑,　李筠,　黄敏. 经食管心房调搏术诊治婴幼儿快速型心律失常临床分析[J]. 临床儿科杂志, 2018, 36(4): 277-.