职业噪声暴露听力正常人耳蜗突触损伤的研究
A Study on Cochlear Synaptic Damage in Normal Hearing Individuals Exposed to Occupational Noise
王翩 1毛杭泽 1彭逹 1郑书坤 1赵乌兰1
作者信息
摘要
目的 探究职业噪声暴露下的不同听力学检查方法,对发现常频听力正常人群耳蜗突触损伤的临床意义,为噪声性耳蜗突触病变的研究提供参考.方法 选取2021年4月—2022年4月浙江中医药大学健康体检者104例(104耳)为研究对象,按照噪音强度分为接噪组和对照组,每组52例.接噪组接受高强度噪声暴露,对照组接受非噪声暴露,采用纯音测听、噪声下言语测听、畸变产物耳声发射、言语声诱发听性脑干反应4种听力学测试,分析两组各测试结果差异和测试间的相关性.结果 对照组在9～16 kHz纯音听阈显著好于接噪组,差异有统计学意义(P<0.01);接噪组噪声下言语测听信噪比损失显著高于对照组,差异有统计学意义(P<0.05);两组畸变产物耳声发射在4～10 kHz比较,差异有统计学意义(P<0.05);两组言语诱发听性脑干反应V、A、O波潜伏期比较,差异有统计学意义(P<0.01),V/A斜率比较,差异有统计学意义(P<0.05).对照组快速傅里叶变换F1幅值显著高于接噪组,差异有统计学意义(P<0.05);PTAEHF和D波潜伏期与DPmean呈负相关,除了E波其余各波潜伏期均与V/A斜率负相关.结论 职业噪声暴露导致可能的耳蜗突触损伤表现为PTAEHF升高,畸变产物耳声发射信噪比下降,噪声下言语识别能力的下降和言语诱发听性脑干反应潜伏期的延迟,联合测试可以提高发现的准确性并及时干预.
Abstract
Objective To identify audiological assessment methods effective in detecting cochlear synaptic dam-age in normal hearing population exposed to occupational noise for further study of this condition.Methods Individu-als undergoing routine health examination at the Zhejiang Traditional Chinese Medicine University from April 2021 to April 2022(n=104,104 ears)were recruited and grouped based on their noise exposure history,including among 52 fac-tory workers exposed to high intensity noise(noise-exposed group)and 52 controls.Pure tone audiometry(PTA)thresh-olds,speech in noise(SIN),distortion product otoacoustic emissions(DPOAEs)and speech-evoked auditory brainstem responses(s-ABRs)were collected and compared between the two groups,and the correlation among the tests analyzed.Results PTA thresholds over 9-16 kHz were better in the control group than in the noise-exposed group(P<0.01).Sig-nal/noise ratio loss in SIN was greater in the noise-exposed group than in the control group(P<0.05).DPOAE differenc-es between the two groups were statistically significant for 4-10 kHz(P<0.05).Differences in latencies of s-ABR waves V,Aand O(P<0.01),V/A slope(P<0.05),and F1 amplitude(P<0.05)were also statistically significant between the two groups.PTAEHF and D wave latency were negatively correlated with DPmean.Latencies of all waves,except wave E,were negatively correlated with V/A slope.Conclusion Potential cochlear synaptic damage caused by occupational noise exposure can be manifested as elevated PTAEHF,deteriorated SNR in DPOAEs,deteriorated SIN performance,and delayed s-ABR latencies.Multimodality assessment can improve the accuracy of detection for timely intervention.
关键词
耳蜗突触病/噪声暴露/畸变产物耳声发射/言语声诱发听性脑干反应/频率跟随反应Key words
cochlear synaptic lesions/noise exposure/distortion product otoacoustic emissions/speech-evoked auditory brainstem response/frequency-following response引用本文复制引用
基金项目
美国国立失聪和其他沟通障碍研究院项目(NIDCD/NIH)
美国国立失聪和其他沟通障碍研究院项目(1R01DC015990-01)
浙江中医药大学校级科研基金(2021ZZ05)
浙江中医药大学横向课题(2018-HT-143)
出版年
2024
国家科技期刊平台
NSTL
万方数据