纯音听阈正常的言语交流障碍患者听觉事件相关电位分析

摘要

Objective To investigate the auditory evoked event - related potentials characteristics in patients of auditory disability with normal hearing. Methods 10 patients, complaining of difficulty in conversation, especially in noisy backgrounds, were continuously studied. 20 sex - and age-matched healthy volunteers without hearing problems were used as controls. Both the patients and volunteers have normal hearing threshold and middle ear status and distortion product otoacoustic emission(DPOAE) and auditory brainstem responses(ABR). They recieced 128 - channel ERP test with speech stimuli, in quiet and noisy backgrounds, respectively. Results Both the patients and controls had P1-N1-P2 and MMN in quiet. In noisy background, 2 patients had neither P1-N1-P2 nor MMN. In quiet. MMN latencies of the patients were 221. 8±23. 9 ms, significantly prolonged compare to the controls' 200. 4±28.1 ms(P=0. 049). In noisy background. MMN latencies of patients and controls were 267.1±27. 8 ms and 233. 4±25. 8 ma. Respectively, and the difference was statistically significant (P=0. 003). There were no statistical differences in latencies or amplititudes of P1 -N1 - P2, or in amplititudes of MMN between patients and normal controls. Conclusion Prolonged MMN latencies in patients of auditory disability with normal hearing, may indicate the possible existence of the central auditory processing disorders.%目的 初步探讨纯音听阈正常的言语交流障碍患者听觉事件相关电位的特征.方法 因听觉障碍尤其在噪声环境下言语理解困难的患者10例作为患者组,正常对照组为性别、年龄匹配的无听力及交流障碍的健康志愿者20例,所有患者及志愿者纯音听阈、鼓室导抗图、畸变耳声发射( DPOAE)及听性脑干反应(ABR)检测均无异常.两组分别在安静和噪声背景下行128导联言语刺激音的听觉事件相关电位(event- related potentials,ERP)检测,比较两组的ERP成分P1—N1—P2和失匹配负波(mismatch negativity,MMN)的潜伏期和波幅.结果 安静背景下,两组均能诱出P1—N1—P2和MMN,患者组MMN潜伏期为221.8±23.9 ms,较正常对照组(200.4±28.1 ms)延长(P＜0.05);噪声背景下,2名患者的P1—N1- P2及MMN不能分辨;患者组及对照组的MMN潜伏期分别为267.1±27.8和233.4±25.8 ms,差异有显著统计学意义(P＜0.01)；在安静及噪声背景下,P1-N1-P2潜伏期及波幅、MMN的波幅两组比较差异均无统计学意义(P＞0.05).结论 纯音听阈正常的言语交流障碍患者MMN的潜伏期明显延长,提示其中枢处理能力可能下降.