不同程度男性OSAHS患者言语诱发听性脑干反应结果分析
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摘要
目的分析不同程度的男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者言语诱发听性脑干反应(speech-ABR)测试结果,并探讨其可能的机制。方法选取男性OSAHS患者60例(18～40岁),根据多导睡眠图(polysomnogram,PSG)结果分为轻度组19例,中度组20例,重度组21例;选取成年男性25例(AHI<5,最低SaO_2>90%)作为对照组;两组分别进行speech-ABR测试,对结果进行比较分析。结果轻、中、重度OSAHS患者speech-ABR波V振幅分别为0.06±0.03、0.06±0.02、0.04±0.02μV,均低于对照组(0.09±0.02μV)(均为P<0.01),重度组低于轻、中度组(P<0.05),但轻度组与中度组间差异无统计学意义(P=0.84)。轻、中、重度OSAHS患者波A振幅分别为-0.16±0.04、-0.15±0.05、-0.12±0.03μV,低于对照组(-0.19±0.03μV)(均为P<0.01),重度组低于轻、中度组(P<0.01),但轻度组与中度组间差异无统计学意义(P=0.459)。轻、中、重度OSAHS患者波V潜伏期分别为6.82±0.39、6.80±0.36、6.83±0.29 ms,波A潜伏期分别为7.92±0.28、7.91±0.26、7.95±0.26 ms,均较对照组(分别为6.59±0.28 ms、7.73±0.25 ms)明显延长(P<0.05),但轻、中、重度OSAHS患者三组间差异均无统计学意义(P>0.05);OSAHS患者组V-A及C-A波间期,频率跟随反应(FFR)C、D、E、F波间期与对照组间差异均无统计学意义(P>0.05)。结论 OSAHS患者speech-ABR测试结果出现异常,提示其脑干水平可能存在言语编码缺陷,这种缺陷可能与缺氧程度有关。
Objective To study the speech-ABR in male patients with OSAHS of different degrees.Methods Sixty male patients with OSAHS aged from 18 to 40 years old were enrolled and divided into the mild group(19 participants), the moderate group(20 participants) and the severe group(21 participants) according to the AHI and extent of hypoxia. The control group consisted of 25 male participants(AHI<5 times/h;the minimum SaO_2>90%).Speech-ABR test was used to all the participants.Results The amplitude of V of the control group(0.09±0.02 μV) was significantly higher than that of the other 3 groups(mild group:0.06±0.03 μV,moderate group:0.06±0.02 μV,and severe group:0.04±0.02 μV)(P<0.01). The severe group differed significantly from the mild and moderate groups in amplitude of V(P<0.01). No significant difference was found between the mild group and moderate group(P=0.84). The amplitude of A of the control group(-0.19±0.03 μV) was significantly higher than the other three groups(mild group:-0.16±0.04 μV,moderate group:-0.15±0.05 μV,and severe group:-0.12±0.03 μV)(P<0.01). The severe group differed significantly from the mild and moderate groups in the amplitude of A(P<0.01). No significant difference was found between the mild and moderate groups(P=0.459). The latencies of V wave were prolonged in the mild group as 6.82±0.39 ms,the moderate group as 6.80±0.36 ms and the severe group as 6.83±0.29) ms compared with the control group(6.59±0.28 ms)(P<0.05 respectively). No significant differences were noted among the mild, moderate and severe groups. The latencies of A wave were prolonged in the mild group as 7.92±0.28 ms,the moderate group as 7.91±0.26 ms and the severe group as 7.95±0.26 ms compared with the control group(7.73±0.25 ms).No significant difference was found between the control and subject groups in in FFR, V-A, C-A, D-C,E-D, and F-E.Conclusion The speech-ABR were abnormal in OSAHS patients, showing the defects in brain stem speech coding, and it may be associated with extent of hypoxia.
Objective To study the speech-ABR in male patients with OSAHS of different degrees.Methods Sixty male patients with OSAHS aged from 18 to 40 years old were enrolled and divided into the mild group(19 participants), the moderate group(20 participants) and the severe group(21 participants) according to the AHI and extent of hypoxia. The control group consisted of 25 male participants(AHI<5 times/h;the minimum SaO_2>90%).Speech-ABR test was used to all the participants.Results The amplitude of V of the control group(0.09±0.02 μV) was significantly higher than that of the other 3 groups(mild group:0.06±0.03 μV,moderate group:0.06±0.02 μV,and severe group:0.04±0.02 μV)(P<0.01). The severe group differed significantly from the mild and moderate groups in amplitude of V(P<0.01). No significant difference was found between the mild group and moderate group(P=0.84). The amplitude of A of the control group(-0.19±0.03 μV) was significantly higher than the other three groups(mild group:-0.16±0.04 μV,moderate group:-0.15±0.05 μV,and severe group:-0.12±0.03 μV)(P<0.01). The severe group differed significantly from the mild and moderate groups in the amplitude of A(P<0.01). No significant difference was found between the mild and moderate groups(P=0.459). The latencies of V wave were prolonged in the mild group as 6.82±0.39 ms,the moderate group as 6.80±0.36 ms and the severe group as 6.83±0.29) ms compared with the control group(6.59±0.28 ms)(P<0.05 respectively). No significant differences were noted among the mild, moderate and severe groups. The latencies of A wave were prolonged in the mild group as 7.92±0.28 ms,the moderate group as 7.91±0.26 ms and the severe group as 7.95±0.26 ms compared with the control group(7.73±0.25 ms).No significant difference was found between the control and subject groups in in FFR, V-A, C-A, D-C,E-D, and F-E.Conclusion The speech-ABR were abnormal in OSAHS patients, showing the defects in brain stem speech coding, and it may be associated with extent of hypoxia.
引文
1 Akhoun I,Gallégo S,Moulin A,et al.The temporal relationship between speech auditory brainstem responses and the acoustic pattern of the phoneme /ba/ in normal-hearing adults[J].Clinical Neurophysiology,2008,119:922.
2 Chandrasekaran B,Kraus N.The scalp-recorded brainstem response to speech:neural origins and plasticity[J].Psychophysiology,2010,47:236.
3 Galbraith GC,Arbagey PW,Branski R,et al.Intelligible speech encoded in the human brain stem frequency-following response[J].Neuroreport,1995,6:2363.
4 Brown AW,Brierley JB.The earliest alterations in rat neurons and astrocytes after anoxia-ischemia[J].Acta Neuropathol,1973,23:9.
5 Gale SD,Hopkins RO.Effects of hypoxia on the brain:neuroimaging and neuropsychological findings following carbon monoxide poisoning and obstructive sleep apnea[J].J Int Neuropsycol Soc,2004,10:60.
6 Findley LJ,Barth JT,Powers DC,et al.Cognitive impairmentin patients with obstructive sleep apnea and associated hypoxemia[J].Chest,1986,90:686.
7 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35:9.
8 Krizman J,Skoe E,Kraus N.Sex differences in auditory subcortical function[J].Clinical Neurophysiology,2012,123:590.
9 付欣,刘锦峰,王宁宇,等.健康更年期后女性的脑干言语编码能力分析[J].听力学及言语疾病杂志,2015,23:343.
10 刘锦峰,付欣,王丹,等.儿童及青年脑干言语编码能力的性别差异[J].中华耳鼻咽喉头颈外科杂志,2016.51:583.
11 Skoe E,Kraus N.Auditory brain stem response to complex sounds:a tutorial[J].Ear Hear,2010,31:302.
12 Vander Werff KR,Burns KS.Brainstem responses to speech in younger and older adults[J].Ear Hear,2011,32:168.
13 Muchnik C,Rubel Y,Zohar Y,et al.Auditory brainstem response in obstructive sleep apnea patients[J].J Basic ClinPhysiol Pharmacol,1995,6:139.
14 Akhoun I,Moulin A,Jeanvoine A,et al.Speech auditory brainstem response (speech ABR) characteristics depending on recording conditions,and hearing status:an experimental parametric study[J].J Neurosci Methods,2008,175:196.
15 Sharma M,Purdy SC,Kelly AS.Comorbidity of auditory processing,language,and reading disorders[J].J Speech Lang Hear Res,2009,52:706.
16 Johnson KL,Nicol TG,Kraus N.Brain stem response to speech:a biological marker of auditory processing[J].Ear Hear,2005,26:424.
17 Elkabariti RH,Khalil LH,Husein R,et al.Speech evoked auditory brainstem response findings in children with epilepsy[J].Int J Pediatr Otorhinolaryngol,2014,78:1277.
18 Strait DL,Hornickel J,Kraus N.Subcortical processing of speech regularities underlies reading and music aptitude in children[J].Behav Brain Funct,2011,7:44.
2 Chandrasekaran B,Kraus N.The scalp-recorded brainstem response to speech:neural origins and plasticity[J].Psychophysiology,2010,47:236.
3 Galbraith GC,Arbagey PW,Branski R,et al.Intelligible speech encoded in the human brain stem frequency-following response[J].Neuroreport,1995,6:2363.
4 Brown AW,Brierley JB.The earliest alterations in rat neurons and astrocytes after anoxia-ischemia[J].Acta Neuropathol,1973,23:9.
5 Gale SD,Hopkins RO.Effects of hypoxia on the brain:neuroimaging and neuropsychological findings following carbon monoxide poisoning and obstructive sleep apnea[J].J Int Neuropsycol Soc,2004,10:60.
6 Findley LJ,Barth JT,Powers DC,et al.Cognitive impairmentin patients with obstructive sleep apnea and associated hypoxemia[J].Chest,1986,90:686.
7 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35:9.
8 Krizman J,Skoe E,Kraus N.Sex differences in auditory subcortical function[J].Clinical Neurophysiology,2012,123:590.
9 付欣,刘锦峰,王宁宇,等.健康更年期后女性的脑干言语编码能力分析[J].听力学及言语疾病杂志,2015,23:343.
10 刘锦峰,付欣,王丹,等.儿童及青年脑干言语编码能力的性别差异[J].中华耳鼻咽喉头颈外科杂志,2016.51:583.
11 Skoe E,Kraus N.Auditory brain stem response to complex sounds:a tutorial[J].Ear Hear,2010,31:302.
12 Vander Werff KR,Burns KS.Brainstem responses to speech in younger and older adults[J].Ear Hear,2011,32:168.
13 Muchnik C,Rubel Y,Zohar Y,et al.Auditory brainstem response in obstructive sleep apnea patients[J].J Basic ClinPhysiol Pharmacol,1995,6:139.
14 Akhoun I,Moulin A,Jeanvoine A,et al.Speech auditory brainstem response (speech ABR) characteristics depending on recording conditions,and hearing status:an experimental parametric study[J].J Neurosci Methods,2008,175:196.
15 Sharma M,Purdy SC,Kelly AS.Comorbidity of auditory processing,language,and reading disorders[J].J Speech Lang Hear Res,2009,52:706.
16 Johnson KL,Nicol TG,Kraus N.Brain stem response to speech:a biological marker of auditory processing[J].Ear Hear,2005,26:424.
17 Elkabariti RH,Khalil LH,Husein R,et al.Speech evoked auditory brainstem response findings in children with epilepsy[J].Int J Pediatr Otorhinolaryngol,2014,78:1277.
18 Strait DL,Hornickel J,Kraus N.Subcortical processing of speech regularities underlies reading and music aptitude in children[J].Behav Brain Funct,2011,7:44.