中文摘要：

目的：分析听神经病谱系障碍患者经内科药物综合治疗的临床疗效以及相关因素对预后的影响。方法：对11例（22耳）经纯音测听、声导抗、畸变产物耳声发射、听性脑干反应测试确诊为听神经病谱系障碍者（治疗组）予以内科药物综合治疗，同时选取同期就诊但未接受治疗的11例听神经病谱系障碍患者作为对照组，分析比较治疗组治疗前后和对照组患者随诊前后的纯音听阈和言语识别率变化，并分析患者的性别、年龄和伴随症状与疗效的关系。统计数据应用SPSS19．0行配对样本t检验、独立样本t检验和Pearson相关分析。结果：经内科药物综合治疗后，治疗组22耳中，治疗有效13耳，有效率为59．09％。治疗组22耳平均纯音听阈由治疗前的（53．92±18．86）dBHI。提升至（47．44±14．98）dBHL，差异有统计学意义（t=5．20，P〈0．05）；而对照组听力无明显变化（P〉0．05）。治疗组言语识别率治疗前后分别为（29．20±25．80）％和（41．60±22．90）％，平均提高（12．40±13．80）％，差异有统计学意义（t=4．02，P〈0．05）。伴有耳鸣症状者疗效较无耳鸣症状者差（t=-3．85，P〈0．05），发病年龄和疗效呈负相关（r=-6．72，P〈0．05），而疗效未见性别差异（P〉0．05）。结论：听神经病谱系障碍患者应用糖皮质激素等内科药物综合治疗可有效改善其纯音听阈和言语识别率，内科药物综合治疗可作为听神经病谱系障碍治疗的可选方案。

英文摘要：

Objective：To investigate the efficacy of combined medical treatment on auditory neuropathy spec- trum disorder and the effect of related factors on the prognosis. Method： Eleven cases （22 ears） diagnosed as audi- tory neuropathy spectrum disorder using multiple criteria including pure tone auditory threshold, impedance audi- ometry, acoustic reflexes, distortion products otoacoustic emission （DPOAE） and auditory brainstem response （ABR） were subjected to combined medical treatment . Eleven auditory neuropathy spectrum disorder patients di- agnosed during the corresponding period but refused treatment were selected as control group. The change of pure tone auditory threshold and speech discrimination score after treatment or follow-up were evaluated for both 2 groups, and the relationship between the patients＇ gender, age, accompanying symptoms and curative effect were also analyzed. Data were analyzed by SPSS 19.0 statistical software using pared-sample t-test, independent-sample t test and Pearson＇s chi-square test. Result：The effective rate of combined medical therapy was 59.09 % （13/22） in the therapy group. PTA levels before and after-treatment were （53.92± 18.86）dB HI. and （47.44± 14.98）dB HL respectively in 22 ears with the combined medical therapy, the improvement of which showed statistically sig- nificance （t= 5.20, P（0.05）. No obvious hearing change was noted in the 11 patients who refused therapy（P） 0.05）. Speech discrimination score before and after-treatment were （29.20±25.80）% and（41.60±22.90）% re- spectively for the treatment group. The average improvement of speech discrimination score was （12.40 ± 13.80） % with statistically significant difference（t=4.02, P〈0.05）. Patients accompanied with tinnitus had rela- tively poorer effect compared with individuals without tinnitus（t=- 3.85, P〈0.05）. Age is negatively correlated with the prognosis（r= - 6.72, P〈0.05）. Gender had no effect on the prognosis（P〉0.05）. Conclusi