Порівняльна характеристика психоакустичних та електрофізіологічних показників стану слухової системи у хворих на цукровий діабет І та ІІ типу

Ключевые слова: сенсоневральная тугоухость, сахарный диабет, тип 1 и 2, РЭГ, ЭЭГ, КСВП, ДСВП, слуховая функция.

Malkovych L.D. Comparative Description of Psycho-Acoustic and Electrophysiological Indicators of the Hearing System Condition of Patients With Pancreatic Diabetes of Types 1 and 2. - Manuscript.

For the first time, the dissertation describes in detail the condition of periphery and central (brainstem and cortical) sections of the auditory analyzer of patients with pancreatic diabetes (PD) depending on the type and considering the data of rheoencephalography and electroencephalography. At this, patients with pancreatic diabetes of Type 2 demonstrate a more expressed dysfunction in brainstem structures of the auditory analyzer as compared to Type 1. Extension of Latency Time of Peaks V wave of Short-Latency Auditory Evoked Potential and Inter-Peak Interval for pancreatic diabetes of Type 2 as compared to Type 1 prove that (in correspondence to Latency Time of Peaks V wave of Short-Latency Auditory Evoked Potential made (6,01±0,06) and (5,72±0,04) ms; (t=4,02; P<0,01), and so does the Inter-Peak Interval I-V - (4,36±0,04) and (4,09±0,03) ms; (t=5,4; P<0,01). This may be connected with a more expressed dysfunction of blood circulation in the brain, in the vertebral-basilar system in particular, of patients suffering from pancreatic diabetes of Type 2 as compared to Type 1. Thus, Ri, describing the pulse volume condition in the vertebral-basilar system was definitely lower for patients with pancreatic diabetes of Type 2 than for pancreatic diabetes of Type 1 (Ri for pancreatic diabetes of Types 1 and 2 were equal correspondently (0,77±0,03) and (0,67±0,02); (t=2,77; P<0,05). Besides, patients suffering from pancreatic diabetes with interested brainstem structures of the auditory analyzer, according to the data of electroencephalography demonstrated stimulation of cortical and diencephalic-stem sections of the brain.

It has been demonstrated for the first time that derangements in the hearing system of patients suffering from pancreatic diabetes go along with changes of hemodynamics in the carotid and vertebral-basilar systems, as well as in the functional state of the CNS, which fact prove quality and quantitative indicators of rheoencephalography and electroencephalography. At this, more expressed changes mentioned herein can be observed for pancreatic diabetes of Type 2. 48, 3% of patients suffering from pancreatic diabetes of Type 2 showed derangements in the brainstem structures, whereas patients with pancreatic diabetes of Type 1 showed them only in 12,5 % of cases. Pancreatic diabetes of Type 1 shows derangements in cortical and diencephalic sections more often that made correspondently 39,3 and 48,2 % for Type 1, and also 27,6 and 24,1 for pancreatic diabetes of Type 2.

The earliest auditory derangements show themselves in the changes of hearing indicators for tones in the area of 14 and 16 kHz, and also in time characteristics of the Long-Latency Auditory Evoked Potential, in the length of the latent period of component N2 of the Long-Latency Auditory Evoked Potential in particular.

It has been demonstrated that Karhart adaptation modified by of B.Ya. Limar can serve as an informational audiometric test for revealing early derangements in the hearing system of patients suffering from pancreatic diabetes of Types 1 and 2. Patients with pancreatic diabetes and irregular adaptation, and also with the increase of the threshold of hearing for tones in the area of 14 and 16 kHz, should be referred to the as a “high-risk group” and need medical and prophylactic measures to be taken in order to prevent the development of sensorineural deafness.

Key words: sensorineural deafness, pancreatic diabetes, Type 1 and 2, rheoencephalography, electroencephalography, Short-Latency Auditory Evoked Potential, Long-Latency Auditory Evoked Potential, hearing function.

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