摘要
目的:分析强直性脊柱炎患者的纯音测听指标,并与正常人对照,观察其听觉损害特征,寻找可能的干预方法。方法:选择2001-04/2005-04沈阳医学院附属沈州医院及鞍钢铁东医院门诊就诊和住院治疗的强直性脊柱炎患者48例。对照组选择同期在本院进行健康体检的正常人55例。听力学检查时间在治疗前1周内,对照组检查时间选择与体检同期进行。受试者坐在标准测听室内,由专业技师检查气、骨导纯音听阈。结果:强直性脊柱炎组48例和对照组55例全部完成各项检查,进入结果分析。①48例强直性脊柱炎患者(96耳)检出听力减退29例(57耳),患病率为59.4%,对照组检出10例(19耳),患病率为17.3%,两组比较差异有显著性意义(χ2=16.742,P<0.001)。②强直性脊柱炎组语言频率为4kHz和8kHz的纯音测听指标均明显高于对照组(t=2.139～3.254,P均<0.05～0.01)。③按临床表现累及范围分组后,强直性脊柱炎病变范围大组(22例,>3.4种)的语音频率,4kHz频率和8kHz双侧纯音测听指标均明显高于范围小组(26例,<3.4种)(t=2.255～3.128,P均<0.05～0.01)。④按病情活动性评分分组后,活动明显组(17例,≥5.6分)的各个频率双侧纯音测听多数指标(4kHz频率左侧除外)均显著高于活动不明显组(31例,<5.6分)(t=2.250～3.243,P均<0.05～0.01)。⑤按病情程度分组后,病情重组(美国风湿协会强直性脊柱炎分期3～4期,19例)的各个频率双侧纯音测听指标均明显高于病情轻组(1～2期,29例)(t=2.288～3.290,P均<0.05～0.01)。⑥按Fries功能障碍指数分组后,功能差组(Fries指数≥14.9,17例)的多数频率纯音测听指标(语言和8kHz频率右侧除外)均明显高于功能佳组(Fries指数<14.9;31例)(t=2.176～3.295,P均<0.05～0.01)。结论:强直性脊柱炎患者有很高的听力减退患病率,与病变范围、病情活动性、分期和功能障碍程度密切相关,对于这一群体应注意监测听力。
AIM： To analyze the pure-tone audiometric indexes in patients with ankylosing spondylitis, compare with normal people, and observe their characters of hearing loss, so as to geek the possible interventions.
METHODS： Forty-eight outpatients and inpatients with ankylosing spondylitis were selected from the Sbenzhou Hospital affiliated to Shenyang Medical College and Anshan Iron＆Steel Complex Tiedong Hospital between April 2001 and April 2005, their disease course was 2-23 years with an average of 5.9 years. Fifty-five healthy physical examinees in this hospital at the same period were taken as controls （control group）. The audiometry was performed within 1 week before treatment in the ankylosing spondylitis group, but at the same time of physical examination in the control group. All the subjects sat in the standard audiometric room, the air and bone conducted pure-tone auditory thresholds were examined by the professional technician.
RESULTS： All the 48 patients in the ankylosing spondylitis group and 55 cases in the control group finished all the examinations and entered the analysis of results. ①Of the 48 patients with ankylosing spondylitis （96 ears）, 29 cases （57 ears） were examined as auditory dysesthesia with the prevalence rate of 59.4%; 10 cases （19 ears） and auditory dysesthesia with the prevalence rate of 17.3%, which were significantly different between the two groups （X^2=16.742, P 〈 0.001）. ②The pure-tone audiometric indexes at the speech frequency and frequencies of 4 and 8 kHz in the ankylosing spondylitis group were obviously higher than those in the control group （t=2.139-3.254, P 〈 0.05-0.01）. ③ After grouping according to the clinical manifestation and involved range, the pure-tone audiometric indexes in the ankylosing spondylitis of large size group （n=22, 〉 3.4 kinds） at the speech frequency and the frequencies of 4 kHz and 8 kHz were all obviously higher than those in the ankylosing spondylitis of small size group （n=26, 〈 3.4 kinds） （t=2.255-3.128; P 〈 0.05-0.01）. ④ After grouping according to the activity score of disease, most of the bilateral pure-tone audiometry indexes at each frequency （except the left side at 4 kHz） in the obvious activity group （n=17, ≥5.6 points） were significantly higher than these in the unobvious activity group （n=31, 〈 5.6 points） （t=2.250-3.243, P 〈 0.05-0.01）.⑤After grouping according to the severity of disease, the bilateral pure-tone audiometry indexes at each frequency were obviously higher in the severe group （the staging of ankylosing spondylitis set by American Rhemaatology Association was 3-4 stages, n=19） than in the mild group （1-2 stages, n=29） （t=2.288-3.290, P 〈 0.05-0.01）.⑥After grouping according to Fries function disability index, most indexes of pure-tone audiometry （except speech and 8 kHz on the right） were significantly higher in the poor function group （Fries index 〉 14.9, n=17） than those in good function group （Fries index 〈 14.9, n=31） （t=2.176-3.295, P 〈 0.05-0.01）.
CONCLUSION： The prevalence of hearing loss in the patients with ankylosing spondylitis is higher than that of the controls, which is associated with lesion range, activities and staging of patient＇s condition and levels of dysfunction, so we should closely focus on monitoring audiometry of the patients with ankylosing spondylitis.
出处
《中国临床康复》
CSCD
北大核心
2006年第4期44-46,共3页
Chinese Journal of Clinical Rehabilitation
