摘要
目的探讨伴发于突发性聋的耳鸣患者临床听力学特征,并分析耳鸣及声治疗短期疗效影响因素。方法回顾性分析伴发于突发性聋的耳鸣患者人口学特征及心理声学特征,按照THI评分等级进行分组,使用卡方检验、单因素方差分析、Spearman相关分析、Logistic回归等分别分析各个因素对耳鸣严重程度的影响及其声治疗效果。结果1.纳入的患者共108名,其中轻度耳鸣组49名(45.5%),中度耳鸣组34名(31.5%),重度耳鸣组25名(23.1%)。2.经卡方检验,3组患者在SAS得分存在统计学差异(χ^(2)=25.239,P<0.05),SAS分数随着耳鸣分级增加有升高的趋势。3.轻度耳鸣组和中度耳鸣组与重度耳鸣组的PQSI结果存在统计学差异(χ^(2)=14.437,P<0.05)。重度耳鸣组睡眠障碍人数多于其他两组,轻度耳鸣组和中度耳鸣组之间则无统计学差异。4.经Spearman相关分析,PQSI、SAS等级与THI得分及各因子之间有显著的正相关(r>0,P<0.005)。5.经多元有序Logistic回归分析,结果显示影响THI等级与SAS等级、睡眠质量问题成正相关(P<0.005)。6.经二元多因素logistic回归结果显示,伴发于突发性聋的耳鸣患者声治疗短时疗效影响因素是残余抑制试验结果(P=0.020)。结论耳鸣发生的严重程度与焦虑症状有显著的关联;重度耳鸣患者更容易合并睡眠障碍;伴发于突发性聋耳鸣患者的声治疗效果与残余抑制试验结果有关,残余抑制试验结果可以为临床声治疗耳鸣提供指导。
Objective To report clinical and audiological characteristics of tinnitus in patients with sudden sensorineural hearing loss,and to identify factors influencing the short-term outcomes of sound therapy for tinnitus.Methods Demographic and psychoacoustic characteristics of patients with tinnitus associated with sudden sensorineural hearing loss were retrospectively analyzed,Patients were grouped according to THI score levels,and factors influencing tinnitus severity and acoustic therapy outcomes were determined by Chi-square test,one-way ANOVA,Spearman correlation analysis and Logistic regression.Results A among the 108 patients included,49(45.5%)had mild tinnitus,34(31.5%)had tinnitus of moderate severity and 25(23.1%)had severe tinnitus.The SAS score increased as tinnitus severity increased(χ^(2)=25.239,P=0.000).PQSI results suggested worse sleep in patients with severe tinnitus than in those with mild or moderate tinnitus(χ^(2)=14.437,P=0.001),but no statistically significant difference between patients with mild tinnitus and those with moderate level of tinnitus.Spearman correlation analysis showed positive correlation among PQSI and SAS grades and THI scores and other variable factors(P<0.005).Multinomial logistic regression analysis showed that the THI score was positively correlated with SAS grades and sleep quality(P<0.005).Binary multivariate logistic regression suggested that the short-term outcomes of sound therapy were affected by residual inhibition(P=0.020).Conclusions The severity of tinnitus was significantly associated with anxiety.Patients with severe tinnitus were more likely to have sleep disturbances.Short term outcomes of sound therapy in patients with sudden sensorineural hearing loss and tinnitus are related to the results of residual inhibition test,which can provide some guidance in clinical sound therapy for tinnitus.
作者
陈婷婷
夏红艳
谌国会
赵立东
王秋菊
CHEN Tingting;Xia Hongyan;CHEN Guohui;ZHAO Lidong;WANG Qiuju(Zhejiang University of Traditional Chinese Medicine,Hangzhou,310053;College of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital,Chinese PLA Medical School,National Clinical Research Center for Otolaryngologic Diseases,Chinese PLA Institute of Otolaryngology,State Key Lab of Hearing Science,Ministry of Education,Beijing Key Lab of Hearing Impairment Prevention and Treatment,28 Fuxing Road,Beijing 100853,China;Department of Otorhinolaryngology Head and Neck Surgery,Children's Hospital Affiliated to Zhejiang University School of Medicine,Hangzhou 310000)
出处
《中华耳科学杂志》
CSCD
北大核心
2022年第6期909-915,共7页
Chinese Journal of Otology
基金
国家重点研发计划项目(2020YFC2005200)第一课题(2020YFC2005201)
北京市自然科学基金(7202075)。
关键词
突发性耳聋
耳鸣
心理声学特征
声治疗
Sudden Sensorineural Hearing Loss
Tinnitus
Psychoacoustic Characteristics
Sound therapy
