门诊老年性听力损失调查研究  

Hearing in geriatric out-patients with hearing complaints

作　　者：雷磊[1] 冀飞[1] 周其友[1] 

机构地区：[1]中国人民解放军总医院耳鼻咽喉-头颈外科中国人民解放军耳鼻咽喉科研究所,北京100853

出　　处：《中华耳科学杂志》2011年第2期179-183,共5页Chinese Journal of Otology

摘　　要：目的分析60岁以上自觉听力障碍的老年人听力损失概况,探讨老年性聋患者的特点。方法调查门诊老年及老年前期患者110例,男95例,女性15例,平均年龄74.4±12.1岁。其中50岁～59岁者15例,作为老年前期对照;60岁以上老年者95例:60～69岁25例,70～79岁26例,80～89岁32例,90岁以上12例。所有110例患者行纯音测听,31例行鼓室图测试。按照Goodman听力障碍分级法将受试者每耳的听力进行分级,并根据听力曲线形状分类。结果全部110名受试者共220耳中,正常听力65耳,占29.5%;轻度到中重度听力损失131耳,占59.5%;重度以上听力损失24耳,占11%。12耳有传导性听力下降,占5.45%。斜坡下降型听力曲线99耳,占45%;陡降型听力曲线34耳,占15.45%;平坦下降型听力曲线45耳,占20.45%;切迹下降型听力曲线5耳,占2.27%;上升和上升-下降型曲线2耳,占0.91%;全聋2耳,占0.91%;正常听力曲线21耳,占9.55%。鼓室图测试结果,A型曲线33例,占接受该测试受试者的53.23%;Ad型曲线9例,占14.52%;As型曲线6例,占9.68%;C型曲线11例,占17.74%;B型曲线3例,占4.84%。老年性聋患者听力随年龄增长缓慢下降,下降速度大约为10dB/10岁。结论老年聋患者在50岁～70岁听阈整体上保持稳定;在70岁～80岁之间会有一个较为明显的听力下降时期;在80岁以后,高频听阈整体稳定在一个较低水平上。中频听力的下降会造成患者响度感知上的明显衰退。Objective To evaluate hearing status in individuals older than 60 years who complain of hearing impairment. Methods One hundred and ten senium and pre-senium patients seen in an out-patient clinic who complained of hearing difficulties （95 males and 15 females, mean age=74.4 ＋ 12.1 years） were included in the study. Of these patients, 15 aged from 50 to 59 years and served as the pre-senium control. The 95 patients older than 60 years were divided into 4 groups according to age： 60 to 69 years （n=25）, 70 to 79 years （n=26）, 80 to 89 years （n=32）, and 〉 90 years （n=12）. Hearing evaluation included pure tone audiometry and tympanometry. Hearing loss was graded according to the Goodman classification criteria. In addition, audiometric patterns were also examined. Results Sixty five ears （29.5%） showed normal hearing, 131 （59.5%） showed slight to moderate hearing loss, and 24 （11%） showed severe or profound hearing loss. Air-bone gaps were found in 12 ears （5.45%）, indicating conductive hearing loss. Of the ears showing sen- sorineural hearing loss, 99 （45%） showed shallow sloping patterns, 34 （15.45%） showed steep sloping patterns, 45 （20.45%） showed flat patterns, 5 （2.27%） showed notch patterns, 2 （0.91%） showed trough and rise patterns, and 2 （0.91%） showed total deafness. As far as the tympanogram was concerned, 33 ears （53.23%） were type A, 9 （14.52%） were type Ad type, 6 （9.68%） were type As, 11 （17.74%） were type C and 3 （4.84%） were type B. On average, hearing threshold increased approximately 10 dB per 10 years for subjects aged 60 and older. Conclusions Hearing thresholds tend to be stable in presbycusis patients between 50 and 70 years of age, increase significantly between 70 and 80 years of age, and reach a plateau after 80 years of age, especially in high frequencies. Hearing loss in middle frequencies accounts for most recession in patients loudness perception.

关 键 词：老年 老年性聋 听力损失 

分 类 号：R764.436[医药卫生—耳鼻咽喉科] R195.4[医药卫生—临床医学]