耳鸣患者耳鸣的心理声学特征变化  

The Psychological and Acoustic Analysis in Patients with Tinnitus

作　　者：骆辉珍[1] 杨海弟[2] 郑亿庆[2] 邱泽恒[2] 黄辉[1] 陈玲[2] 李湘辉[2] 

机构地区：[1]广东省惠州市中心人民医院耳鼻喉科,惠州516001 [2]中山大学孙逸仙纪念医院耳鼻喉科

出　　处：《听力学及言语疾病杂志》2012年第5期425-428,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨随时间推移主观性耳鸣患者的临床特征及其变化,研究长期耳鸣对患者听力的影响。方法分析比较随访3年以上的30例主观性耳鸣患者初诊时和3年后复诊时的临床表现、耳鸣心理声学特征等的变化。结果 30例患者中,初复诊时均以左侧耳鸣最多见,为12例(40%),三年后复诊时有1例由右侧耳鸣转变为双侧耳鸣。初诊时耳鸣主调多为高频,复诊时耳鸣主调发生变化的有8例,占26.67%,其中,主调频率降低1例,升高6例,1例由初诊时的200Hz纯音复诊时变得无法匹配。复诊时患者500～4 000Hz的平均听阈与初诊时比较无明显变化(P>0.05),耳鸣主调所在频率的平均听阈复诊时较初诊时提高,差异有统计学意义(P<0.05),初、复诊时耳鸣主调相邻的正、负1倍频程频率平均听阈无明显变化(P>0.05)。复诊时30例总体耳鸣响度较初诊时降低(P<0.05),其中,响度不变者2例,变大者3例,变小者25例;复诊时总体的烦躁级别较初诊时减轻(P<0.05),其中,烦燥级别不变8例,减轻18例,加重4例;THI分级不变12例,降低12例,升高6例,总体THI分级无变化。初、复诊时Feldman曲线均主要以汇聚型为主,间距型和重叠型次之,后效抑制阳性率也以汇聚型曲线最高。结论随着耳鸣病程的延长,患者耳鸣的响度较前变小,烦躁级别较前减轻,耳鸣可成为代偿性耳鸣,对患者的心理影响减轻;耳鸣主调频率的听力损失可加重,耳鸣主调频率会出现漂移现象。Objective To study the clinical and psychological characteristics and the effects of tinnitus to hearing in patients with subjective tinnitus. Methods Thirty cases of tinnitus patients with 3 years follow-up who visited our clinic from January 2007 to December 2008 were included. Their basic information, past medical history, clinical manifestation, tinnitus information and psychological acoustic information changes were analysed and compared. Results The left ear was the most common affected ear（40 %） in 30 tinnitus patients,folloowed by the bilateral tinnitus in 10 patients （33%）, and the right ear（27%） was the least. There were 8 cases（27%） with tinnitus main frequency change when re-visiting. However, the average of hearing threshold had no significant change（P〉0.05）. The hearing threshold of the tinnitus at main frequency was higher than that of first visit, which was statistically significant different （P〈0.05）. The tinnitus loudness was smaller than that of first visit, which had statistically significant difference （P〈0.05）. Conclusion With the extension of tinnitus, some patients may become compensatory. But the hearing loss at the tinnitus main frequency may increase, and the tinnitus main frequency may shift.

关 键 词：主观性耳鸣 耳鸣特征 听阈 频率漂移 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]