老年性聋患者噪声下言语识别能力的评估  

Hearing in Noise Test for Older Adults with Age-related Hearing Loss

作　　者：孙靖雯[1,2] 黄治物[1,2] 陈建勇[1,2] 梅玲[1,2] 李蕴[1,2] 任燕[1] 沈敏[1] 张勤[1] 吴皓[1] 

机构地区：[1]上海交通大学医学院附属新华医院耳鼻咽喉头颈外科,上海200092 [2]上海交通大学医学院耳科学研究所

出　　处：《听力学及言语疾病杂志》2015年第1期16-20,共5页Journal of Audiology and Speech Pathology

基　　金：十二五国家科技支撑计划项目(2012BAI12B00)资助

摘　　要：目的：评估老年性聋患者噪声下言语识别能力，探讨年龄、听力损失程度、认知功能对噪声下言语识别能力的影响。方法以90例60岁以上老年性聋者为受试者，按年龄分为三组，60～69岁（44例88耳）、70～79岁（32例64耳）、＞79岁（14例28耳），完成纯音听阈测试、普通话噪声下言语测试（Mandarin hearing in noise test ， MHINT）及简易智能精神状态量表（mini－mental state examination ，MMSE）评估，分别获得0．5、1、2、4 kHz平均听阈、MHINT自适应信噪比及MMSE量表总得分；分析年龄、平均听阈、自适应信噪比及MMSE量表得分之间的相关性。结果①平均听阈、M HINT信噪比随年龄增长而提高，不同年龄组间的平均听阈、M HINT 信噪比差异有统计学意义（P＜0．01）；②不同程度听力损失组间的M HINT信噪比差异显著（P＜0．01），控制认知得分的情况下其差异仍然有统计学意义（P＜0．01），且平均听阈与 MHINT 信噪比具有显著的直线相关性（r＝0．326，P＜0．01），随着受试者平均听阈提高，MMSE得分下降，二者有直线相关性（r＝－0．187，P＜0．05）；③MHINT信噪比与MMSE量表得分具有相关性（r＝－0．201，P＜0．01），认知功能减退组（＜27分）的MHINT信噪比平均值较认知功能正常组（27～30分）显著增加（P＜0．01）；不同听力损失程度组中，认知功能正常组与减退组之间M HINT信噪比差异无统计学意义（P＞0．05）。结论噪声下言语测试可用于老年人听觉功能评估，老年性聋者的年龄、听力损失程度、认知功能与噪声下言语识别能力之间相互影响，评估老年人听觉功能时应考虑认知功能的影响。Objective To evaluate the speech recognition ability in noise enviroment in older adults with age-related hearing loss and to discuss the influences of age ,hearing loss and cognitive function on the ability of speech recognition in noise enviroment .Methods A total of 90 older adults aged over 60 years at the hearing clinic of Xinhua hospital were divided into three groups according to the age ,which were 60～69 y group （88 ears） ,70～79 y group （64 ears） ,＆gt; 79 y group （28 ears） .All the participants completed pure tone audiometry ,the Mandarin hearing in noise test （MHINT） and the mini-mental state examination （MMSE） .The pure tone average hearing threshold （PTA） ,signal-to -noise ratio （SNR） of MHINT and MMSE scores were obtained .We used the statis_tical software SPSS 17 .0 to analyze the correlations among age ,PTA ,adaptive SNR and MMSE scores .ResuIts ①PTA and SNR increased with the age .The difference of PTA and SNR for different age groups was statistically sig_nificant （P〈0 .01） .②The difference SNR among different PTA groups were significant （P〈0 .01） ,and when the influence of MMSE scores was controlled the difference was still significant .There was a significant linear correlation between PTA and SNR （r=0 .326 ,P〈0 .01） .MMSE scores decreased with the increasing of PTA ,and there was also a linear correlation between PTA and MMSE scores （-0 .187 ,P〈0 .05） .③Adaptive SNR and MMSE scores were correlated （r= -0 .201 ,P〈0 .01） ,but there was no significant linear relationship .Besides ,SNR of the cog_nitive function impairment group P〈27 points） was significantly greater than that of the normal cognitive function group （27～30 points） （P〈0 .01） .However ,among the three PTA groups ,the differences were not statistically significant .ConcIusion The hearing in noise test reflects the ability of speech recognition in noise enviroment in ol_der adults ,and can be used to assess the hearing functions in elder .Speech recogn

关 键 词：老年性聋 噪声下言语测试 年龄 纯音听阈 认知功能 

分 类 号：R764.436[医药卫生—耳鼻咽喉科]