梅尼埃病的耳鸣特征与影响因素分析  

Characteristics and contributing factors of tinnitus in patients with Meniere's disease

作　　者：张祎[1] 李云[2] 刘博[1] 刘冬鑫[1] 贾若[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科中心北京市耳鼻咽喉科研究所耳鼻咽喉头颈科学教育部重点实验室,北京100730 [2]石家庄市第三医院耳鼻咽喉科,河北050011

出　　处：《中华耳科学杂志》2016年第2期153-157,共5页Chinese Journal of Otology

基　　金：国家科技支撑计划项目(2012BAI12B02)~~

摘　　要：目的分析与探讨梅尼埃病患者耳鸣的临床特征与影响因素。方法 90例梅尼埃病患者,收集纯音听阈、耳鸣匹配结果,记录耳鸣侧别、时间、睡眠质量,使用耳鸣残障量表（Tinnitus Handicap Inventory,THI）进行评价。结果 1患者平均年龄48.08±10.28岁,男女比例为1.09：1;耳鸣主调频率匹配为低频和言语频率耳鸣者65例（72.2%）;响度匹配为响度〈10d B SL者（51例,56.7%）,≥10d BSL者（39例,43.3%）,其中以5-9d B SL最多,为30例（33.3%）;≥15d B SL者最少,为15例（16.7%）;持续性耳鸣患者77例（85.6%）;单侧耳鸣患者68例（75.6%）;有睡眠障碍者28例（31.1%）。2耳鸣响度较大（F=3.203,P=0.027）、睡眠质量较差（t=2.813,P=0.006）和持续性耳鸣（t=3.018,P=0.003）的患者其THI评分高于耳鸣响度较小、睡眠质量较好和间断性耳鸣的患者。双侧耳鸣患者THI评分高于单侧耳鸣患者,但差异无统计学意义（t=1.892,P=0.062）。不同性别、听力损失水平和耳鸣频率的患者THI评分间无明显差异（P〉0.05）。3耳鸣影响因素有序多分类Logistic回归分析：耳鸣严重程度与耳鸣响度[P=0.011,95%可信区间（confidence interval,CI）1.019~1.151,优势比（odds ratio,OR）=1.083]、睡眠质量（P=0.011,95%CI1.288~6.931,OR=2.986）和耳鸣持续时间（P=0.007,95%CI1.559~16.265,OR=5.033）有关。结论梅尼埃病患者的耳鸣常常为低频、持续性的。耳鸣的严重程度与耳鸣的响度、睡眠质量和耳鸣的持续有关。Objective To report clinical characteristics and contributing factors of tinnitus in patients with Meniere＇s disease. Methods Detailed medical histories were collected in 90 patients with Meniere＇s disease. Routine physical examination, pure tone test and pitch matching were recorded. The affected sides, tinnitus duration and quality of sleep were inquired. All the patients were evaluated by the Tinnitus Handicap Inventory（THI）. Results 1 The mean age was 48.08 ±10.28 years, and male to female ratio was 1.09：1. Sixty-five（72.2%） patients presented with low-frequency or speech-frequency tinnitus. Loudness of tinnitus was 5-9 d B SL. Seventy-seven patients（85.6%） had persistent tinnitus, 68（75.6%）had unilateral tinnitus, and 28（31.1%） had sleep disturbances. 2 The greater the loudness, the higher the THI score（F=3.203,P=0.027）. Patients with sleep disturbances（t=2.813,P=0.006）and persistent tinnitus（t=3.018,P=0.003）had higher THI scores, and the differences were significant. The THI scores showed no significant differences for sex, hearing level,and tinnitus frequency（P〉0.05）. 3The contributing factors were evaluated using logistic regression, and included tinnitus loudness [P=0.011, 95% confidence interval（CI）： 1.019-1.151,odds ratio（OR） =1.083], quality of sleep（P=0.011, 95% CI：1.288-6.931,OR=2.986）and duration of tinnitus（P=0.007,95%CI： 1.559-16.265,OR=5.033）. Conclusion Tinnitus in patients with Meniere＇s disease tends to be low in pitch and persistently present, and its severity is related to its loudness,sleep quality and duration of tinnitus.

关 键 词：梅尼埃病 耳鸣 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]