特发性耳鸣患者心理声学特征的临床价值研究  

Clinical value of psychoacoustic characteristics in patients with idiopathic tinnitus

作　　者：李辉[1,2] 李明[1] 张剑宁[1] LI Hui;LIMing;ZHANG;Jianning(Department of Otolaryngology, Yueyang Hospital of Integrated Chinese and Western Medi- cine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, Chin)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院耳鼻咽喉科,上海200437 [2]湖北省中医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第8期570-575,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市科委科研计划项目(No：14401971400); 上海市申康市级医院新兴前沿技术联合攻关项目(No：SHDC12014125)

摘　　要：目的:分析特发性耳鸣患者心理声学指标与临床严重程度评分的关系,明确心理声学检测在耳鸣严重程度及疗效评估中的价值。方法:收集165例特发性耳鸣患者,均接受常规听力学检测和心理声学测试。心理声学测试包括音调匹配(PM)、响度匹配(LM)、最小掩蔽级测试(MMLs)和残余抑制等。选用耳鸣障碍量表(THI)和耳鸣评价量表(TEQ)进行耳鸣严重程度评估。采用SPSS 18.0对耳鸣心理声学指标与严重程度关系进行单因素分析、多因素Logistic回归分析。所有患者接受耳鸣综合疗法5周,分析治疗5周后患者心理声学指标的变化。结果:(1)单因素分析结果显示:耳鸣声种类和响度匹配感觉级(LMSL)与THI评分存在显著相关性(P<0.05);耳鸣病程、耳鸣音调匹配的音调类型(PM2)和响度匹配听力级(LMHL)与TEQ评分存在显著相关性(P<0.05)。(2)多因素回归分析显示,PM2、LMSL与THI评分存在显著相关性(P<0.05)。单一耳鸣声患者严重程度更轻;随着LMSL值增大,耳鸣患者严重程度逐渐加重。LMHL与TEQ评分存在显著相关性(P<0.05),LMHL值越大,耳鸣严重程度越重。(3)治疗前后LMSL、MMLs、MMLs差值、Feldman曲线类型存在显著差异(P<0.05)。结论:部分耳鸣心理声学指标与耳鸣临床严重程度相关。耳鸣心理声学检测有助于对耳鸣临床严重程度进行辅助评估。Objective：To analyze the relationship between psychological parameters and clinical severity score in patients with idiopathic tinnitus,and clarify the value of psychoacoustic testing in the severity of tinnitus and evaluation of curative effect.Method：A total of 165 patients with idiopathic tinnitus were collected.All patients received conventional audiological and psychoacoustic tests.Psychoacoustic tests include pitch matching（PM）,loudness matching（LM）,minimal masking levels（MMLs）and residual suppression（RI）.Tinnitus handicap inventory（THI）and tinnitus evaluation questionnaire（TEQ）were used to evaluate the severity of tinnitus.SPSS18.0 was used to analyze the relationship between the severity of tinnitus and psychosocial parameters by univariate analysis and multivariate Logistic regression analysis.Changes of patients＇psychological parameters were analyzed after five weeks of tinnitustherapy.Result：（1）Results of univariate analysis showed that there were significant difference with THI score：types of sound and loudness matching sensory level（LMSL）（P0.05）.There were also a significant correlations with TEQ score：the duration of tinnitus,tinnitus pitch matching（PM2）and loudness matching hearing level（LMHL）（P0.05）.（2）Multivariate analysis showed that PM2 and LMSL had significant correlation with THI（P0.05）,while patients with a single sound were less severe：with the increasing of LMSL,the severity of tinnitus was aggravated.There was also a significant correlation between LMHL and TEQ scores（P0.05）,and the greater the LMHL value,the more severe the tinnitus.（3）The statistically significant indicators are：LMSL,MMLs,MMLs difference,Feldman curve（P0.05）.Conclusion：The clinical severity of tinnitus is correlated with some psychological parameters of tinnitus.Tinnitus psychoacoustic tests help to assess the clinical severity of tinnitus.

关 键 词：耳鸣 心理声学测试 耳鸣评估量表 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]