常规纯音测听正常的耳鸣患者临床特征与严重程度影响因素分析  

Analysis of Clinical Characteristics and Influencing Factors of Tinnitus Severity in Patients with Normal Hearing by Conventional Pure-tone Audiometry

作　　者：白雪 林颖 齐柳 宋勇莉 查定军 BAI Xue;LIN Ying;QI Liu;SONG Yongli;ZHA Dingjun(Department of Otolaryngology-Head and Neck Surgery,Xijing hospital,Air Force Medical University,Xian,710032,China)

机构地区：[1]空军军医大学第一附属医院耳鼻咽喉头颈外科,西安710032

出　　处：《中华耳科学杂志》2021年第5期769-773,共5页Chinese Journal of Otology

基　　金：空军军医大学西京医院学科助推项目(XJZT19MDT02、XJZT18ML18);国家自然科学基金(81670924、81870732)。

摘　　要：目的分析常规纯音测听正常的患者耳鸣的临床特征与严重程度的影响因素。方法收集149例听力正常的耳鸣患者基础听力学检查,耳鸣精细化检查,焦虑、抑郁量表,匹兹堡睡眠质量指数量表,耳鸣严重程度评估表。结果①患者中男性63例(42.3%);女性86例(57.7%);②任何环境下持续耳鸣的患者(20.8%)THI评分(55.40±21.76)明显高于安静环境下耳鸣的患者(65.1%)的THI评分(36.43±22.50),且差异具有统计学意义(P<0.05);有睡眠障碍的患者(66.4%)THI评分(48.55±23.16)明显高于无睡眠障碍的患者(33.6%)THI评分(34.21±22.80)(P<0.05);有焦虑情况的患者(21.5%)THI评分(51.36±25.02)明显高于无焦虑情况的患者(78.5%)THI评分(37.23±22.67)(P<0.05);有抑郁情况的患者(29.5%)THI评分(54.71±23.29)明显高于无抑郁情况的患者(70.5%)THI评分(34.43±21.53)(P<0.05);③耳鸣影响因素先采用单因素相关性分析,再采用有序多分类logistic回归,耳鸣严重程度与抑郁[P=0.000,95%可信区间(CI)1.825-8.329,优势比(OR)=3.898],睡眠障碍(P=0.022,95%CI0.964-1.026,OR=2.174)以及耳鸣出现环境(P=0.028,95%CI1.078-3.807,OR=2.026)有关。结论耳鸣严重程度与耳鸣侧别、主频率、病程无关;有焦虑、抑郁与睡眠障碍的患者耳鸣严重程度明显高于无焦虑、抑郁与睡眠障碍的患者。耳鸣严重程度和抑郁、睡眠障碍及耳鸣出现环境显著相关。Objective To report clinical characteristics and factors contributing to tinnitus in patients with normal hearing.Methods Tinnitus patients with normal hearing(n=149)were asked to finish multiple clinical examinations and questionnaires,including tinnitus evaluation,the Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI)and Tinnitus Handicap Inventory(THI-C).Results The 149 patients included 86 females and 63 males,aged 24-35 years(average 29.5 years).The THI-C score showed a significant difference(P<0.05)between patients experiencing tinnitus all times(55.40±21.76)and those hearing tinnitus only in quiet(36.43±22.50).66.44%of the patients reported sleep disorders with their THI-C score(48.55±23.16)higher than that in patients with-out sleep disorders(34.21±22.80)(P<0.05).21.48%of patients had anxiety with their THI-C score(51.36±25.02)high-er than that in patients without(37.23±22.67)(P<0.05).Patients with depression(29.53%)also showed higher THI-C scores(54.71±23.29)than patients without depression(34.43±21.53)(P<0.05).Ordinal logistic regression suggested that the THI-C score was correlated to sleeping disorders(P=0.022,95%CI=0.964-1.026,OR=2.174),depression(P=0.000,95%CI=1.825-8.329,OR=3.898)and whether tinnitus could be perceived all times or only in quiet(P=0.028,95%CI=1.078-3.807,OR=2.026).Conclusion The severity of tinnitus is unrelated to the side of tinnitus,its main pitch or clinical course.Tinnitus is more severe in patients with anxiety/depression and sleep disorders.The severity of tinnitus is also related to if tinnitus is perceived all times.

关 键 词：正常听力 耳鸣 

分 类 号：R764[医药卫生—耳鼻咽喉科]