川渝两地耳鸣流行病学调查研究  

Epidemiological investigation of tinnitus in Sichuan and Chongqing

作　　者：代佳秋 庞颖 陈子琦 王思霁 彭斌[2] 许红[2] 余奉徽 朱琳 欧阳曦 向长超 吕萍[3] 何芸 杨东宝 黄秋棠 杨森[7] 余文兴 姜霞 康厚墉[1] Dai Jiaqiu;Pang Ying;Chen Ziqi;Wang Siji;Peng Bin;Xu Hong;Yu Fenghui;Zhu Lin;Ouyang Xi;Xiang Changchao;Lyu Ping;He Yun;Yang Dongbao;Huang Qiutang;Yang Sen;Yu Wenxing;Jiang Xia;Kang Houyong(Department of Otorhinolaryngology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;School of Public Health and Management,Chongqing Medical University,Chongqing 400016,China;Department of Otorhinolaryngology,Affiliated Hospital of North Sichuan Medical College,Sichuan 637000,China;Department of Otorhinolaryngology,Jiangjin Central Hospital,Chongqing 402260,China;Department of Otorhinolaryngology,Fengdu People′s Hospital,Chongqing 408200,China;Department of Otorhinolaryngology,Yunyang People′s Hospital,Chongqing 404500,China;Department of Otorhinolaryngology,Suining Central Hospital,Sichuan 629000,China;Department of Otorhinolaryngology,Ya′an Central Hospital,Sichuan 625000,China)

机构地区：[1]重庆医科大学附属第一医院耳鼻咽喉科,重庆400016 [2]重庆医科大学公共卫生与管理学院,重庆400016 [3]四川省川北医学院附属医院耳鼻喉科,南充637000 [4]重庆市江津区中心医院耳鼻咽喉科,402260 [5]重庆市丰都县人民医院耳鼻咽喉科,408200 [6]重庆市云阳县人民医院耳鼻咽喉科,404500 [7]四川省遂宁市中心医院耳鼻咽喉科,629000 [8]四川省雅安市中心医院耳鼻咽喉科,625000

出　　处：《中华耳鼻咽喉头颈外科杂志》2021年第11期1164-1173,共10页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：重庆市卫生计生委中医药科技项目(ZY201802143);重庆市科学技术委员会面上项目(csts2018jscx-msybX0006);重庆市卫生健康委员会适宜推广技术项目(2018jstg003)。

摘　　要：目的调查川渝两地人群耳鸣患病情况,探讨耳鸣发病的相关危险因素。方法设计统一的《耳鸣流行病学调查问卷》,选择南充、江津、丰都、云阳、遂宁、雅安6个地市区进行多中心合作流行病学调查,采用多阶段分层整群随机抽样方法确定研究对象。经过培训的调查人员以入户调查的方式指导被调查者填写《耳鸣流行病学调查问卷》,了解其耳鸣的相关特征以及可能的危险因素暴露情况。应用SPSS 22.0软件进行相关统计学分析。结果入户调查共收集问卷10289份,有效问卷9273份,其中男性4281人,女性4992人,年龄6~97岁,平均47.3岁。34.83%(3230/9273)的被调查者经历过耳鸣,3.99%(370/9273)诊断为恼人的耳鸣。对经历过耳鸣人群的年龄、性别、睡眠情况、是否接触噪声进行二元Logistic回归分析,发现年龄、是否接触噪声、睡眠情况均影响耳鸣的发生,年龄在30~40岁时患病风险最低,而低于30岁及大于40岁者患病风险均升高,接触噪声与不接触噪声的OR值为1.99,睡眠质量不好相对睡眠质量好的OR值为3.74。对恼人的耳鸣患者选择年龄、性别、是否接触噪声以及睡眠情况进行二元Logistic回归分析,发现年龄、是否接触噪声、睡眠不佳均为耳鸣发展为恼人耳鸣的危险因素,年龄越大,越容易遭受耳鸣的困扰,接触噪声相对不接触者患病相对风险为1.56倍,睡眠质量不好相对睡眠质量好者患病相对风险为4.68倍。结论川渝两地人群中耳鸣患病率较高,约1/3的人经历过耳鸣,但大多数耳鸣短暂存在且响度较低,不会对患者本身造成影响;仅有3.99%的人会出现恼人的持续性耳鸣,且影响患者的身心健康,需要进一步干预。耳鸣的发生以及加重可能与睡眠情况、年龄、噪声接触等因素相关。Objectives To investigate the prevalence and associated risk factors of tinnitus in Sichuan and Chongqing.Methods We designed a tinnitus epidemiological questionnaire.The multi-stage stratified cluster random sampling methods was applied to obtain study subjects in six areas(Nanchong,Jiangjin,Fengdu,Yunyang,Suining and Ya′an),which were selected for epidemiological investigation.Home visit completion of epidemiological questionnaires was conducted.The trained investigators guided the respondents to fill in the tinnitus epidemiological questionnaires,and the epidemiological status of six areas on prevalence and risk factor was investigated.SPSS 22.0 software was used for statistical analysis.Results Sampling population were 10289,in which 9273 were valid questionnaires.There were 4281 males and 4992 females,with an average age of 47.3 years,among which 34.83%(3230/9273)had tinnitus.3.99%(370/9273)were diagnosed with bothersome tinnitus.In a multivariable logistic regression mod,the following factors were associated with onsetting of tinnitus:sleep disorder[Odds Ratio(OR)=3.74]and noise exposure(OR=1.99).The risk of disease was lowest in the age of 30-40 years old,while the risk of disease was higher for people under 30 and over 40.In another multivariable logistic regression mode,the following factors were associated with having bothersome tinnitus:older people were more likely to suffer from tinnitus,sleep disorders(OR=4.68)and noise exposure(OR=1.56).Conclusions The prevalence of tinnitus in Sichuan and Chongqing is about 34.83%,but most of the tinnitus is short-lived and has low loudness,which will not affect the patients.Only a small number of patients with tinnitus(3.99%)persist and affect their health and need treatment.The occurrence and exacerbation of tinnitus may be related to sleep,age,and noise exposure.

关 键 词：耳鸣 流行病学研究 

分 类 号：R181.3[医药卫生—流行病学] R764.45[医药卫生—公共卫生与预防医学]