听力正常高调耳鸣患者药物治疗前后畸变产物耳声发射变化分析  

Changes of distortion product otoacoustic emissions in patients with high-profile tinnitus and normal hearing before and after drug treatment

作　　者：陈向红[1] 高永平[1] 李佳[2] 刘素芬[1] 孟峥 田从哲[1] CHEN Xianghong;GAO Yongping;LI Jia;LIU Sufen;MENG Zheng;TIAN Congzhe(Department of Otorhinolaryngology,Hebei University Affiliated Hospital,Baoding 071000,China;Department of Otorhinolaryngology,Baoding Second Hospital,Baoding 071000,China)

机构地区：[1]河北大学附属医院耳鼻咽喉科,河北保定071000 [2]保定市第二医院耳鼻咽喉科,河北保定071000

出　　处：《中国耳鼻咽喉颅底外科杂志》2022年第2期37-42,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：青年科技课题(20190946)。

摘　　要：目的通过对急性耳鸣、亚急性耳鸣和慢性耳鸣3组高调耳鸣患者药物治疗前后畸变产物耳声发射(DPOAE)反应幅值变化及3组不同发病时长高调耳鸣患者药物治疗前后DPOAE反应幅值差值结果的分析,了解药物治疗对高调耳鸣患者DPOAE反应幅值的影响及分析药物疗效与疾病发病时长的关系。方法按发病时长将收治的68例(77耳)听力正常高调耳鸣患者分为3组,急性耳鸣组(病程≤3个月)25例(27耳),亚急性耳鸣组(3﹤病程≤12个月)23例(26耳),慢性耳鸣组(病程>12个月)20例(24耳),对3组患者检测其DPOAE反应幅值。通过药物治疗2周后,再次测量3组患者DPOAE反应幅值,初步评估药物治疗对耳鸣患者DPOAE反应幅值的影响和药物疗效与疾病发病时长的关系。结果3组患者在药物治疗2周后,其在0.5~1 kHz频点DPOAE反应幅值的变化以及DPOAE反应幅值变化差值比较均无统计学意义,但在2~8 kHz频点,除第3组患者在6、8 kHz治疗前后DPOAE反应幅值的变化无统计学意义外,其余每组患者经药物治疗后,DPOAE反应幅值的改变均具有统计学意义(P<0.05),且3组患者治疗前后DPOAE反应幅值的差值比较具有统计学意义(P<0.05)。3组患者在治疗前后DPOAE引出率变化,在0.5~1.5 kHz频点无明显差异;在2~8 kHz频点有明显差异,但第3组患者在6、8 kHz频点除外。3组患者经药物治疗后,第1组患者有效率100%,第2组患者有效率65.38%,第3组患者有效率29.17%。3组间治疗有效率比较差异具有统计学意义(χ^(2)=19.38,P<0.01)。结论高调耳鸣患者给予改善内耳微循环等药物治疗是一种有效的治疗方法,发病时长越短,治疗后DPOAE反应幅值提高越大,且治疗后有效率越高,表明病程越短、疗效越佳,让其早发现、早干预,提高治愈率,以改善患者的生活质量。Objective To understand the influence of drug treatment on the response amplitude of distortion product otoacoustic emissions(DPOAE)in patients with high-profile tinnitus,and to analyze the relationship between therapeutic effect and the duration of the disease via analyzing the changes in the response amplitude of DPOAE before and after drug treatment in patients with high-profile acute tinnitus,subacute tinnitus,and chronic tinnitus.Methods According to the duration of onset,the patients with high-profile tinnitus and normal hearing were divided into three groups:acute tinnitus group[disease duration≤3 months,25 cases(27 ears)],subacute tinnitus group[3 months﹤disease duration≤12 months,23 cases(26 ears)],chronic tinnitus group[disease duration>12 months,20 cases(24 ears)].Before and after drug treatment of two weeks,all the patients underwent DPOAE examination with record of response amplitude.The influence of drug treatment on the response amplitude of DPOAE was preliminarily evaluated and the relationship between therapeutic effect and disease duration was analyzed.Results After drug treatment of two weeks,the DPOAE response amplitude did not changes significantly at the frequencies of 0.5~1 kHz and the differences in the changes of DPOAE response amplitude among three groups were statistically insignificant.However,the changes in DPOAE response amplitude at the frequencies of 2~8 kHz,except for the chronic tinnitus group at 6 and 8kHz,were statistically significant(all P<0.05),and the differences in the changes of DPOAE response amplitude before and after treatment among the three groups were also statistically significant(all P<0.05).The changes in the DPOAE elicitation rate before and after treatment among the three groups were statistically insignificant at the frequencies of 0.5~1.5 kHz,but significant at the frequencies of 2~8 kHz except the chronic tinnitus group at 6 and 8kHz.After drug treatment,the effective rates were 100%in the acute group,65.38%in the subacute group,and 29.17%in the chroni

关 键 词：高调耳鸣 畸变产物耳声发射 耳鸣评价量表 发病时长 疗效 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]