主观性耳鸣患者合并头痛的相关因素分析  

The Analysis of Factors Associated with Headache in Patients with Subjective Tinnitus

作　　者：宋勇莉 齐柳 陈阳 查定军 Song Yongli;Qi Liu;Chen Yang;Zha Dingjun(Department of Otolaryngology-Head and Neck Surgery,Xijing Hospital,PLA Air Force Military University,Xi’an,710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院,西安710032

出　　处：《听力学及言语疾病杂志》2022年第4期384-388,共5页Journal of Audiology and Speech Pathology

基　　金：西京医院学科助推计划(XJZT18KL60)。

摘　　要：目的分析主观性耳鸣患者合并头痛的特点及其影响因素。方法回顾性分析2019年12月至2020年5月就诊于西京医院耳鼻喉科门诊的361例主观性耳鸣患者的资料,记录所有患者详细的病史和耳鸣评估,包括:性别、年龄、耳鸣起病情况、耳鸣声性质、耳鸣侧别、病程、听力下降、是否伴头痛,其它伴发疾病或症状等,同时填写耳鸣残疾量表(timnitus handicap inventory,THI)、广泛性焦虑障碍量表(generalized anxiety disorder,GAD-7)、抑郁筛查量表(patient health questionnaire,PHQ-9)及匹兹堡睡眠质量指数量表(Pittsburgh sleep scale,PSQI)等量表,所有患者均接受纯音测听及耳鸣心理声学测试;根据是否合并头痛将患者分为头痛组(140例)、无头痛组(221例),并对两组患者间各相关因素进行统计学分析。结果361例主观性耳鸣患者中140例(38.80%,140/361)合并头痛,女性患者合并头痛的比例(61.43%,86/156)显著高于男性(38.57%,54/205)(P<0.01),其中偏头痛62例(44.29%,62/140),紧张性头痛34例(24.29%,34/140),无法分类的头痛44例(31.42%,44/140)。头痛组患者THI评分(48.85±24.68分)显著高于无头痛组(37.55±24.30分),且中度以上耳鸣患者中合并头痛的比例(48.42%)显著高于轻度耳鸣患者(28.07%),头痛组听觉过敏、耳闷、头晕/眩晕、焦虑、抑郁及睡眠障碍发生率高于无头痛组(P<0.05)。结论主观性耳鸣患者常合并头痛,其中以偏头痛和紧张性头痛较为常见,合并头痛的患者耳鸣严重程度更高,更易合并听觉过敏、头晕/眩晕、焦虑、抑郁及睡眠障碍等。Objective To study the characteristics of headache distribution in patients with subjective tinnitus and the associated factors.Methods The data of 361 patients with subjective tinnitus who visited the otolaryngology department of Xijing hospital from December 2019 to May 2020 were retrospectively analyzed.The detailed history and tinnitus evaluation,including patient gender,age,type of tinnitus onset,tinnitus acoustic properties,tinnitus sides,course of diseases,hearing loss,comorbidity of headaches or other diseases were studied.All patients were required to fill THI,GAD-7,PHQ-9 and PSQI scales,and accepted pure tone audiometry and tinnitus psychological acoustics tests.Then the results were analyzed statistically finally.Results A total of 140 in 361 patients(38.80%)had headache,among whom 62 cases were migraine(44.29%),34 cases were tension headaches migraines(24.29%),and 44 cases were unclassified headache(31.42%),according to the ICHD-Ⅲβ.The incidence of headache in females(61.43%)was significantly higher than that in males(38.57%)(P<0.01).The THI score in the headache group(48.85±24.68)was significantly higher than that in the non-headache group(37.55±24.30),and the proportion of headache in the moderate-severe tinnitus(48.42%)was significantly higher than that in mild tinnitus(28.07%).There were statistically significant differences in the proportion of comorbidities such as hyperacusis,aural fullness,dizziness/vertigo,anxiety,depression,and sleep disorder between the two groups(P<0.05%).Conclusion Headache was common comorbidities of subjective tinnitus,among which migraine and tension headache were the most common types.Patients with headache had higher severity of tinnitus,and were more likely to combine with hyperacusis,dizziness/vertigo,anxiety,depression,and sleep disorders.

关 键 词：主观性耳鸣 偏头痛 紧张性头痛 听觉过敏 

分 类 号：R764.45[医药卫生—耳鼻咽喉科]