突发性耳聋耳鸣与特发性耳鸣的临床特征比较  

A Comparative Study on Clinical Characteristics of Tinnitus in Sudden Sensorineural Hearing Loss and Idiopathic Tinnitus

作　　者：王倩滢 雷艳[1] 潘小燕[1] 江黎珠[1] 钟时勋[1] 康厚墉[1] 宗小芳 WANG Qianying;LEI Yan;PAN Xiaoyan;JIANG Lizhu;ZHONG Shixun;KANG Houyong;ZONG Xiaofang(Department of Otolaryngology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,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

出　　处：《中华耳科学杂志》2024年第3期367-371,共5页Chinese Journal of Otology

摘　　要：目的 探讨突发性耳聋(sudden sensorineural hearing loss,SSHL)耳鸣与特发性耳鸣的临床特征,并对临床特征进行相关性分析,为耳鸣临床研究提供依据。方法 回顾性选取2019年1月至2022年1月重庆医科大学附属第一医院耳鼻咽喉科收治的以耳鸣为主诉的患者108例,根据临床症状及听力学检查结果分为A组(单侧SSHL耳鸣)49例,B组(单侧特发性耳鸣)59例。对选取患者进行系统的耳鼻咽喉常规检查、耳鸣检查、听力学检查以及耳鸣残疾量表(tinnitus handicap inventory,THI)评分,比较A组和B组年龄、性别、侧别、耳鸣频率、耳鸣响度视觉模拟量表(visual analogue scale,VAS)评分、残余抑制试验(residual inhibition test,RI)、THI量表评分。分析两组THI量表评分与年龄、性别、患侧、耳鸣频率、耳鸣响度、VAS量表评分的关系。结果 A组耳鸣频率低于B组,耳鸣响度高于B组,差异均有统计学意义(P<0.05)。A组耳鸣响度VAS量表评分、RI阳性率、THI量表评分与B组比较,差异均无统计学意义(P>0.05)。A组THI量表评分与病程、耳鸣频率、耳鸣响度VAS量表评分无相关性(P>0.05),与年龄呈正相关(P<0.05),不同性别、患者的THI量表评分比较,差异无统计学意义(P>0.05)。B组THI量表评分与年龄、病程、耳鸣频率、耳鸣响度无相关性(P>0.05),与耳鸣响度VAS量表评分呈正相关(P<0.05),不同性别、患侧的THI量表评分比较,差异无统计学意义(P>0.05)。结论 SSHL耳鸣与特发性耳鸣在耳鸣频率、耳鸣响度存在差异。SSHL伴耳鸣THI量表评分与年龄呈正相关,特发性耳鸣THI量表评分与耳鸣响度VAS量表评分呈正相关,为临床SSHL耳鸣和特发性耳鸣鉴别诊疗和耳鸣严重程度评估提供一定的支持。Objective Clinical characteristics of concomitant tinnitus in sudden sensorineural hearing loss and idiopathic tinnitus and their correlation were analyzed to advance clinical research of tinnitus.Methods Cases with tinnitus as the initial chief complaint(n=108) seen at the Department of Otolaryngology-Head and Neck Surgery,First Affiliated Hospital of Chongqing Medical University from January 2019 to January 2022,were divided into two groups based on presence of concomitant sudden sensorineural hearing loss(Group A,n=49) or without(Group B,n=59).Routine ENT examination,tinnitus evaluation,audiological tests and tinnitus disability scales were administered.Age,gender,side,pitch,matched and perceived loudness(VAS score) of tinnitus,residual inhibition(RI),and the Tinnitus Disability Inventory(THI) score were compared between the two groups.The relationship between the THI score and age,gender,tinnitus side,pitch,matched loudness and loudness VAS score were analyzed for both groups.Results Pitch of tinnitus in group A was significantly lower than that in group B,greater loudness(P<0.05).Tinnitus loudness VAS score and rate of positive RI in group A were lower than in group B,with higher THI scores in group A,although the differences were not statistically significant(P>0.05).In both groups,the THI score was not correlated with gender,disease duration,side,pitch or loudness of tinnitus(P>0.05).The THI score showed a positive correlation with age(P<0.05) but not loudness VAS score in Group A,and with loudness VAS score(P<0.05) but not age in Group B.Conclusion The pitch and loudness of tinnitus in sudden sensorineural hearing loss appear to be different from those in idiopathic tinnitus.The THI score is positively correlated with age in the former and with the VAS score in the latter.The information may help differential diagnosis and treatment for sudden sensorineural hearing loss and tinnitus,as well as for assessment of tinnitus severity.

关 键 词：突发性耳聋 特发性耳鸣 耳鸣残疾量表 

分 类 号：R764.45[医药卫生—耳鼻咽喉科] R764.437[医药卫生—临床医学]